Desmopressin Acetate (DDAVP) for Diabetes Insipidus :: Nationwide Children's Hospital

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Desmopressin Acetate (DDAVP) for Diabetes Insipidus

Desmopressin acetate (des moe PRES in As e tate) is also called DDAVP. It is used to replace a natural hormone called antidiuretic hormone, or ADH, in children with diabetes insipidus (“water diabetes”). Diabetes insipidus may be caused by a brain tumor, an injury, or other unknown causes. Diabetes insipidus is not the same as diabetes mellitus or “sugar diabetes.”
 

How This Medicine Works

DDAVP helps the kidneys make less urine. Normally, the body releases ADH from the pituitary, a tiny gland in the brain. ADH controls how much urine is made by the kidneys. If the body does not release enough ADH, too much urine is made. This causes the body to lose too much water. This causes dehydration. If diabetes insipidus is not treated, severe dehydration and seizures can happen.
 
Doctor's Order form
 

Remember For Oral Tablets

  • Read the label carefully. Make sure you are giving your child the right amount. It is easy to confuse the different dosage forms and strengths.
  • Wash and dry your hands before giving the medicine.
  • Give the exact amount of medicine as ordered by your doctor.
  • Stay with your child until the medicine is taken.
  • Ask for Helping Hand HH-IV-28, Medications: How to Give by Mouth, if your child has trouble taking medicine and the tablet is used.

Remember For Nasal Spray or Drops

  • Read the label carefully. Make sure you are giving your child the proper amount. It is easy to confuse the different dosage forms and strengths.
  • Wash and dry your hands before giving the medicine.
  • When using the nasal forms of DDAVP, have your child blow his or her nose before giving DDAVP. If your child cannot do this, bulb-suction mucus out of the nose. Ask your child’s nurse for Helping Hand HH-II-25, Suctioning Nose and Mouth at Home if your child cannot blow his or her nose.
  • Give the exact amount of medicine as ordered by your doctor.
  • Stay with your child until the medicine is taken.
  • Ask your nurse for Helping Hand HH-V-34, Nose Drops if the nasal spray or drops are used.

Other Information

It’s very important to give the medicine exactly as the doctor or pharmacist tells you, even if your child is feeling fine.
Drug-Nutrient Interactions
  • Do not give non-prescription medicines (like ibuprofen, cold, or flu medicine) without checking with your child’s doctor or pharmacist first.
  • Your child should not drink large amounts of soft drinks, chocolate drinks, tea, or coffee while taking this medicine.

If You Forget to Give a Dose

If you forget to give a dose of this medicine, but remember within 6 hours, give it right away. Then go back to your regular dosing schedule. If you do not remember until later, do not give the missed dose at all. Do not double the next dose. Instead, go back to your regular dosing schedule.
 

Possible Side Effects

  • Dehydration if too little DDAVP is given (or if the dose needs to be increased by your child’s doctor).
  • Stomach cramps or nausea
  • Nose bleeds (For nasal spray or drops only.) If your child has a nosebleed, tilt the head back until it stops. If it does not stop after 30 minutes, call your child’s doctor.
  • Stuffy nose (For nasal spray or drops only.)
  • Too much DDAVP can cause a problem called “water intoxication.” This happens when there is too much water in the body because the kidneys are saving too much fluid. Some signs of this condition are:
    • Confusion
    • Increased sleepiness
    • Constant severe headache
    • Swelling of the hands and feet
    • Seizures
    • Coma
  • Too little DDAVP can cause:
    • Increased urination
    • Increased thirst
    • Weight loss
    • Dehydration.

What to Watch For

  • When the dose of DDAVP begins to wear off, your child will need more water and will have to urinate more often. This could also be a sign that your doctor needs to change the dose.
  • Your child’s thirst and urination should be less within 2 hours of giving the medicine. If it is not, call your child’s doctor. The dose may need to be changed.

When to Call the Doctor

Call your child’s doctor right away if any of the following happens:
  • Fast heartbeat (pulse)
  • Signs of water intoxication
  • If your child has a nosebleed that does not stop after having his or her head tilted backwards for 30 minutes. (For nasal spray or drops only.)
  • If your child is confused, hard to wake up, or is sleeping more than usual.
  • If your child complains of a constant severe headache.
  • If your child seems dehydrated or loses weight.
  • If your child has to urinate more than usual or has more thirst than usual.
  • If you have questions about the medicine.
  • If your child is having any side effects that continue or bother him a lot.
  • If your child is not well, has vomiting or diarrhea, or cannot take the DDAVP. The doctor may need to change the dose of medicine and watch your child’s blood salt (sodium) level.

How to Give the Medicine by Nasal (Rhinal) Tube

  • The nasal forms of DDAVP are given through a very small, soft, plastic nose tube called a rhinal tube. Sometimes medicine may be given by nasal (nose) spray. It is given this way because it is absorbed through tissues inside the nose.
  • In most cases, even children who have a stuffy nose (congestion) will be able to take DDAVP. However, severe congestion or a "runny nose" may keep the medicine from being absorbed.

Image of opening new bottle of medicine

1. To open a new bottle of medicine, pull the plastic tag on the neck of the bottle.

Image of breaking security seal

2. Break the security seal and remove the plastic cap.

 Image of dropper   

3. Twist off the small inner cap from the dropper. Be sure to save this small cap to prevent leakage if the bottle is not stored upright

 Image of tube 

4. In one hand, hold the part of the tube marked with an arrow. Hold the dropper part of the bottle with your other hand. Insert the top of the dropper in a downward position into the end of the tube marked with an arrow.
 
5. Gently squeeze the bottle until the right amount of medicine is measured into the tube. Keep a constant pressure on the bottle to prevent air bubbles from forming.
 
NOTE: Always measure and give the exact dose of DDAVP prescribed by your doctor. Be sure there are no air bubbles in the tube. Bubbles make it hard to get the right dose.
 
6. Remove the bottle from the tube by quickly pulling the bottle away in a downward motion.
 
7. Have your child lie down or tilt his head back.
 
Image of inserting tube
8. Gently insert the tubing into the child's nose -- just far enough so that the medicine does not run out. A baby must be held firmly and securely.
 
Image of blowing medicine through tube
9. Put your lips around the end of the tube. Blow the medicine through the tube into your child's nose with a short, strong puff.
 
10. Put the small inner cap back on the dropper.
 
11. Wash the tube with water. Be sure to shake all the water out of the tube.
 
12. When you give the next dose, give it in the other side of the nose.

When You Get the Prescription Filled

  • Have your pharmacist give you two labeled containers if your child care provider will be giving this medicine.
  • Get this prescription filled at least two days before the last dose is given. This is very important.
  • Some pharmacies may not have this medicine. Please ask your nurse to call your pharmacy before you leave the hospital to see if they have this medicine or can order it for you. You may also have the prescription filled at Nationwide Children’s Hospital Outpatient Pharmacy.

Storage of Medicine

Image of nose drops in refrigerator

Picture 7: Store DDAVP nose drops or spray in the refrigerator. Do not freeze.

  • Store all medicines out of children's reach.
  • For DDAVP nose spray or nose drops, store in the refrigerator (Picture 7). DO NOT FREEZE.
  • For DDAVP tablets, store in the pharmacy container in a dry room (not in the bathroom).
  • DDAVP may be kept at room temperature for several hours at a time, but do not expose to high heat sources such as direct sunlight or a closed car.
  • DO NOT use this medicine after the expiration date printed on the container.

 

 

Safety Tips

  • Tell your child’s doctor and pharmacist if your child has a strange or allergic reaction to any medicine.
  • If you carry the medicine in your purse, keep it in its childproof container and not above room temperature. Keep your purse out of the reach of children.
  • Bring all of your child’s medicines with you in the original containers whenever your child sees a doctor, goes to an emergency room, or is admitted to the hospital. This helps doctors who may not know your child.
  • Learn the name, spelling, and dose of this medicine. Also, teach your child if he or she is old enough.
  • If your child takes too much of this medicine, or if someone else takes this medicine, first call the Poison Center at 1-800-222-2212 (TTY 614-228-2272). They will tell you what to do.
  • Do not stop giving this medicine or change the amount given without first talking with your child’s doctor or pharmacist. Reason: too much or too little DDAVP can cause serious health problems.
  • Tell your child’s teacher, school nurse, coach, babysitter, and other caregivers that your child is taking this medicine. Tell them what side effects to watch for. It is important for the older child or adolescent to wear a medical alert bracelet or necklace to advise people of their condition in case of an accident.
  • Always measure and give the exact dose of DDAVP prescribed by your doctor.
  • Be sure to keep your doctor's appointments (this medicine may need to be adjusted).

Follow-Up Appointments

  • You can expect to have regular follow-up appointments with your child’s doctor.
  • You child’s next appointment is on (date) ___________________ at (time) __________.
  • Write down all of your questions as you think of them. Bring this list with you when you see the doctor.
  • Be sure to call your child’s doctor if you cannot keep the appointment
If you have questions, be sure to ask your child’s doctor, nurse or pharmacist.
 
 
 
 
HH-V-133 11/95 Revised 1/15 Copyright 1995, Nationwide Children’s Hospital
Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000