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Repeat dosing is not recommended; therefore, the risk of toxicities associated with accumulation of desmopressin is expected to be low, especially with single-dose intermittent use and appropriate monitoring. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. For continuous infusions, conc. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> The initial response is reproducible if desmopressin is given every 2 to 3 days. Increased Factor VIII activity is noted 30 minutes after IV administration, with peak activity occurring in 90 minutes to 2 hours. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Careful fluid intake restrictions are required in pediatric patients to prevent hyponatremia and water intoxication. Which lab value should prompt the nurse to question a medication dosage increase? The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. In the elderly, careful dosage selection and monitoring of renal function are recommended. Intranasal: Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). Peak plasma concentrations are noted within 40 to 45 minutes of a dose. Administration of intranasal desmopressin may be compromised by nasal mucosa changes (e.g., nasal trauma, nasal surgery, nasal blockage, nasal mucosal atrophy, congestion, or severe atrophic rhinitis), cranial surgery, and nasal packing. Child 2-11 years Following oral administration, the bioavailability of desmopressin is about 5% and 0.16% compared to intranasal and intravenous administration, respectively. [42295], 2 to 4 mcg IV or subcutaneously given in 1 or 2 divided doses daily. In additio A systematic review of 30 studies of desmopressin for the treatment and prophylaxis of bleeding disorders in pregnancy (n = 216) concluded that the drug is effective in reducing bleeding complications associated with pregnancy and childbirth with a good safety record. To investigate (1) the pharmacokinetic and pharmacodynamic profiles of desmopressin in men from an age group with a high incidence of nocturia; and (2) circadian variation in the pharmacokinetic parameters. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Scand J Urol Nephrol Suppl. Conversion of IV Midazolam. In patients receiving desmopressin nasal spray for nocturia, discontinue treatment in patients with concurrent nasal conditions that may increase systemic absorption of desmopressin (e.g., atrophy of nasal mucosa, and acute or chronic rhinitis), because the increased absorption may increase the risk of hyponatremia. Fosinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. Fluid intake restrictions in these patients are recommended. Grading Central Diabetes Insipidus Induced by Immune Checkpoint Inhibitors: A Challenging Task. NOTE: Use parenteral desmopressin in patients for whom the intranasal route is compromised or inappropriate. Reassess patient after the initial 24 hours; if clinical status has improved may begin gradually tapering the dose. Desmopressin, sold under the trade name DDAVP among others, is a medication used to treat diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease, and high blood urea levels. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Management focuses on controlling symptoms with drug therapy. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Desmopressin has been used safely in many women during pregnancy, including those with bleeding disorders and diabetes insipidus. In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. Intravenous desmopressin should be considered when indicated. Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Celecoxib; Tramadol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. For endotoxin-induced fever, IV is favored over PO acetaminophen in reducing temperature for up to . In general, desmopressin is contraindicated in persons with heart failure or uncontrolled hypertension because fluid retention increases the risk for worsening of underlying conditions that are susceptible to volume status. Max IV rate (usual): 5 mg/min. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Guardrail Drug Requires documentation of two (2) RN's for double-checking. 1 spray (150 mcg) per nostril (300 mcg total dose) if >12 years of age or >50 kg body weight. 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. A woman who took both desmopressin and ibuprofen was found in a comatose state. Betamethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If patients are receiving intranasal therapy, begin oral therapy 12 hours after the last intranasal dose. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. A woman who took both desmopressin and ibuprofen was found in a comatose state. sharing sensitive information, make sure youre on a federal Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. -, Br J Urol. June 30, 2022 by . Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. The volume of diluent is weight-based. DDAVP, Minirin, Nocdurna, Stimate, +2 more. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. The initial and terminal half-lives for desmopressin are 7.8 and 75.5 minutes, respectively, resulting in a prompt onset of action with a long duration of action. 4. -. Dose should be reduced. Trauma Surg Acute Care Open. Hydrocodone; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. Generic Name. Ensure that serum sodium is normal prior to initiating or resuming treatment with DDAVP Injection. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. Drug class: Antidiuretic hormones. 2022 Mar 8;7(1):e000852. Preoperative doses may be given 2 hours prior to the scheduled procedure. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Valsartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. A comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. A woman who took both desmopressin and ibuprofen was found in a comatose state. A woman who took both desmopressin and ibuprofen was found in a comatose state. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. endobj This increase is dose-dependent, with an IV dosage of 0.4 mcg/kg producing a 300% to 400% maximum increase in Factor VIII activity. Only start or resume therapy in patients with a normal serum sodium concentration. 1999 Dec;84 Suppl 1:5-8 PATIENTS NOT AT INCREASED RISK FOR HYPONATREMIA: 1 spray (1.66 mcg) in either the left or right nostril approximately 30 minutes before going to bed. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Telmisartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. News Article Holder This page will generate the the news article from the ID supplied in the URL. Medication guideline for the management of neonates requiring desmopressin acetate. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. Budesonide; Glycopyrrolate; Formoterol: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Pediatric Pharmacology of Desmopressin in Children with Enuresis: A Comprehensive Review. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. IV: 0.3 mcg/kg once slowly over 15-30 minutes. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. For All Patients Receiving Repeated Doses: Patients changing from intranasal desmopressin: We comply with the HONcode standard for trustworthy health information. When switching between formulations, the below text is meant as guidance for starting dose. During the initial titration period and continued therapy, observe and monitor closely. Formoterol; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Rapid IV bolus For patients who have been controlled on intranasal desmopressin acetate and who must be switched to the injection form, either because of poor intranasal absorption or because of the need for surgery, the comparable antidiuretic dose of the injection is about one-tenth the intranasal dose. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. administration route. Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mL; 15 mcg/inh. Pharmacokinetics and pharmacodynamics in clinical use of scopolamine. Response should be estimated by 2 parameters, adequate duration of sleep and adequate, not excessive, water turnover. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. DDAVP ( desmopressin) is a synthetic analog of vasopressin (antidiuretic hormone) that promotes release of factor VIII Reversing anticoagulation and achieving hemostasis after cardiopulmonary bypass In a male subject with mild Von Willebrand (vW) disease, intravenous infusion of DDAVP 2 hours after administration of oral tolvaptan did not produce the expected increases in vW Factor Antigen or Factor VIII activity. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Methyclothiazide: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Bethesda, MD 20894, Web Policies Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. HHS Vulnerability Disclosure, Help Following an intranasal dose of 1.66 mcg of desmopressin for nocturia, the median apparent terminal half-life was 2.8 hours; the half-life range in patients with an eGFR above 50 mL/minute/1.73 m2 was 1.4 to 3.8 hours. Infants 3 months of age to children 12 years of age: As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Lisinopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Carbetapentane; Guaifenesin; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. This medication helps to control increased thirst and too much urination due to these conditions . Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Determine need for repeat dosage based on laboratory response and patient's clinical condition. National Library of Medicine After Desmopressin is first used, a review of your child's progress and response should be made within 4 weeks. DDAVP will also stop bleeding in hemophilia A patients with episodes of spontaneous or trauma-induced injuries such as hemarthroses, intramuscular hematomas or mucosal bleeding. Conversion from injection to intranasal: Administer 10 times the amount of desmopressin acetate, rounded down to the nearest 10 mcg. Demeclocycline: (Major) The antidiuretic response to desmopressin or vasopressin (ADH) may be reduced in patients concomitantly receiving demeclocycline. Ddavp, Nocdurna, Octostim. (Synthetic analog of vasopressin-posterior pituitary hormone). Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Oxycodone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The presence of platelet-vWF and normally functioning platelet glycoprotein (GP) IIb/IIIa seem to be essential for desmopressin's effect on platelets. Blood pressure and pulse should be monitored during infusion. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. Desmopressin is in a class of medications called hormones. The following pharmacist will check on these open i-Vents and close then when appropriate. Corticosteroids: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Inject subcutaneously taking care not to inject intradermally. For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Pseudoephedrine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Chlorpromazine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including chlorpromazine. 0.1 to 0.4 mL via rhinal tube intranasally twice a day. . 14 A commonly cited double-blind trial suggests a conversion of 1 mg IV lorazepam to 2 mg of IV midazolam, which is further supported using a midazolam oral bioavailability of 40% due to a . A woman who took both desmopressin and ibuprofen was found in a comatose state. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). [33605], Initially, 10 mcg (0.1 mL) intranasally, given in 1 to 3 divided doses, then titrated to response. Last updated on Apr 7, 2022. Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. endobj x}n y)Zn91Iv l38Y8bIkYbX$=x:9\>?}st_~xOo^\~dt&&=\~o~g/}~y%;]V|s{h+j/~\f'iqriwZgI~IOk[b,n6'K+%Y{Y?k{]U4{H}mWRa |3}ktz_>iCy>VbZ{SZ(_!> _~{pz.5'Kxo'wW0P*okGa? Caution should be used when coadministering these agents. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Nonsteroidal antiinflammatory drugs: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). Consider other treatment options for this condition. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Patients previously receiving intranasal treatment may begin oral therapy the night following (24 hours) the last intranasal dose. peak plasma concentration (Cmax) was 4 (+/- 3.85) pg/mL for the 0.83 mcg dose and 9.11 (+/- 6.90) pg/mL for the 1.66 mcg dose. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. To prime, press down 4 times. Desmopressin is contraindicated in persons with moderate to severe renal impairment (CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2) and renal failure. A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution and monitor patients for signs and symptoms of hyponatremia, which may include seizures. Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN prepared solution; 4microgram/mL injection solution - SA Neonatal Medication Guidelines | SA Health Medication guideline for the management of neonates requiring desmopressin acetate. 2002 Jun;89(9):855-62 Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. On Day 7, 6 subjects were given a single SC bolus injection of desmopressin. Levels of FVIII are also increased, which increases hemostasis by accelerating fibrin formation. So, if a patient is on a nasal (spray or intranasal) dose of 10mcg (0.1 ml) twice a day, then a suitable tablet oral dose may be 100mcg or 200mcg twice a day. Dependent on route of administration and indication for therapy. Desmopressin has also been used in congenital or acquired bleeding disorders, including drug-induced platelet dysfunction (e.g., aspirin, dextran, ticlopidine, and heparin). THOSE AT INCREASED RISK FOR HYPONATREMIA: 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Only start or resume therapy in patients with a normal serum sodium concentration. Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.For 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diflunisal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Acetaminophen; Chlorpheniramine; Phenylephrine : (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. 2 0 obj Also known as antidiuretic hormone (ADH), vasopressin is secreted by the hypothalamus in response to hyperosmolarity, volume depletion, stress (emotional or physiological), certain drugs, and painful stimuli. Median time to reach Cmax (tmax) was 1.5 (range 1.0-4.1) h at night and 1.5 (range 0.5-3.0) h in the day. Diclofenac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Interrupt therapy for acute illness (e.g., systemic infection, fever, recurrent vomiting or diarrhea), extremely hot weather, vigorous exercise, or other conditions associated with increased water intake. Einstein (Sao Paulo). 2 0 obj Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. This site needs JavaScript to work properly.