18.104.22.168 Diabetes insipidus
|1st choice||Desmopressin nasal spray 10micrograms/metered spray; intranasal solution 100micrograms/mL||Dose: Intranasally, diabetes insipidus, treatment, 10-40micrograms daily in 1-2 divided doses|
|2nd choice||Desmopressin tablets 100micrograms, 200micrograms|
|Desmopressin sublingual tablets 60 micrograms, 120 micrograms, 240 micrograms||Dose:|
diabetes insipidus, initially 180 micrograms daily in 3 divided doses; range 120-720 micrograms daily
- 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.