Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Treatment of SIADH

To be initiated on specialist advice for the treatment of hyponatraemia resulting from inappropriate secretion of anti-diuretic hormone, if fluid restriction alone does not restore sodium concentration or is not tolerable.

Demeclocycline
Demeclocycline 150mg capsules

To be initiated on specialist advice. Initially 0.9-1.2g daily in divided doses; maintenance 600-900mg daily.

Prescribing Notes:

  • Sodium supplements are generally regarded as first line for the management of hyponatraemia.
  • Demeclocycline is only very rarely indicated for chronic Syndrome of Inappropriate Secretion of Anti-Diuretic Hormone (SIADH) where fluid deprivation is unsuccessful.
  • Higher doses of demeclocycline may be associated with a decline in glomerular filtration. Creatinine should be monitored along with plasma sodium.

History Notes

16/02/2022

East Region Formulary content agreed.

Treatment of SIADH

Prescribing Notes:

  • Refer to specialists, measure urine and serum osmolality and urine sodium before commencing treatment.
  • The most common treatment for SIADH in children is limiting fluid intake.

History Notes

29/02/2024

East Region Formulary content agreed.