Alternate Name(s):
DDAVP, OCTOSTIM
Classification:
Antidiuretic hormone analogue
Original Date:
August 2005
Revised Date:
October 2024
Indications:
- Maintenance of hemostasis in patients with hemophilia A during and after surgical procedures
- May be used for patients with mild - moderate type 1 von Willebrand disease
- Antidiuretic hormone replacement therapy for central diabetes insipidus
- Adjunctive management of active hemorrhage in person with hemophilia A or von Willebrand disease
Reconstitution and Stability:
- Available as 4 mcg/mL and 15 mcg/mL solution
- Refrigerate, DO NOT freeze
- Protect from light
- Diluted solutions in NS or D5W are stable for 24 hours at room temperature
Compatibility:
- Solutions Compatible: D5W, 0.9% NaCl
- Additives/Above Cassette Compatible: no information
- Y-site Compatible: no information
- Incompatible: no information
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | YES, preferred for diabetes insipidus -slowly over 10 - 20 seconds |
| IM | YES, preferred for diabetes insipidus |
| IV Direct | YES, diabetes insipidus only. Critical care areas only |
| IV Intermittent Infusion | YES Usual dilution: 0.1 microgram/mL Infusion time: 15-30 minutes |
| IV Continuous Infusion |
YES |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Diabetes Insipidus:
- < 12 years: No definitive dosing available. Some studies have used 0.1 to 1 mcg IV/SC in 1 or 2 divided doses. Initiate at low dose and increase as necessary
- > = 12 years and adult: 2-4 mcg/day IV/SC divided BID or 1/10 of the maintenance intranasal dose
Hemophilia A, von Willebrand's disease Type I (pre-procedural or active bleeding):
- 0.3 mcg/kg (Maximum: 20 mcg/dose)
Potential hazards of parenteral administration:
- Facial flushing, headache, abdominal cramps
- Hypertension or hypotension, tachycardia, palpitations
- ** Decreased urine output for 6-8 hours, hyponatremia (CAUTION: water intoxication may occur - regulate fluid intake carefully; monitor serum sodium, urine output and osmolarity)
- Vein irritation (local burning or pain)
Notes:
- Contraindicated in patients with severe hemophilia A with factor VIII antibodies, hemophilia B, severe Type I von Willebrand, Type II B von Willebrand, or platelet-type (pseudo) von Willebrand disease
- Use with caution in patients with predisposition to thrombus formation, conditions associated with fluid and electrolyte imbalance and in patients with coronary artery disease and/or hypertensive cardiovascular disease
- Desmopressin can increase fibrinolysis, due to plasminogen activator release; concurrent use of aminocaproic acid or tranexamic acid is recommended for patients with clotting disorders
- For patients stabilized on intranasal therapy, the parenteral/subcutaneous dose is approximately 1/10 of the intranasal dose
- Dosage equivalency when changing routes of administration: 1 mcg IV/SC/IM = 10 mcg intranasal = 100-200 mcg oral
- Peak effect on blood clotting occurs within 1 hour of IV dose