Desmopressin (injection Route)

When used as an injection, Desmopressin is most commonly used to treat bleeding disorders such as hemophilia A or von Willebrand disease (Type I) or as a method to control the frequent urination and increased thirst caused by certain types of brain damage.

Overview:

Desmopressin is a versatile drug that can be used as an antidiuretic treatment for a variety of disorders. When used as an injection it is a very effective treatment for bleeding conditions such as hemophilia A and von Willebrand disease. When used in this fashion, Desmopressin works by increasing the blood levels of von Willebrand factor and factor VIII. The end result is less bleeding by the patients who have low levels of these factors. It also has treatment applications when used to treat central cranial diabetes insipidus. It is often used by physicians as an aid to control frequent or uncontrolled urination and increased thirst experienced by patients who have had certain types of brain injuries and brain surgeries. The drug functions in this area as a hormone that is produced by the body which acts on the kidneys to reduce the flow of urine.

This injection is useful to patients suffering from these diseases but there are certain factors that need to be taken into consideration before this treatment is prescribed. Desmopressin should not be used if a patient has kidney disease or has ever experienced the chronic low sodium levels associated with hyponatremia. Other conditions that may disqualify this drug as a treatment include electrolyte imbalance, dehydration, heart conditions or high blood pressure, and SIADH. If used inappropriately or excessively this drug can cause a life-threatening condition.

Conditions treated:

  • Hemophilia A
  • Von Willebrand disease
  • Central cranial diabetes insipidus
  • Incontinance

Type of medicine:

  • Antidiuretic

Side Effects:

Desmopressin may have some unwanted side effects that come with its intended results, and although these symptoms may not necessarily occur, both patient and doctor should be aware of the potential for them. If these serious side effects occur they may require medical attention. If a patient experiences any of the following side effects they should immediately report them to their medical professional.

Rarely, those who use Desmopressin injections experience neurological side effects such as confusion, headaches, dizziness, or convulsions. Other rare but serious side effects include those associated with the urinary tract including decreased urine output. This can be accompanied by increased thirst, nausea, or vomiting. Some patients have reported severe coughing and difficulty swallowing. A tightness in the chest and a fast or irregular heartbeat have also been experienced. A rare condition associated with Desmopressin can make the patient feel very weak and tired while using the drug. A rare allergic reaction to the medication can result in several symptoms including muscle pain/cramps, puffiness/swelling of the facial/mouth area, skin rash, hives, itching, and swelling of the ankles or hands.

In addition to the rare but serious side effects, there are certain documented affects whose incidence is not known. In such cases, patients may experience sweating, chest pain, numbness of the hands, and pain in different areas of the body such as the neck, back, arms, or jaw.

Not all side effects will necessarily be serious enough to seek out medical attention. These routine side effects are usually caused by the body adjusting to the medication. When this period of adjustment has elapsed the symptoms will usually subside. If they don't or if they are unusually intense a doctor should be informed as this could indicate a more serious medical condition.

Some of the less common of these routine side effects includes a redness or swelling at the injection site along with a burning sensation of the skin. This can also include pain in the vagina or stomach cramps. Rarely, patients will experience temporary redness and warmness in the facial area when first using Desmopressin. While this is not an all-inclusive list of possible side effects they are the ones that are most notable. If any symptoms occur that are not on this list consult your physician for possible causes and remedies.

Dosage:

Usually, Desmopressin will be administered by a trained healthcare professional such as a nurse. It is given as an injection into a vein. If the patient does not need to be hospitalized for their condition the injection may be given at home. If authorized to self-administer this injection, make sure that the person giving the injection has been taught and prepared to administer the injection properly. This medication can be harmful to the skin if continuously injected into the same body area, so different areas of the body should be used each time an injection is given. The easiest way to keep track of this is to keep a chart that tracks this rotation of body parts. A new needle and new syringe should be used each time Desmopressin is injected.

The dose the patient receives will vary depending on a number of factors including age, general health, and severity of the condition treated by Desmopressin. All instructions on the prescription should be followed, and if the prescription dose varies from that recommended by the manufacturer the doctor's orders should take precedence.

When used as an injected solution for the treatment of diabetes insipidus, the dosage will consist of 1/2mL to 1mL divided into 2 injections in the morning and evening. This dosage may be an initial dose and may be increased by your doctor depending on the severity of the condition. For children under the age of 12 years old the dosage must be determined by a pediatric specialist.

If a dose of Desmopressin is missed it should only be injected if there are more than 8 hours remaining until the next injection. If the next injection time is closer, skip to the next dose. Do not double doses as this can cause a dangerous condition.

Interactions:

Certain medications are known to have a poor reaction when used with Desmopressin. Many should not be used with it at all, but if they must be used together precautions should be taken by the physician such as changing dosages of one or both medications. Your doctor should be fully appraised of everything that is being taken at the same time as Desmopressin including prescription medication, over the counter medication, vitamins, supplements, and herbal remedies.

Other interactions are also possible when using Desmopressin. Doctors may restrict the amount of fluid that you drink while taking it as this can lead to a potentially dangerous electrolyte imbalance. Alcohol and other diuretics such as caffeine may exacerbate this condition. If you have any doubt about limiting a beverage while using Desmopressin consult with your doctor for further guidance.

There are certain medical problems that may affect how Desmopressin works or affects a patient. In other cases, the drug can make these conditions worse. If there is a history of any of the following health problems or if the patient is currently suffering from any of them the prescribing doctor should be told before making a decision regarding whether to continue a Desmopressin regimen.

  • Blood clotting problems
  • Hypertension
  • Hypotension
  • Tachycardia
  • Coronary artery disease
  • Cystic fibrosis
  • Heart failure
  • Kidney problems
  • Polydipsia
  • Hyponatremia
  • Kidney disease
  • Type IIB von Willebrand disease

Warnings:

The decision to use Desmopressin should be an informed one, and both patients and doctors need to weigh certain risk factors before making this decision. There is a chance that the use of this medication can trigger a rare allergic reaction. Ensure that the doctor is fully appraised of any existing allergies or those that have been experienced in the past. These can include allergies to medicines, food, plants, animals, or any number of substances. Desmopressin has been known to rarely cause a severe allergic reaction called anaphylaxis. Anaphylaxis is a very serious and life-threatening condition that requires emergency medical attention. Signs that it is occurring include a rash, itching, trouble breathing, difficulty swallowing, and swelling of several areas of the body including the hands, face, and mouth. If a patient using Desmopressin experiences any of these symptoms emergency medical aid needs to be called immediately.

There have not been appropriate studies performed on this medication to demonstrate specific effects on children or the elderly, but there are certain precautions that should be taken in both cases. Children younger than 12 should only be prescribed this medication with great caution as the safety and efficacy of desmopressin is unproven. Elderly patients are more likely to have specific problems related to age such as kidney problems that may make the use of Desmopressin potentially harmful. These concerns may lead a prescribing doctor to adjust the dosage or to put additional precautionary measures in place when using this injection.

Desmopressin is a very potent medication and should be taken only as prescribed. Communication between doctor and patient is crucial while taking this medication. Regular examinations including blood and urine tests are necessary when taking this drug for an extended period of time to determine if it is working properly or to discover any unwanted side effects. Based on the results of these tests a doctor may decide to discontinue the medication, but do not stop taking the injections without direction by a physician.

One of the effects of Desmopressin is a significant lowering of the amount of sodium in the bloodstream. If these levels get too low this can threaten the patient's health. A doctor should be informed immediately if the injections make the patient feel unusually weak or if they become confused, nauseous, experience muscle cramps, vomit, or have uncontrollable muscle movements like spasms.

Storage:

In general, this medication will be stored by medical professionals in a hospital or clinic, but if approved for home use care should be taken not to refrigerate or freeze this medication. It is best to keep this medication in a secure location out of the reach of children, along with any sharps that are used for the injections. Disposal of this medication and used needles/syringes needs to be undertaken with care. Dispose of any unused or expired medication in a timely fashion.

Your doctor should provide you with guidelines for this disposal that is in accordance with laws regarding the disposal of medical waste in your area. Any used needles should immediately be deposited into a hard-sided closed container that is intended for the purpose of holding sharps for disposal. This container should be secured away from the reach of children or pets.

Summary:

Desmopressin is a versatile medication with many uses for various conditions. It is a man-made form of a naturally occurring hormone that is distributed through the pituitary gland. The hormone is associated with essential body functions such as kidney function, blood flow, and the regulation of water in the body. When used to treat bleeding disorders it can be a life-saving injection, as such episodes in patients with hemophilia A or von Willebrand's disease can be fatal. It is also a helpful treatment for central cranial diabetes insipidus, providing relief for its most serious symptoms. While there are some allergic reactions and side effects that should be taken into consideration when deciding whether or not to use Desmopressin, it is important to note that most of them are uncommon or rarely experienced.