Desmopressin

Desmopressin is used to control the symptoms of a certain type of diabetes insipidus ('water diabetes'; condition in which the body produces an abnormally large amount of urine). Desmopressin is also used to control excessive thirst and the passage of an abnormally large amount of urine that may occur after a head injury or after certain types of surgery. Desmopressin is also used to control bed-wetting. Desmopressin is in a class of medications called hormones. It works by replacing vasopressin, a hormone that is normally produced in the body to help balance the amount of water and salt.

Desmopressin comes as a tablet to take by mouth. It is usually taken two to three times a day. When desmopressin is used to treat bed-wetting, it is usually taken once a day at bedtime. Try to take desmopressin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take desmopressin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of desmopressin and gradually increase your dose. Follow these directions carefully.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking desmopressin,

• tell your doctor and pharmacist if you are allergic to desmopressin, any other medications, or any of the ingredients in desmopressin tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); carbamazepine (Tegretol); chlorpromazine (Thorazine, Sonazine); chlorpropamide (Diabinese); clofibrate; demeclocycline (Declomycin); fludrocortisone; heparin; lamotrigine (Lamictal); lithium (Eskalith); narcotic (opiate) medications for pain; oxybutynin (Ditropan); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine, paroxetine (Paxil), and sertraline (Zoloft); and urea (Pytest). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Other medications may also interact with desmopressin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had kidney disease or a low level of sodium in your blood. Your doctor will probably tell you not to take desmopressin.
• tell your doctor if you have or have ever had high blood pressure, any condition that causes you to be extremely thirsty, cystic fibrosis, or heart disease.
• if you are taking desmopressin to treat bed-wetting, tell your doctor if you develop an infection, fever, vomiting, or diarrhea; if the weather is unusually hot; or if you plan to exercise more than usual. You may need to drink more fluid than usual in these situations. Drinking too much fluid while you are taking desmopressin can be dangerous, so your doctor will probably tell you to stop taking desmopressin temporarily.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking desmopressin, call your doctor.
• talk to your doctor about the risks and benefits of taking desmopressin if you are 65 years of age or older. Older adults should not usually take desmopressin because it is not as safe or effective as other medications that can be used to treat the same condition.
• ask your doctor about the safe use of alcoholic beverages while you are taking desmopressin.

Your doctor may tell you to limit the amount of fluid you drink during your treatment with desmopressin. If you are taking desmopressin to treat bed-wetting, your doctor will probably tell you to avoid drinking for at least one hour before you take desmopressin and at least 8 hours after you take desmopressin. Follow your doctor's directions carefully to prevent serious side effects.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Desmopressin may cause side effects. Call your doctor if either of the following symptoms is severe or does not go away:

• diarrhea
• abnormal thinking

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately:

• nausea
• vomiting
• loss of appetite
• weight gain
• headache
• irritability
• restlessness
• extreme tiredness
• confusion
• slowed reflexes
• muscle weakness, spasms, or cramps
• hallucinations (seeing things or hearing voices that do not exist)
• seizures
• loss of consciousness for a period of time

Desmopressin may cause other side effects. Tell your doctor if you experience any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from heat, light, and moisture.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• confusion
• drowsiness
• headache
• difficulty urinating
• sudden weight gain

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to desmopressin.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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