Desmopressin

Introduction

Written by Ashley Wong, PharmD
Medically reviewed by Christina Bookwalter, PharmD, MS MEd, BCPS, BCACP 
Updated on November 29, 2023

Desmopressin (des moe PRES in) is a generic medication prescribed for certain conditions that cause excess urination and certain bleeding disorders. It’s used for these purposes in adults and some children. Desmopressin belongs to a group of drugs called antidiuretics.

These approved uses differ based on the form of desmopressin your doctor prescribes.

This article doesn’t provide coupons for all forms of desmopressin. To find coupons for desmopressin oral tablet, see this article.

Boxed warning: Risk of low sodium levels with desmopressin injection

Desmopressin injection has a boxed warning about the risk of low sodium levels. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for desmopressin” section.

Side effects of desmopressin

Desmopressin may cause mild or serious side effects. More common mild side effects of desmopressin and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about desmopressin’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for desmopressin listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of desmopressin are listed below. These side effects may differ based on the form of desmopressin you use.

This article doesn’t include all possible mild side effects of the drug. To learn more about desmopressin’s side effects based on the form, refer to the prescribing information for desmopressin listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Desmopressin nasal spray’s mild side effects* include:

• increase in blood pressure
• headache
• stuffy nose
• runny nose
• mild allergic reaction†

Desmopressin oral tablet’s mild side effects include:

• headache
• nausea
• diarrhea
• flushing (temporary warmth, redness, or deepening of skin color)
• mild allergic reaction†

* These side effects weren’t reported in studies of the drug. But they have occurred in people after the drug was approved for use.
† For details about this side effect, see the “Interactions and warnings for desmopressin” section.

Serious side effects

Serious side effects of desmopressin are listed below. These side effects may differ based on the form of desmopressin you use.

This article doesn’t include all possible serious side effects of the drug. To learn more about desmopressin’s side effects based on the form, refer to the prescribing information for desmopressin listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, desmopressin’s serious side effects include:

• boxed warning: risk of low sodium levels*
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for desmopressin” section.

Common questions about desmopressin

Below you’ll find answers to a few commonly asked questions about desmopressin.

What is desmopressin’s mechanism of action? And how does the drug work?

Desmopressin is a human-made form of a hormone in your body called antidiuretic hormone (ADH). When you don’t have enough ADH in your body, it will cause excess urination. Desmopressin works by replenishing ADH in your body. This lowers the amount of urine your body makes by increasing the amount of water that’s reabsorbed in your kidneys. To treat bleeding disorders, desmopressin works by increasing the level of a protein in your blood that helps you stop bleeding.

Desmopressin nasal spray starts working within 30 minutes. Desmopressin oral tablet starts working about 1 hour after you take your dose. Desmopressin injection starts working within 30 minutes after it’s given.

If you’d like to know more about this, talk with your doctor or pharmacist.

Is desmopressin safe for older adults?

Maybe. Older adults (age 65 years and older) may not clear desmopressin from their bodies as easily as younger adults. This can cause the medication to build up in the body and increase the risk of side effects. Due to this risk, doctors may prescribe desmopressin at a dosage that’s on the low end of the recommended range for older adults.

Also, older adults should pay special attention to their fluid intake while taking desmopressin. Drinking too much fluid may raise the risk of low sodium levels in your blood. Your doctor will discuss with you how much fluid you can drink while taking this drug.

If you have concerns about taking desmopressin given your age, talk with your doctor.

Uses of desmopressin

The Food and Drug Administration (FDA) approves prescription drugs such as desmopressin for certain conditions. Approved uses for desmopressin are described below. These uses differ based on the form of desmopressin prescribed.

Use for diabetes insipidus

Doctors may prescribe desmopressin nasal spray, oral tablet, and injection for treating central diabetes insipidus. Desmopressin nasal spray and oral tablet are used for this purpose in children ages 4 years and older and adults. Desmopressin injection as a subcutaneous injection (injection under your skin) or an intravenous (IV) injection (injection given into a vein) is used for this purpose in children ages 12 years and older and adults. It’s usually prescribed as a long-term treatment.

Diabetes insipidus is a condition where your kidneys cannot conserve water. This results in extreme thirst and frequent urination. There are different types of diabetes insipidus. Desmopressin is approved to treat central diabetes insipidus, which is caused by damage to certain parts of the brain. This damage causes irregular amounts of antidiuretic hormone (ADH) to be made, stored, or released. Low levels of ADH cause large amounts of fluid to be released in your urine. Desmopressin treats central diabetes insipidus by replenishing ADH in your body.

Doctors may not prescribe desmopressin nasal spray in certain situations, such as for:

• nephrogenic diabetes insipidus (rare disorder in which your kidneys can’t concentrate your urine)
• nighttime bedwetting
• people with conditions that make it difficult to use nasal sprays, such as severe nasal congestion
• people with decreased consciousness
• people who require unique dosages of desmopressin

Doctors may not prescribe desmopressin injection in certain situations, such as for nephrogenic diabetes insipidus.

Use for nighttime bedwetting

Doctors may prescribe desmopressin oral tablet to help prevent nighttime bedwetting. It’s used for this purpose in children ages 6 years and older and adults. It’s usually prescribed for up to 6 months.

Nighttime bedwetting occurs when there’s a loss of bladder control during the night. One of the causes of bedwetting is hormonal imbalances. ADH is a hormone that tells your body to slow down the production of urine overnight. People who don’t make enough ADH can have nighttime bedwetting. Desmopressin treats bedwetting by replenishing ADH in your body.

It’s important to note that desmopressin nasal spray is not approved for nighttime bedwetting.

Use for certain bleeding disorders

Doctors may prescribe desmopressin injection for treating hemophilia A and von Willebrand disease (Type I). It’s given as an intravenous (IV) infusion (an injection into your vein given over time) for this purpose in adults and children ages 3 months and older. It’s usually prescribed as a long-term treatment.

Bleeding occurs when your blood vessel is damaged. When this happens, small cells called platelets form a plug at the injury site. Then, small proteins called clotting factors are turned on to help the platelets stick to the opening. This forms a sticky plug that stops blood from flowing out. Desmopressin treats bleeding disorders by increasing the levels of a specific clotting factor called factor VIII.

Doctors may not prescribe desmopressin injection in certain situations, such as for treatment of severe type I von Willebrand disease or if you have certain abnormal results on a factor VIII blood test.

Interactions and warnings for desmopressin

Below, you’ll find information about desmopressin’s possible interactions and warnings.

Interactions of desmopressin

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you use desmopressin, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for desmopressin” section below.

Warnings for desmopressin

Some people should not use desmopressin, and others should use it cautiously.

Boxed warning: Risk of low sodium levels

Desmopressin injection has a boxed warning about the risk of hyponatremia (low sodium levels in the blood). Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Sodium is an electrolyte that helps maintain the balance of water in and around your cells. It also plays a role in muscle and nerve function, and it helps maintain blood pressure levels. Having too little sodium in your blood can be dangerous and life threatening if it’s not diagnosed and treated. It can lead to seizures, coma, stopped breathing, or death. Because of this risk, your doctor will not prescribe desmopressin injection if you have health conditions or take medications that affect your sodium and water balance.

Your doctor will order tests to check your sodium levels before and during treatment with desmopressin.

If you experience any symptoms of hyponatremia, such as weakness, fatigue, muscle cramps, confusion, or overactive reflexes, tell your doctor. They’ll likely order tests to check your sodium levels. And if your levels are low, your doctor may recommend stopping desmopressin either temporarily or permanently.

To learn more, talk with your doctor or pharmacist.

Other warnings

Desmopressin could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether desmopressin is a safe option for you. These warnings may differ based on the form of desmopressin you use or take.

Ask your doctor about specific warnings for desmopressin, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Desmopressin can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to desmopressin or any of its ingredients, your doctor will likely not prescribe desmopressin. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to desmopressin, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of desmopressin

You should not take or use more desmopressin than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve used too much desmopressin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and desmopressin

Information about desmopressin and pregnancy and breastfeeding is described below.

Desmopressin and pregnancy

It’s not known whether desmopressin should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

Desmopressin and breastfeeding

It’s not known whether desmopressin should be used while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication.

What to ask your doctor

Let your doctor know if you have questions about desmopressin or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Is there a limit to the amount of liquid I can consume while taking desmopressin?
• Which form of desmopressin is best for my condition?
• How can I lower my risk of side effects from desmopressin?

Resources

• Desmopressin acetate injection, for intravenous or subcutaneous use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/9725ba8e-ac0f-4655-bb98-9ea926142815/spl-doc
• Desmopressin acetate tablets. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c04357fd-478a-4909-b098-ae6710be071c/spl-doc
• Desmopressin nasal spray. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/1ac423b8-27a6-4cef-4a82-c50bf81b4f49/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.