Desmopressin Acetate, Oral/Intranasal/Injection

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KEY POINTS

• This medicine is taken by mouth, sprayed in the nose, or given by injection to treat some kinds of problems with urination, or to treat hemophilia A or von Willebrand's disease. Use it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antidiuretic; antihemorrhagic

Generic and brand names: desmopressin acetate, injection; desmopressin acetate, intranasal; desmopressin acetate, oral; DDAVP; Stimate

What is this medicine used for?

This medicine may be used to treat:

• Diabetes insipidus (excess urination and thirst from too little of a hormone called ADH)
• Hemophilia A and von Willebrand's disease (bleeding disorders)
• Frequent urination caused by brain injuries or pituitary surgery
• Bedwetting at night

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Blood clots
• Cystic fibrosis
• Heart problems such as angina, irregular heartbeat, heart failure, or a heart attack
• High or low blood pressure
• Hyponatremia (low levels of sodium in your blood)
• Kidney problems
• Nose injury or sinus problems (if you use the nasal form of this medicine)

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine comes in several forms: a nasal spray, tablets taken by mouth, and injections (shots).

Check the label on the medicine for directions about your specific dose. Take the exact number of tablets prescribed by your healthcare provider. Do not take more or take longer than prescribed.

Use the nasal spray exactly as directed by your healthcare provider. Read the instructions that come with the spray. Do not use more of it or use it more often than prescribed. Using too much can increase the risk of side effects.

Check with your healthcare provider before using this medicine in children. Some forms of this medicine should not be used in children under a certain age.

The nasal solution is available in a nasal tube delivery system that allows the solution to be blown deep into the nasal cavity. Read the instructions carefully if your healthcare provider prescribes this form.

Stimate nasal solution comes in a spray pump that must be primed before the first use. To prime the pump, press down 4 times. The spray pump is set to deliver 25 doses. After 25 doses, throw out any leftover spray because it may not be the proper strength.

Shots may be given by your healthcare provider. Some people can give themselves shots. If you are to give yourself the shots, be sure you know how to give them and how much medicine to use. Use disposable syringes and needles. Do not reuse them, and dispose of them properly.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: headache, nausea, vomiting, stomach cramps, flushing, seizures, confusion, unexplained swelling, drowsiness, trouble urinating.

What should I watch out for?

You need to watch how much liquid you drink while you are being treated with this medicine. Talk with your provider about this. Do not drink alcohol while taking this medicine. It may make you dehydrated. Contact your healthcare provider if you develop severe vomiting or diarrhea while you are taking this medicine.

You may need to have blood or urine tests regularly to see how this medicine affects you. Keep all appointments.

If you are using this medicine to control bleeding, contact your healthcare provider if you have bleeding that is not controlled after a dose.

If your child is using this medicine and has severe diarrhea, nausea, or vomiting, contact your healthcare provider. Your child’s medicine may need to be adjusted. Talk with your healthcare provider about this.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe headache; chest pain; shortness of breath; coughing up blood; nausea; vomiting; unexplained loss of appetite; fever; severe stomach cramps; swelling in arms or legs, or any unexplained swelling; nosebleed; unexplained sore throat; muscle pain or weakness; fast or irregular heartbeat; hallucinations (seeing or hearing things that are not there); confusion; unusual tiredness; unusual restlessness or irritability; severe dizziness or fainting; pain, swelling, or redness in lower legs; seizures.

Other: Drowsiness, dizziness, dry mouth, light-sensitive eyes, mild headache, facial flushing, trouble sleeping, runny or stuffy nose, pain or swelling where injections are given.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antidepressants such as amitriptyline, desipramine (Norpramin), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), and sertraline (Zoloft)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol) and lamotrigine (Lamictal)
• Chlorpromazine
• Chlorpropamide
• Demeclocycline
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Fludrocortisone
• Lithium (Lithobid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat low sodium levels such as conivaptan (Vaprisol) and tolvaptan (Samsca)
• Narcotic pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone/acetaminophen (Norco, Vicodin), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), and pentazocine (Talwin)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Oxybutynin (Ditropan XL, Oxytrol)
• Paroxetine (Brisdelle, Paxil, Pexeva)

Do not drink alcohol while you are taking this medicine without your healthcare provider's approval.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Carefully follow the instructions on the package for how to store this medicine.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.