IV Dilution &
Medication Reference

DESMOPRESSIN (DDAVP ®)

Usual Diluents

Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]

Stability / Miscellaneous

Supplied: 4 mcg/ml-1 ml vial.

Indications: Hemophilia (increases factor VIII levels): 0.3 mcg/kg in 50ml normal saline over 15-30 minutes.
Diabetes insipidus: 2-4 mcg/day IV push or SC.
Decrease bleeding following cardiac bypass: 0.3 mcg/kg ivpb.
Provide short term protection for uremic hemorrhagic tendency: 0.3 mcg/kg ivpb q8h x 2 doses (diminishing response).

Greatly enhanced ADH activity. Less vasopressor activity. Longer DOA. (Synthetic analog of vasopressin-posterior pituitary hormone).

ADH activity : Pressor activity [DDAVP: 2000-4000: 1 Vasopressin: 1:1]

WARNINGS
When Desmopressin Acetate Injection is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular in pediatric and geriatric patients, fluid intake should be adjusted downward to decrease the potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain).

Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma.

Desmopressin acetate should not be used to treat patients with Type IIB von Willebrand's disease since platelet aggregation may be induced.

DOSAGE AND ADMINISTRATION
Hemophilia A and von Willebrand's Disease (Type I): Desmopressin Acetate Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg desmopressin acetate/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. Blood pressure and pulse should be monitored during infusion. If Desmopressin Acetate Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure.

The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient.

Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover.

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. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. 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.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

HOW SUPPLIED
Desmopressin Acetate Injection 4 mcg/mL is available as a clear colorless sterile solution as follows:
Ampul - 4 mcg/mL - 1 mL - 10 per Box

KEEP REFRIGERATED AT 2° to 8°C (36° to 46°F).

September, 2004
©Hospira 2004 EN-0511 Printed in USA
HOSPIRA, INC., LAKE FOREST, IL 60045 USA