Choice | Drug | Dosage |
---|---|---|
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 | Dose: |
Or | ||
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 |
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.