desmopressin iv to po conversion

Vincristine Liposomal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Saint-Prex, Switzerland - 21 June, 2022 - Minirin (desmopressin) Nasal Spray 0.1 mg/ml room temperature stable (RTS)/ Octostim (desmopressin) Nasal Spray 1.5 mg/ml/ DDAVP (desmopressin acetate, 10 mcg/0.1 mL)/ Stimate (desmopressin acetate, 1.5 mg/1 mL) Nasal Spray/ Generic Desmopressin Acetate (10 mcg/0.1mL) Nasal Spray - Recall and Production Hold Statement You may require 10 to 20 times a greater dose of desmopressin with the tablet oral formulations than with the nasal formulations. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of . As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. 27.7 mcg sublingually once daily, 1 hour before bedtime without water. A woman who took both desmopressin and ibuprofen was found in a comatose state. All Rights Reserved. Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. Medically reviewed by Drugs.com. Withdraw the necessary volume of DDAVP Injection from the vial and dilute by adding to the infusion bag of 0.9% Sodium Chloride Injection, USP per Table 1. Nclex ATI Live Review - pearsonvue/NCLEX On day of exam - Bring a valid As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. A woman who took both desmopressin and ibuprofen was found in a comatose state. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. More than 50 kg: 150 mcg in each nostril. Urine, for measurements of volume and osmolality, was collected in predetermined intervals before and until 12 h after dosing. The recommended starting dose is 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. The pharmacokinetic profile of desmopressin is biexponential. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. 150 mcg into each nostril once for a total dose of 300 mcg. Persons with vWD subtype 1C, which is characterized by a shorted vWF half-life, may require alternative management in the setting of surgery. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia, which may include monitoring serum sodium or electrolytes periodically. Commonly central DI is treated with desmopressin. HOW SUPPLIED Desmopressin Acetate Injection 4 mcg/mL is available as a clear colorless sterile solution as follows: Ampul - 4 mcg/mL - 1 mL - 10 per Box. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Hydrocortisone (systemic): Drug information - UpToDate Fatal anaphylaxis has been reported with intravenous desmopressin. Codeine; Phenylephrine; Promethazine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. In this study, efficacy and side effects of oral desmopressin. 2020 Aug;22(4):369-383. doi: 10.1007/s40272-020-00401-7. DDAVP (Desmopressin Acetate Tablets): Uses, Dosage, Side - RxList A woman who took both desmopressin and ibuprofen was found in a comatose state. Benazepril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Store refrigerated 2 to 8C (36 to 46F). Baseline renal function should be assessed. Desmopressin is also used to control bed-wetting. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis due to the risk for developing severe hyponatremia that can result in seizures and death. 1183.34 100 unit / 100 ml (1 unit/ml). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Nonsteroidal antiinflammatory drugs: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. government site. 1997;183:53-4. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Wirtz MR, Roelofs JJ, Goslings JC, Juffermans NP. In patients receiving desmopressin nasal spray for nocturia, discontinue treatment in patients with concurrent nasal conditions that may increase systemic absorption of desmopressin (e.g., atrophy of nasal mucosa, and acute or chronic rhinitis), because the increased absorption may increase the risk of hyponatremia. desmopressin: Dosing, contraindications, side effects, and pill Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Keep this seal as it is reversed to prevent leakage from the dropper.Squeeze the correct dose into this tube from the dropper bottle. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10 th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses Hemophilia A and von Willebrand's Disease (Type I): Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. Ketoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. desmopressin iv to po conversion - finbi.no Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin is in a class of medications called hormones. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 1 to 2 mcg IV twice a day or Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. The distribution of the drug is unknown, and it is not clear whether desmopressin crosses the placenta. Carbinoxamine; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. After at least 7 days of treatment, the dose may be increased to 1.66 mcg, if needed, provided the serum sodium is within the normal range during treatment with the 0.83 mcg dose. Monoamine oxidase inhibitors: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia and SIADH including monoamine oxidase inhibitors (MAOIs). MeSH 1 0 obj Monitor blood pressure during desmopressin administration, particularly in persons with coronary artery disease (insufficiency) and/or hypertension; desmopressin may cause hypotension (with compensatory increase in heart rate) or hypertension. PMC PDF Converting oral to intravenous or subcutaneous infusions - APPM . Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin Intranasal (Noctiva, low dose) Each spray delivers 0.83 to 1.66 mcg Marketed for Nocturia in adults (but other non-medication approaches are preferred) Expensive: $425/month in 2018 Desmopressin Oral Initial: 0.2 mg PO qhs Use lowest effective dose Increase as needed to 0.6 mg at bedtime VII. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 40 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. Disclaimer. A woman who took both desmopressin and ibuprofen was found in a comatose state. doi: 10.31744/einstein_journal/2023RC0124. The initial response is reproducible if DDAVP is administered every 2 to 3 days. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Demonstration of an adequate improvement in coagulation profile after administration is recommended prior to any surgical procedures. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. eCollection 2022. SEQUENTIAL THERAPY : Refers to the act of replacing a parenteral version of a medication with its oral counterpart. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. common IV -> PO conversions & some dosing Flashcards | Quizlet Caution should be used when coadministering these agents. The administration of carbamazepine prior to administration of desmopressin may act to reduce the duration of action of desmopressin. 2 mg PO - 15 mg IV. These highlights do not include all the information needed to use DDAVP Some studies have used 0.1 to 1 mcg IV/SC in 1 or 2 divided doses. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The time to reach maximum plasma desmopressin levels is 0.9 hours. After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. DDAVP Injection (Desmopressin Acetate Injection): Uses, Dosage - RxList There are several recommended conversions ranging from 50 to 80% of the oral dose but the American Association of Clinical Endocrinologists/American Thyroid Association guidelines recommend an intravenous dose 50-70% of the patient's oral dose. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 55.3mcg of desmopressin acetate (equivalent to 50 mcg of desmopressin) Diabetes Insipidus Intranasal (DDAVP) Indicated as antidiuretic replacement therapy in the management of central cranial. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. Brompheniramine; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. May repeat dose if needed. Desmopressin nasal spray can be resumed when these conditions resolve. The risk of toxic reactions (including water intoxication and low sodium concentrations) appears to be greater in the geriatric patient and other patients with impaired renal function. If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. Medically reviewed by Drugs.com. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Desmopressin - FPnotebook.com Permanently discontinue for serious hypersensitivity reaction. PLEASE READ THE. National Library of Medicine The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. Chlorpromazine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including chlorpromazine. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. Initially, 0.05 mg PO once daily. PDF Intravenous to Oral Therapy Conversion - FormWeb Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Initiate at low dose and increase as necessary. Treatment longer than 4 to 8 weeks has not been studied. endobj A woman who took both desmopressin and ibuprofen was found in a comatose state. Ensure the serum sodium concentration is within normal limits prior to starting or resuming desmopressin therapy. This medication helps to control increased thirst and too much urination due to these conditions . Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 Meclofenamate Sodium: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Last updated on Sep 28, 2022. DDAVP/Desmopressin Injection - Summary of Product Characteristics (SmPC In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. DDAVP Injection (desmopressin acetate) dose, indications, adverse - PDR Following oral administration, the bioavailability of desmopressin is about 5% and 0.16% compared to intranasal and intravenous administration, respectively. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. -, BJU Int. Dopamine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like dopamine only with careful patient monitoring. anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known.