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Home Formulary 6.0 Endocrine 6.5 Pituitary hormones and anti-oestrogens 6.5.2 Posterior pituitary hormones and antagonists 6.5.2.1 Diabetes insipidus

6.5.2.1 Diabetes insipidus

ChoiceDrugDosage
1st choiceDesmopressin nasal spray 10micrograms/metered spray

Dose: See BNF

2nd choiceDesmopressin tablets 100micrograms, 200micrograms

Dose:
See BNF

Or
Desmopressin sublingual tablets 60 micrograms, 120 micrograms, 240 microgramsDose:
See BNF

Prescribing Notes

  • A single dose of desmopressin is also used as part of a test following fluid deprivation in the differential diagnosis of thirst and polyuria.
  • For nephrogenic diabetes insipidus, the usual treatment is a thiazide diuretic. Caution if due to lithium – refer to endocrinologist.
  • Desmopressin injection (4 micrograms/mL) may be indicated in unconscious patients (dose 1-4 micrograms daily by subcutaneous, intramuscular or intravenous injection).
  • Measurement of plasma sodium should be undertaken to guard against excessive water intake which would be reflected by a low plasma sodium. The frequency of monitoring should be individualised and more frequent monitoring will be required during the stabilisation phase.

 

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