Desmopressin Nasal Spray Safety and Usage
Indications and Safety Considerations
- The American Urological Association recommends that oral formulations of desmopressin are preferred over nasal spray for most indications, as the nasal spray has been associated with higher risk of water intoxication, hyponatremia, and convulsions, leading to removal of the enuresis indication for nasal spray in many countries 1, 2
- Desmopressin can also be used for nosebleeds in patients taking platelet-inhibiting drugs or with von Willebrand disease 3
Dosage and Administration
- The American Urological Association recommends that fluid restriction should be observed to prevent water intoxication, and evening fluid intake should be limited to 200 mL (6 ounces) or less, with no drinking until morning 1, 2
- Polydipsia is a contraindication to desmopressin treatment, as recommended by the American Urological Association 1, 2
Alternative Formulations
- The American Urological Association recommends oral tablets (0.2-0.4 mg) or oral melt tablets (120-240 mcg) as preferred alternatives to nasal spray, with oral tablets taken at least 1 hour before sleep and oral melt tablets taken 30-60 minutes before bedtime 1, 2