Diabetes insipidus – Treatment – NHS

Treatments for diabetes insipidus aim to reduce the amount of urine your body produces.

Depending on the type of diabetes insipidus you have, there are several ways of treating your condition and controlling your symptoms.

Cranial diabetes insipidus

Mild cranial diabetes insipidus may not require any medical treatment.

Cranial diabetes insipidus is considered mild if you produce approximately 3 to 4 litres of urine over 24 hours.

If this is the case, you may be able to ease your symptoms by increasing the amount of water you drink to avoid dehydration.

Your GP or endocrinologist (a specialist in hormone conditions) may advise you to drink a certain amount of water every day, usually at least 2.5 litres.

But if you have more severe cranial diabetes insipidus, drinking water may not be enough to control your symptoms.

As your condition is caused by a shortage of vasopressin (AVP), your GP or endocrinologist may prescribe a treatment that takes the place of AVP, known as desmopressin.

Desmopressin

Desmopressin is a manufactured version of AVP that’s more powerful and more resistant to being broken down than the AVP naturally produced by your body.

It works just like natural AVP, stopping your kidneys producing urine when the level of water in your body is low.

Desmopressin can be taken as a nasal spray, in tablet form or as a form that melts in your mouth, between your gum and your lip.

If you’re prescribed desmopressin as a nasal spray, you’ll need to spray it inside your nose once or twice a day, where it’s quickly absorbed into your bloodstream.

If you’re prescribed desmopressin tablets, you may need to take them more than twice a day.

This is because desmopressin is absorbed into your blood less effectively through your stomach than through your nasal passages, so you need to take more to have the same effect.

Your GP or endocrinologist may suggest switching your treatment to tablets if you develop a cold that prevents you using the nasal spray.

Desmopressin is very safe to use and has few side effects.

But possible side effects can include:

• headache
• stomach pain
• feeling sick
• a blocked or runny nose
• nosebleeds

If you take too much desmopressin or drink too much fluid while taking it, it can cause your body to retain too much water.

This can result in:

• headaches
• dizziness
• feeling bloated
• hyponatraemia – a low level of sodium (salt) in your blood

Symptoms of hyponatraemia include:

• a severe or prolonged headache
• confusion
• feeling sick (nausea) and vomiting

If you think you may have hyponatraemia, stop taking desmopressin immediately and call your GP for advice.

If this is not possible, go to your local A&E department.

Nephrogenic diabetes insipidus

If you have nephrogenic diabetes insipidus that’s caused by taking a particular medication, such as lithium or tetracycline, your GP or endocrinologist may stop your treatment and suggest an alternative medication.

But do not stop taking it unless you have been advised to by a healthcare professional.

As nephrogenic diabetes insipidus is caused by your kidneys not responding to AVP, rather than a shortage of AVP, it usually cannot be treated with desmopressin.

But it’s still important to drink plenty of water to avoid dehydration.

If your condition is mild, your GP or endocrinologist may suggest reducing the amount of salt and protein in your diet, which will help your kidneys produce less urine.

This may mean eating less salt and protein-rich food, such as processed foods, meat, eggs and nuts.

Do not alter your diet without first seeking medical advice.

Your GP or endocrinologist will be able to advise you about which foods to cut down on.

Find out more about eating a healthy, balanced diet.

If you have more severe nephrogenic diabetes insipidus, you may be prescribed a combination of thiazide diuretics and a non-steroidal anti-inflammatory drug (NSAID) to help reduce the amount of urine your kidneys produce. 

Thiazide diuretics

Thiazide diuretics can reduce the rate the kidneys filter blood, which reduces the amount of urine passed from the body over time.

Side effects are uncommon, but include:

• dizziness when standing
• indigestion
• very sensitive skin
• erectile dysfunction (impotence) in men 

This last side effect is usually temporary and should resolve itself if you stop taking the medication.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce urine volume further when they’re used in combination with thiazide diuretics.

But long-term use of NSAIDs increases your risk of developing a stomach ulcer.

To counter this increased risk, an additional medication called a proton pump inhibitor (PPI) may be prescribed.

PPIs help protect your stomach lining against the harmful effects of NSAIDs, reducing the risk of ulcers forming.

Find out more about treating stomach ulcers

Help with health costs

If you have diabetes insipidus, you do not have to pay prescription charges for desmopressin.

You’ll need to fill in a medical exemption (MedEx) certificate to qualify.

See who can get free prescriptions for more information about how to apply for a MedEx certificate.

You may have to pay for other medicines that may be required on a short-term basis, such as thiazide diuretics.

Support

Read more about diabetes insipidus and how to get support from the Pituitary Foundation

Page last reviewed: 13 October 2022
Next review due: 13 October 2025

Desmopressin Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Desmopressin can rarely cause a low level of sodium in the blood (hyponatremia), which can be serious or even fatal. Drinking too much liquid, using certain medications (such as “water pills”/diuretics including furosemide, glucocorticoids such as prednisone), being 65 years or older, or having certain medical conditions may increase the risk of low sodium in the blood. Lab tests (such as urine tests, sodium blood levels) must be done before you start using this medication and while you are using it. Keep all medical and lab appointments.

Tell your doctor right away if you develop symptoms of low sodium in the blood, such as nausea, vomiting, headache, muscle weakness/cramps, unusual tiredness, unusual drowsiness, dizziness, restlessness, mental/mood changes including confusion/irritability.

Get medical help right away if you have any very serious side effects, including seizure or trouble breathing.

Warnings:

Desmopressin can rarely cause a low level of sodium in the blood (hyponatremia), which can be serious or even fatal. Drinking too much liquid, using certain medications (such as “water pills”/diuretics including furosemide, glucocorticoids such as prednisone), being 65 years or older, or having certain medical conditions may increase the risk of low sodium in the blood. Lab tests (such as urine tests, sodium blood levels) must be done before you start using this medication and while you are using it. Keep all medical and lab appointments.

Tell your doctor right away if you develop symptoms of low sodium in the blood, such as nausea, vomiting, headache, muscle weakness/cramps, unusual tiredness, unusual drowsiness, dizziness, restlessness, mental/mood changes including confusion/irritability.

Get medical help right away if you have any very serious side effects, including seizure or trouble breathing.

… Show More

Uses

Desmopressin is used to control the amount of urine your kidneys make. Normally, the amount of urine you make is controlled by a certain substance in the body called vasopressin. In people who have “water diabetes” (diabetes insipidus) or certain kinds of head injury or brain surgery, the body does not make enough vasopressin. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. This medication helps to control increased thirst and too much urination due to these conditions, and helps prevent dehydration.Desmopressin is also used to control nighttime bedwetting in children. It reduces how often your child urinates and decreases the number of bedwetting episodes.

How to use Desmopressin ACETATE

For the treatment of diabetes insipidus, take this medication by mouth, usually 2 to 3 times a day or as directed by your doctor.

For the treatment of bedwetting, take this medication by mouth, usually once a day at bedtime. Children should limit the fluids they drink after dinner, especially 1 hour before the desmopressin dose until the next morning, or at least 8 hours after the dose. If your child wakes up during the night, limit the amount that your child drinks.

All patients taking desmopressin, especially children and older adults, must limit drinking of water and other fluids. Consult your doctor for details. If you find that you are drinking more fluids than directed, tell your doctor right away. Your treatment will need to be adjusted.

Dosage is based on your medical condition and response to treatment. Do not take more desmopressin or take it more often than prescribed.

Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Tell your doctor if your condition does not improve or if this medication stops working well.

Side Effects

See also Warning section.

Headache, nausea, upset stomach, or flushing of the face may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking desmopressin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, high blood pressure, heart problems (such as blocked blood vessels, heart failure), conditions that may increase your risk of fluid/mineral imbalance (such as cystic fibrosis), the urge to drink too much water without being thirsty, a low level of sodium in the blood (hyponatremia), bleeding/clotting problems.

If you become dehydrated, your doctor will correct that condition first before starting treatment with desmopressin.

Limit alcohol because it can interfere with how well desmopressin works.

Tell the doctor right away if you develop any illness that can cause water/mineral imbalance (including fever, diarrhea, vomiting, infections such as the flu) or if you experience conditions that require drinking more fluids (for example, exposure to very hot weather, strenuous exercise, heavy sweating). The doctor may need to stop or adjust desmopressin treatment, especially in children and older adults.

Children may be more sensitive to the side effects of this drug, especially water/mineral imbalance and a low level of sodium in the blood.

Older adults may be at greater risk for water/mineral imbalance and a low level of sodium in the blood while using this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: tolvaptan, “water pills”/diuretics (such as furosemide).

Does Desmopressin ACETATE interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: headache that is severe or doesn’t go away, confusion, drowsiness, sudden weight gain.

Do not share this medication with others.

Lab and/or medical tests (such as urine tests, sodium blood level) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you take 1 dose daily and miss a dose, take it as soon as you remember. If you do not remember until the next day, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

If you take more than 1 dose daily and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

desmopressin 0.2 mg tablet

Color: whiteShape: roundImprint: APO DES 0.2

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: roundImprint: APO DES 0. 1

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.2 mg tablet

Color: whiteShape: ovalImprint: WPI 22 26

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: ovalImprint: WPI 22 25

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.2 mg tablet

Color: whiteShape: roundImprint: A 19

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: ovalImprint: A 18

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.2 mg tablet

Color: whiteShape: roundImprint: I

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: ovalImprint: S

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0. 2″.

desmopressin 0.2 mg tablet

Color: whiteShape: roundImprint: HP 319

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: roundImprint: HP 318

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.2 mg tablet

Color: whiteShape: roundImprint: 0.2

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: ovalImprint: 0.1

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

desmopressin 0.1 mg tablet

Color: whiteShape: ovalImprint: WPI 22 25

This medicine is a white, round, scored, tablet imprinted with “APO” and “DES 0.2”.

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Drug Survey

Are you currently using Desmopressin ACETATE?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Vasopressin – instructions for use

Vasopressin

Instruction:

• Pharmacological action
• Pharmacodynamics
• Pharmacokinetics
• Readings
• Contraindications
• Pregnancy and breastfeeding
• Dosage and Administration
• Side effects
• Overdose
• Interaction
• Special instructions
• Classification

Pharmacological action

Vasopressin has antidiuretic and vasopressor effects.

Pharmacodynamics

Vasopressin interacts with V- and Vi-receptors, which are located on vascular smooth muscle cells, thus regulating vasoconstriction. There is an increase in the permeability of the epithelium of the collecting duct for water located in the kidneys and an increase in the process of fluid reabsorption. The substance causes an increase in the volume of blood circulating in the body, hyponatremia and a decrease in osmolarity.

Vasopressin is able to increase the tone of the smooth muscles of internal organs, in particular the gastrointestinal tract, by interacting with V1a receptors. This leads to an increase in vascular tone and an increase in peripheral vascular resistance. Blood pressure rises (the medicine narrows the arterioles). Vasopressin has a hemostatic effect, spasms small vessels and capillaries, affects the von Willebrand coagulation factor, and stimulates platelet aggregation.

Vasopressin also affects the central nervous system, takes part in the regulation of aggression and the process of memorization. Studies have been conducted on the use of vasopressin in mice – prairie voles. In the course of these studies, by acting on vasopressin receptors in the brains of animals, mice were able to be made monogamous, faithful to one partner. Thus, it was possible to prove that vasopressin (its AVPR1A) is responsible for the social behavior of animals, finding a partner and the formation of a paternal instinct in males.

Synthetic hormone preparations are administered parenterally.

Pharmacokinetics

With injection or intranasal administration of vasopressin, the half-life (T _½ ) is about 20 minutes. The metabolism of vasopressin occurs in the tissues of the liver and kidneys, where disulfide bonds are restored and further cleavage of peptides occurs. A small amount of vasopressin is excreted unchanged in the urine.

Indications

Prevention and treatment of central diabetes insipidus. Differential diagnosis of central and nephrogenic diabetes insipidus. Gastrointestinal bleeding, in particular bleeding from varicose veins of the esophagus.

Contraindications

• Hypersensitivity to vasopressin;
• coronary circulation disorders, peripheral vascular diseases;
• ischemic heart disease;
• for intranasal use – rhinitis, sinusitis.

Pregnancy and lactation

Use in pregnancy

FDA fetal category C.

There are no adequate and well-controlled studies on the use of vasopressin in pregnant women.

Vasopressin is not absorbed into the systemic circulation.

Contraindicated in pregnancy.

Use during breastfeeding

Special studies on the possibility of using vasopressin during breastfeeding have not been conducted.

Breast-feeding should be discontinued during treatment.

Dosage and administration

Diabetes insipidus

Intramuscularly, subcutaneously.

Children: 2.5–5 units 2–4 times daily.

Adults: 5-10 units 2-4 times daily.

In the nose: a swab moistened with a solution of the drug is placed, or an inhaler is used, the dose is selected individually.

Gastrointestinal bleeding, children and adults, IV infusion: Initial infusion rate 0.1–0.4 U/min, gradually increased to 0.9 U/min if necessary.

Side effects

Headache, dizziness, nausea; pain and inflammation at the injection site; abdominal cramps; allergic skin rashes, itching, urticaria.

Rarely, when using large doses, there may be: ischemia, ventricular arrhythmia, myocardial or intestinal infarction; cardiac arrest, skin necrosis.

Overdose

Symptoms

Intoxication, agitation, confusion and headaches, convulsions, hyponatremia, coma, lowering blood pressure, abdominal pain, vomiting.

Treatment

Symptomatic therapy.

Interactions

Chlorpropamide, carbamazepine and clofibrate increase the effect of vasopressin.

Special instructions

During treatment, it is recommended to limit fluid intake.

Classification

• ATX

  H01BA01

• Pharmacological group

  Hormones of the hypothalamus, pituitary gland, gonadotropins and their antagonists

• FDA pregnancy category

  C
  (risk not excluded)

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Learn more about the active substance Vasopressin:

• INN
• Reviews
• Questions
• Latin name
• Chemical formula

Information about the active substance Vasopressin is intended for medical and pharmaceutical professionals, for reference purposes only.