Desmopressin (Sublingual route)

Pronunciation:

des-moe-PRES-in

Brand Names:

  • Nocdurna

Dosage Forms:

  • Tablet

Warnings:

Sublingual route(Tablet)

Warning: HyponatremiaDesmopressin acetate can cause hyponatremia. Severe hyponatremia can be life-threatening, leading to seizures, coma, respiratory arrest, or death.Desmopressin acetate is contraindicated in patients at increased risk of severe hyponatremia, such as patients with excessive fluid intake, illnesses that can cause fluid or electrolyte imbalances, and in those using loop diuretics or systemic or inhaled glucocorticoids.Ensure the serum sodium concentration is normal before starting or resuming desmopressin acetate. Measure serum sodium within 7 days and approximately 1 month after initiating therapy, and periodically during treatment. More frequently monitor serum sodium in patients 65 years of age and older and in patients at increased risk of hyponatremia.If hyponatremia occurs, desmopressin acetate may need to be temporarily or permanently discontinued .

Classifications:

Therapeutic—

Endocrine-Metabolic Agent

Pharmacologic—

Vasopressin (class)

Uses of This Medicine:

Desmopressin is used to treat patients who awaken 2 or more times at night to urinate caused by nocturnal polyuria, a condition wherein your body makes too much urine at night. Your doctor may tell you to collect and measure your urine and the times that you urinate for 24 hours to determine if you have nocturnal polyuria.

Desmopressin is similar to a hormone that is produced in the body. It acts on the kidneys to reduce the flow of urine.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of desmopressin in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of desmopressin in the elderly. However, elderly patients are more likely to have hyponatremia (low sodium in the blood), which may require caution and an adjustment in the dose for patients receiving desmopressin.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Acetohexamide
  • Alfentanil
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Amtolmetin Guacil
  • Anileridine
  • Aspirin
  • Bendroflumethiazide
  • Benzhydrocodone
  • Benzthiazide
  • Bromfenac
  • Bufexamac
  • Buprenorphine
  • Butorphanol
  • Carbamazepine
  • Celecoxib
  • Chlorothiazide
  • Chlorpromazine
  • Chlorpropamide
  • Chlorthalidone
  • Choline Salicylate
  • Citalopram
  • Clomipramine
  • Clonixin
  • Clopamide
  • Codeine
  • Desipramine
  • Dexibuprofen
  • Dexketoprofen
  • Dezocine
  • Diacetylmorphine
  • Diazoxide
  • Dibenzepin
  • Diclofenac
  • Difenoxin
  • Diflunisal
  • Dihydrocodeine
  • Diphenoxylate
  • Dipyrone
  • Doxepin
  • Droxicam
  • Escitalopram
  • Ethylmorphine
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fentanyl
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Hydrochlorothiazide
  • Hydrocodone
  • Hydroflumethiazide
  • Hydromorphone
  • Ibuprofen
  • Imipramine
  • Indapamide
  • Indomethacin
  • Ketobemidone
  • Ketoprofen
  • Ketorolac
  • Lamotrigine
  • Levorphanol
  • Lofepramine
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Melitracen
  • Meloxicam
  • Meperidine
  • Meptazinol
  • Methadone
  • Methyclothiazide
  • Metolazone
  • Morniflumate
  • Morphine
  • Morphine Sulfate Liposome
  • Nabumetone
  • Nalbuphine
  • Naproxen
  • Nepafenac
  • Nicomorphine
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nortriptyline
  • Opipramol
  • Opium
  • Opium Alkaloids
  • Oxaprozin
  • Oxycodone
  • Oxymorphone
  • Oxyphenbutazone
  • Papaveretum
  • Parecoxib
  • Paregoric
  • Paroxetine
  • Pentazocine
  • Phenylbutazone
  • Piketoprofen
  • Piritramide
  • Piroxicam
  • Polythiazide
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Protriptyline
  • Remifentanil
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sertraline
  • Sodium Salicylate
  • Sufentanil
  • Sulindac
  • Tapentadol
  • Tenoxicam
  • Tianeptine
  • Tiaprofenic Acid
  • Tilidine
  • Tolazamide
  • Tolbutamide
  • Tolfenamic Acid
  • Tolmetin
  • Tolvaptan
  • Tramadol
  • Trichlormethiazide
  • Trimipramine
  • Valdecoxib
  • Vilazodone
  • Vortioxetine
  • Xipamide

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Gastroenteritis (inflammation of the stomach or bowels) or
  • Heart failure or
  • Hypertension (high blood pressure), uncontrolled or
  • Hyponatremia (low sodium in the blood), or history of or
  • Infection (systemic) or
  • Kidney disease, moderate to severe or
  • Polydipsia (excessive thirst) or
  • Salt-wasting nephropathies (kidney disease) or
  • Syndrome of inappropriate antidiuretic hormone (SIADH), known or suspected—Should not be used in patients with these conditions.
  • Increased pressure in the head or
  • Urinary retention, history of—Use is not recommended in patients with these conditions. May increase risk of fluid retention (body swelling).

Proper Use of This Medicine:

Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

This medicine comes with Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Limit the amount of fluids you drink from 1 hour before using this medicine and until 8 hours after. Also avoid drinks containing caffeine or alcohol before bedtime.

Keep the tablet under your tongue until it has fully dissolved. Do not use this medicine with water.

Your doctor may instruct you to empty your bladder before bedtime.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of nocturnal polyuria:
      • Adults:
        • Men—55.3 micrograms (mcg) under the tongue once a day, 1 hour before bedtime.
        • Women—27.7 mcg under the tongue once a day, 1 hour before bedtime.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it 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. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine together with certain diuretics (eg, furosemide, torsemide, Demadex®, Lasix®) or systemic or inhaled glucocorticoids (eg, dexamethasone, fluticasone, methylprednisolone, prednisolone, prednisone, Cortef®, Medrol®).

This medicine lowers the amount of sodium in your blood. Check with your doctor right away if you have confusion, nausea, vomiting, muscle cramps or spasms, or unusual tiredness or weakness.

Check with your doctor right away if you have an infection with fever and severe vomiting or diarrhea. Your doctor may limit the amount of fluid or water you drink. If you drink too much water during hot weather, after strenuous exercise, or after severe vomiting or diarrhea, this medicine may cause serious unwanted effects.

This medicine may cause fluid retention (body swelling). Check with your doctor right away if you have decrease in the amount of urine, noisy, rattling breathing, swelling of the fingers, hands, feet, or lower legs, troubled breathing at rest, or weight gain.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
Confusion
decreased urine output
dizziness
fast or irregular heartbeat
headache
increased thirst
loss of consciousness
muscle pain or cramps
nausea
seizures
swelling of the face, ankles, or hands
unusual tiredness or weakness
vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Dry mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 6/18/2019

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
All rights reserved.

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