Diabetes insipidus
Nasal spray.
To be initiated on specialist advice. Intranasally, diabetes insipidus, treatment, 10-40micrograms daily in 1-2 divided doses.
Tablets or oral lyophilisates.
To be initiated on specialist advice. diabetes insipidus, treatment, initially 300micrograms daily in 3 divided doses; maintenance 300-600micrograms daily in 3 divided doses; range 0.2-1.2mg daily.
To be initiated on specialist advice. diabetes insipidus, treatment, initially 300micrograms daily in 3 divided doses; maintenance 300-600micrograms daily in 3 divided doses; range 0.2-1.2mg daily.
Initially 180micrograms daily in 3 divided doses; range 120-720micrograms daily.
Initially 180micrograms daily in 3 divided doses; range 120-720micrograms daily.
Initially 180micrograms daily in 3 divided doses; range 120-720micrograms daily.
Prescribing Notes:
- Patients and/or carer(s) should be advised that there is a risk of severe harm or death when desmopressin is omitted or delayed in patients with cranial diabetes insipidus.
- Measurement of plasma sodium once or twice a year guards against excessive water intake which would be reflected by a low plasma sodium.
- Desmopressin injection 4micrograms/mL may be indicated in unconscious patients (dose 1-4micrograms daily by subcutaneous, intramuscular or intravenous injection).
- For the management of nephrogenic diabetes insipidus, a thiazide diuretic may be used, but only under the advice of an endocrinologist.
- A single dose of desmopressin is also used as part of a test following fluid deprivation in the differential diagnosis of thirst and polyuria.
History Notes
16/02/2022
East Region Formulary content agreed.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
Prescribing Notes:
- Desmopressin is also used, following fluid deprivation, in the differential diagnosis of diabetes insipidus.
- Desmopressin is not suitable for nephrogenic diabetes insipidus.
- For the management of nephrogenic diabetes insipidus, a thiazide diuretic may be used, but only under the advice of an endocrinologist.
- Patients and/or carer(s) should be advised that there is a risk of severe harm or death when desmopressin is omitted or delayed in patients with cranial diabetes insipidus.
- Due to a lack of suitable available dosage forms for delivery of low oral doses local specialists recommend the use of Desmopressin oral lyophylisates off label. The paediatric endocrinology team will provide patient specific guidance on administration of smaller sublingual doses using the desmopressin oral lyophilisates – a guideline is currently in development.
- Measurement of plasma sodium once or twice a year guards against excessive water intake which would be reflected by a low plasma sodium.
- Desmopressin injection 4micrograms/mL may be indicated in unconscious patients (dose 1-4micrograms daily by subcutaneous, intramuscular or intravenous injection).
History Notes
29/02/2024
East Region Formulary content agreed.