Desmopressin (DDAVP ) for diabetes insipidus

Desmopressin (DDAVP®)
for diabetes insipidus
How does this medicine work?
Diabetes inspidus (DI) is a decrease in
vasopressin, a hormone made by the
pituitary gland, which controls the making
of urine. Lack of this hormone causes
increased urination and may lead to high
body sodium levels. If DI is not treated,
dehydration and seizures may occur.
Giving DDAVP into the nose
1. Make sure you have the correct
DDAVP solution.
•
If your prescription is for DDVAP
given by a special nasal tube system,
the concentration should be 100mcg
in each 1 ml of medicine.
•
If your prescription is for DDVAP
nose spray, the concentration of the
medicine should be 10 mcg in each
spray.
•
Do not use the more concentrated
nose spray called Stimate®. It has
a different purpose.
DI may be caused by a brain tumor or
injury, but many times the cause is
unknown.
Desmopressin (DDAVP) is a synthetic form
of vasopressin. It works on the kidneys to
help decrease the amount of urine made.
How is the medicine given?
DDAVP can be given by mouth, into the
nose, or into a vein (IV). It may be given in
the hospital, clinic, or home.
Your doctor will explain how much DDAVP
to give and how often to give it. Give the
medicine at regular times to keep a steady
level in the bloodstream.
Giving DDAVP by mouth
2. Read the patient instruction guide for
DDAVP before giving it.
3. If possible, children should blow their
nose to clear out any mucus before
receiving DDAVP. (If your child cannot
do this, bulb-suction mucus out of the
nose.)
Using the tube system
1. If this is the first time you open a bottle,
pull the security seal off of the bottle’s
neck.
For children who cannot swallow pills:
1. Crush the tablet between 2 spoons, inside
a plastic bag, or in folded paper.
2. Mix the powder with a very small
amount of soft food, such as applesauce,
chocolate syrup, ice cream, jelly, or
yogurt.
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2. Remove the plastic cap.
5. Tilt the child’s head back and gently
insert the arrow-marked end of the tube
into the nose.
3. Twist off the small seal from the dropper
and set aside. Do not throw it away.
6. Place the other end of the tube in your
mouth and give a short, strong puff of air
into the tube to give the medicine into
the nose.
7. Tell the child to sniff in (if able) as the
medicine is put into the nose.
4. Measure the exact amount of medicine
into the nasal tube:
•
Hold the arrow-marked part of the tube
in one hand and the end of the dropper
bottle in the other hand.
•
Insert the tip of the dropper into the end
of the tube and hold the tube lower than
the dropper tip.
•
Squeeze the dropper steadily until the
medicine reaches the dose mark. Do not
start and stop the squeezing, to prevent
air bubbles.
8. Older children can be taught to blow
their own medicine into their nose.
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9. Put the small seal back on the dropper
tip to prevent leaking. Put the plastic
cap on the bottle.
Are there any precautions for my
child’s diet?
The doctor or nurse will give you specific
instructions if fluids need to be restricted.
There are no restrictions for solid foods.
What should I do if a dose is
missed?
If the usual dose is once a day, give the
missed dose as soon as possible. Then go
back to your normal dosing schedule. If you
do not remember until the next day, skip the
missed dose and go back to your regular
dosing schedule. Do not give two doses in
the same day unless instructed.
10. Wash the tube with water and shake
well, until no more water is left. If the
markings become faint, darken them
with a permanent marker.
Using the nose spray
1. Before using the medicine the first time,
prime it by spraying into the air 4 times.
If it has not been used for a week or
more, prime it again by spraying once.
2. Give the prescribed number of sprays.
If the usual dose is more than once a day,
give the missed dose as soon as possible.
However, if it is almost time for your next
dose, skip the missed dose and go back to
your regular dosing schedule. Never give a
double dose.
If you have any questions on how to make
up a missed dose, please call the doctor.
What are the side effects?
Common
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fluid retention
redness and warmth in face
Occasional
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runny or stuffy nose
headache
nausea (upset stomach)
dizziness
increased heart rate
pain, redness, or swelling at
the IV site (if given IV)
Rare
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slight increase or decrease in
blood pressure
blood clots in undesired
areas
seizure
3. Tell the child to sniff in (if able) as the
medicine is sprayed into the nose.
4. Rinse the spray tip with hot water and
dry with a clean cloth or tissue.
Other instructions:
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When should I call the doctor?
•
headaches or other pain not relieved by
acetaminophen (such as Tylenol )
irritation or bleeding in the nose (if using
the nose solution)
faster heart rate
rapid weight gain
dizziness
vision problems
confusion
seizures
signs of an allergic reaction:
- fever or chills
- rash or hives
- wheezing
- trouble breathing- call 911
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What else do I need to know?
DDAVP should not be used by any patient
who has heart problems or who has ever had
a blood clot.
If you are using the spray, check the bottle
for the number of sprays it contains. After
that number of sprays, throw the bottle away
(even if there is still some liquid in the
bottle). The patient instruction sheet that
comes with it tells you how to keep track of
the number of sprays.
Always make sure you have enough
medicine on hand. Each time you refill your
prescription, check to see how many refills
are left. If no refills are left, the pharmacist
will need 2 or 3 days to contact the doctor to
renew the prescription.
Before giving the first dose, read the label.
Be sure it is what was prescribed. After a
refill, if the medicine looks different to you,
ask your pharmacist about it before giving it.
Check the label for the expiration date.
Flush outdated medicines down the toilet
instead of putting them in the garbage.
It is best to store this medicine in the
refrigerator, as far from children’s reach as
possible. Do not let it freeze. Closed bottles
are good for up to 3 weeks at room
temperature (68º to 77º F or 20º to 25º C).
If too much or the wrong kind of medicine is
taken, call the doctor right away.
Questions?
This sheet is not specific to your child but
provides general information. If you have
any questions, please call the doctor or
pharmacist.
For more reading material about this and
other health topics, please call or visit the
Family Resource Center library, or visit our
Web site: www.childrensmn.org.
Children’s Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
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