Desmopressin

Desmopressin treats diabetes insipidus, von Willebrand disease, bedwetting, hemophilia A, and high blood urea levels. In bedwetting, it is prescribed in the form of desmopressin acetate, by mouth. In 2017, the FDA approved it for the treatment of Nighttime urination in adults. It is also the first choice of treatment in Bleeding disorders and treatment of mild to moderate type 1 von Willebrand disease, but it is not recommended for treating another type of Willebrand disease. It is also prescribed but only to patients with mild hemophilia A. It may also be used to prevent bleeding due to trauma or in preventing bleeding due to surgery. However, it should not be used for the treatment of hemophilia B or severe hemophilia A. in some cases it has also been used to treat uremia-induced bleeding and also in the treatment of central diabetes insipidus where it is given as a replacement for endogenous antidiuretic hormone. Desmopressin is sold under the brand name DDAVP among others. Wyeth John & Brother Ltd filed for the first patent in 1976 and by 1978 it was being sold for medical use in the USA. Due to its applications and efficacy, it has earned a place on the World Health Organization's List of Essential Medicines and after the expiry of the initial patent is now sold as a generic medication.

Dosage and administration

Desmopressin is available as tablets. In the treatment of Central Diabetes Insipidus, the dosage of is set based on each individual patient. The doses are also adjusted according to the diurnal pattern of response. In evaluating the Response, the two parameters are the adequate duration of sleep and adequate but not excessive, water turnover by the patient. If the Patients are already on the intranasal DDAVP therapy and want to shift to tablet therapy, they should do so within twelve hours after the last intranasal dose. And the patients switching should be monitored during the initial dose-titration period In Adults and Children, the patients are started on an initial dose of 0.05 mg, taken two times a day and individually adjusted for optimum effect.

The price of Desmopressin

In the USA, the average cost for 30 Tablets of 0.1mg each of the generic brands is $146.99. the price of this medication is much lower in the developing world. In India, the supply of 30 same tablets as in the USA will cost around USD 6.5, and the nasal spray costs around USD 8.

How does Desmopressin work?

Desmopressin mimics the actions of endogenous ADH. Desmopressin is a selective agonist of V2 receptors expressed in the renal collecting duct. This results in increased water re-absorption and reduction in the urine produced. Desmopressin exerts its hemostatic effect by Inducing synthesis of the von Willebrand factor by endothelial cells. This stimulation releases the VWF from its storage sites in endothelial cells.

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