Dr. med. Dirk Manski



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Desmopressin

Mechanism of Action

Desmopressin, an analogue of vasopressin (ADH), reduces the nocturnal urine output and therefore the frequency of enuresis. Desmopressin does not have an influence on the smooth muscles tonus or blood pressure (such as vasopressin).

Urological Indications

Pharmacokinetics of Desmopressin

Side Effects of Desmopressin

Contraindications of Desmopressin

Pharmacological Interactions of Desmopressin

Do not prescribe desmopressin together with drugs that stimulate ADH secretion, cause water retention or with an increased risk of hyponatremia: antidepressants, selective serotonin reuptake inhibitors, chlorpromazine, carbamazepine or NSAIDs. When given orally, the treatment with loperamide triples the desmopressin concentration.

Dosage of Desmopressin

Treatment of Enuresis

First trial with desmopressin is done with 200 micrograms p.o. 0-0-1 for 2 weeks. Only if the treatment effect is insufficient, the dosage is increased to 400 micrograms p.o. 0-0-1 for 2 weeks. If the treatment is successful, the treatment with desmopressin is continued. It is important to observe the drinking rules to avoid the above mentioned side effects of desmopressin.

Treatment of Diabetes Insipidus

The initial dosage of desmopressin is 100 micrograms three times daily in adults and children. The dosage is increased depending on the clinical effects (diuresis, body weight, sodium concentration...), the maintenance dosage ranges usually between 300 and 600 micrograms per day.







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References

Schultz-Lampel und Thüroff 2000 SCHULTZ-LAMPEL, D. ; THÜROFF, J. W.:
Enuresis und kindliche Harninkontinenz.
In: THÜROFF, JW (Hrsg.) ; SCHULTE-WISSERMANN, H (Hrsg.): Kinderurologie in Klinik und Praxis.
Stuttgart New York : Thieme, 2000, S. 265–275


  Deutsche Version: Desmopressin