desmopressin iv to po conversion

Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 1:2. documenting the conversion using the "IV to PO conversion" category. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 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. 8600 Rockville Pike A woman who took both desmopressin and ibuprofen was found in a comatose state. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Clipboard, Search History, and several other advanced features are temporarily unavailable. Atenolol; 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. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. Acetaminophen; 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. A woman who took both desmopressin and ibuprofen was found in a comatose state. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Bupivacaine; Meloxicam: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. A woman who took both desmopressin and ibuprofen was found in a comatose state. 1 0 obj Noctiva Nasal SprayNoctiva nasal spray delivers either 0.83 mcg or 1.66 mcg of desmopressin acetate (equivalent to 0.75 mcg or 1.5 mcg of desmopressin) per spray (0.1 mL).Two sprays of the 0.83 mcg nasal spray are not interchangeable with 1 spray of the 1.66 mcg nasal spray; the 1.66 mcg/0.1 mL nasal spray should be prescribed for patients who are or will be taking the 1.66 mcg dose.Do NOT shake the bottle.Prime the nasal spray before using for the first time by pumping 5 actuations into the air away from the face. Flunisolide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. A desmopressin response requires an increase of at least 2 times the baseline von Willebrand factor (vWF) activity and an increase of both vWF and factor VIII concentrations of more than 0.5 International Units/mL for at least 4 hours. 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. The time to reach maximum plasma desmopressin levels is 0.9 hours. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) 1.2 mg/day PO, 4 mcg/day SC/IV; Alt: 2-4 mcg/day SC/IV divided qd-bid; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; parenteral dose is approx. Tolvaptan is a V2 receptor antagonist and may interfere with the V2 agonist activity of DDAVP. 1.5-2 mg IM/SC = 6-7 mg PO. Caution should be exercised when desmopressin is administered to a woman who is breast-feeding. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Repeat dosing is not recommended due to tachyphylaxis. For antimicrobial interchanges: the pharmacist must notify the covering provider that the antimicrobial has been converted from IV to PO per protocol. Tachyphylaxis may occur with repeated administration given more frequently than once every 48 hours. Repeat administration should be determined by laboratory response and clinical condition of the patient. Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. A woman who took both desmopressin and ibuprofen was found in a comatose state. 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 Amlodipine; 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. Desmopressin acts similarly to native vasopressin. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 1999 Dec;84 Suppl 1:5-8 Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 2005 Oct;27(5):655-65. doi: 10.1097/01.ftd.0000168293.48226.57. Acetaminophen; Dextromethorphan; 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. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. Initially, 0.05 mg PO twice daily. Nabumetone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lamotrigine: (Major) Caution is recommended if a drug that may increase the risk of water intoxication with hyponatremia, such as lamotrigine, is administered with desmopressin acetate. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 4. Determine need for repeat dosage based on laboratory response and patient's clinical condition. The plasma levels given by the intravenous dose resulted in a duration of action of 12 h or more. All Rights Reserved. The initial response is reproducible if DDAVP is administered every 2 to 3 days. Desmopressin acetate 100 microgram Tablet Active Ingredient: desmopressin acetate Company: Aspire Pharma Ltd See contact details ATC code: H01BA02 About Medicine Prescription only medicine Healthcare Professionals (SmPC) Patient Leaflet (PIL) This information is for use by healthcare professionals Last updated on emc: 02 Mar 2022 Quick Links Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Indomethacin: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Store refrigerated 2 to 8C (36 to 46F). A woman who took both desmopressin and ibuprofen was found in a comatose state. Stimate Nasal SprayStimate nasal spray delivers doses in 0.1 mL (150 mcg) increments. Although rare, chlorpropamide has caused a reaction identical to symptom of inappropriate antidiuretic hormone (SIADH). 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. Gasthuys E, Dossche L, Michelet R, Nrgaard JP, Devreese M, Croubels S, Vermeulen A, Van Bocxlaer J, Walle JV. Guidelines recommend administering no more than once every 24 hours or for more than 3 consecutive days to minimize risk of hyponatremia and seizures. Would you like email updates of new search results? Available for Android and iOS devices. Intranasal: If Desmopressin Acetate Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure. Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been well studied in mechanically ventilated patients. If patient responded to 20 mcg/day, the dose was adjusted downward to 10 mcg/day to see if response could be maintained. Consider other treatment options for this condition. 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. Initially, 0.2 mg PO once daily at bedtime. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. .2/ZfG[:{oH}ZJUmniOF F.\6K"abU:hiVyz6gAKt_|pgrqx9MUWz,_LgMvU ?>MJx 'A7 gk\nd^=zff3plgZn7GL:nnL0R2 \mSKu-08W}yx8m}R,Q3}Mm/Metadata 485 0 R/ViewerPreferences 486 0 R>> Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Children more than 12 years of age: 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. This medication helps to control increased thirst and too much urination due to these conditions . DB00035. 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. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The usual dosage range in adults is 0.5 mL (2 mcg) to 1 mL (4 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. 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. Vasopressin, ADH: (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 vasopressin, ADH only with careful patient monitoring. Brompheniramine; 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. Also remove sticky note when IV to po is addressed. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. 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. 1995 Apr;42(4):373-8. doi: 10.1111/j.1365-2265.1995.tb02645.x [ PubMed ] 10646654 Yamamoto T, Fukuyama J, Fujiyoshi A. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. <> Repeat administration should be determined by laboratory response and clinical condition of the patient. Initiate at low dose and increase as necessary. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. Guardrail Drug Requires documentation of two (2) RN's for double-checking. Only start or resume therapy in patients with a normal serum sodium concentration. Less vasopressor activity. Confirm responsiveness before using desmopressin for therapeutic interventions. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Fluid intake restrictions in these patients are recommended. Loop diuretics: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. When switching between formulations, the below text is meant as guidance for starting dose. Initially, 0.05 mg PO twice daily, then titrate to response. The bioavailability was 0.08%. -, BJU Int. A woman who took both desmopressin and ibuprofen was found in a comatose state. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. 100 unit / 100 ml (1 unit/ml). <> The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (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. DDAVP will often maintain hemostasis in patients with hemophilia A during surgical procedures and postoperatively when administered 30 minutes prior to scheduled procedure. It may be given in the nose, by injection into a vein, by mouth, or under the tongue. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Urea: (Minor) The manufacturer notes that the antidiuretic effect of desmopressin can be enhanced by the concomitant administration of urea. If patients are receiving intranasal therapy, begin oral therapy 12 hours after the last intranasal dose. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. If used preoperatively, administer 2 hours before surgery. A woman who took both desmopressin and ibuprofen was found in a comatose state. Intermittent intravenous infusionFor adults and children weighing greater than 10 kg, dilute dose in 50 mL of 0.9% Sodium Chloride for injection. 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. Paediatr Drugs. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. Your doctor may adjust the dose as needed. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. Dextromethorphan; 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. [61810], Initially, 5 mcg (0.05 mL) intranasally, given in 1 to 2 divided doses, then titrated to response. Infusion Pump Required. David McAuley, Pharm.D. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Pretreatment Testing and On-Treatment Monitoring Diabetes Insipidus Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Esomeprazole: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Famotidine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Sulindac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin is administered intravenously or subcutaneously.Desmopressin (DDAVP) injection has an antidiuretic hormone activity of 16 International Units/mL; 1 mcg desmopressin is equivalent to 4 International Units antidiuretic hormone activity.If given preoperatively, desmopressin injection should be given 30 minutes before the scheduled procedure.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. I would recommend making an appointment with your regular doctor to see what might be causing this. Prilocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. IV: 0.3 mcg/kg once slowly over 15-30 minutes. A woman who took both desmopressin and ibuprofen was found in a comatose state. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . 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. The nasal spray should not be used to treat patients with type IIB von Willebrand's disease since platelet aggregation may be induced. C. The pharmacist must enter Epic order comments stating "IV to PO Conversion per P&T policy for all interchanged orders. Preoperative doses may be given 2 hours prior to the scheduled procedure. Repeat administration should be determined by laboratory response as well as the clinical condition of the patient. 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. 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. Max IV rate (usual): 5 mg/min. Last updated on Apr 7, 2022. Desmopressin is contraindicated in patients with moderate to severe renal impairment (e.g., CrCl less than 50 mL/minute or eGFR less than 50 mL/minute/1.73 m2). Renal concentration capacity testing in children below the age of 1 year should only be performed under carefully supervised conditions in hospital. If there is no response, the medication will be stopped. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. To minimize risk of hyponatremia and seizures, administer no more than once every 24 hours or for more than 3 consecutive days. Gently breathe in through the nose and out through the mouth several times.Wipe the nasal applicator using a clean tissue and replace the cap on the bottle.To avoid the spread of infection, do not use the container for more than 1 person.Do not co-administer with other intranasal products.Discard nasal spray 60 days after opening. 1 0 obj Persons with vWD type 1 and von Willebrand factor (vWF) concentrations less than 0.3 International Units/mL or factor VIII activity equal to or less than 5% of normal may not respond to desmopressin. A woman who took both desmopressin and ibuprofen was found in a comatose state. This site complies with the HONcode standard for trust- worthy health information: verify here. A woman who took both desmopressin and ibuprofen was found in a comatose state. There are several recommended conversions ranging from 50 to 80% of the oral dose but the American Association of Clinical Endocrinologists/American Thyroid Association guidelines recommend an intravenous dose 50-70% of the patient's oral dose. Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. Most adults require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. Permanently discontinue for serious hypersensitivity reaction. Main menu. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 1/10 of intranasal dose . Infants 3 months of age and children: National Library of Medicine Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . Meclofenamate Sodium: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 0.2 to 0.6 mg orally once daily before bedtime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Caution should be used when coadministering these agents. Caution should be used when coadministering these agents. Desmopressin nasal spray can be resumed when these conditions resolve. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. 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.