D-Void

D-Void is a drug that is prescribed to both adults and children. The second name of the drug is Desmopressin. Let's consider who and when should take D-Void, the specifics of prescribing the drug, precautions and interactions with other drugs.

D-Void or Desmopressin is a synthetic drug that acts as an analogue of vasopressin. The drug has a high antidiuretic effect. It has a direct effect on blood vessels and their smooth muscles, as well as on internal organs.

D-Void is a drug that helps cure many diseases, both in adults and in small patients. Remember that the drug should be prescribed by a doctor, do not self-medicate.

Indications D-Void

Indications for use are controlled by the attending physician. Before giving indications for use, the doctor must fully examine and accurately diagnose the disease.

Prescribed for:

• Treatment of diabetes insipidus in children and adults.
• To conduct testing for concentration characteristics of the kidneys.
• Treatment of nocturnal enuresis (incontinence) in children over six years of age.
• Treatment of polyuria and polydipsia in the postoperative period.
• Treatment of swelling of the nasal mucosa, as well as severe rhinitis.

When administered intravenously, D-Void is prescribed for:

• Treatment of von Willebrand disease.
• Treatment of hemophilia A of the first forms of severity.

To avoid overloading the body when using the drug D-Vodid, special monitoring is required for such groups of patients as: the elderly, adolescents and young children, as well as patients who are at risk of increased intracranial pressure, impaired renal function, electrolyte and water imbalance, bladder fibrosis and cardiovascular disease.

If D-Void is used as a diagnostic tool and for repeated dosing, there is no need to perform forced hydration. The patient must maintain the body's water balance independently. If the drug is taken by children under one year of age to study the concentration capacity of the kidneys, then the drug should be taken only under the supervision of a doctor and during inpatient treatment.

Release form

• Nasal metered dose spray
• Nasal drops
• Tablets of 0.1 mg and 0.2 mg

The tablets are white round capsules with a score line on one side and the first letter of the drug name on the other. One tablet contains desmopressin acetate - 100 mcg, and the excipients are: povidone K30 - 2 mg, lactose monohydrate - 120 mg, magnesium stearate - 1 mg and potato starch - 76.9 mg. The tablets are available in packages of 20, 30 and 90 pieces in polyethylene containers and cardboard packages.

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Pharmacodynamics

Pharmacodynamics of the drug as a structural analogue of the natural hormone in the human body - arginine-vasopressin. D-Void is obtained as a result of changes in the structure of vasopressin molecules, i.e. deamination of 1 cysteine and its replacement with 8-L arginine and 8-D arginine.

The therapeutic effect is achieved due to a significant increase in epithelial permeability and increased reabsorption. D-Void helps reduce the volume of urine excreted by the body and increases its osmolarity, while reducing the osmolarity in the blood plasma. The result of D-Void pharmacodynamics is a decrease in the frequency of urination, normalization of night diuresis. Please note that the therapeutic effects begin to manifest themselves within the first hour and last from 8 to 12 hours.

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Pharmacokinetics

Pharmacokinetics allows us to learn about all stages of chemical transformations of the drug in the human body. Thus, intranasal use of D-Void is about 10%. While the absorption of D-Void with intranasal use is not complete, but fast.

There is also a significant concentration of the drug in the blood plasma. As a rule, the increase occurs 30 minutes after administration and reaches its maximum after an hour and depends entirely on the dose of the drug administered.

The volume of distribution of D-Void is up to 0.3 l/kg. D-Void does not penetrate the blood-brain barrier. After intranasal administration, the half-life of the drug is up to 5 hours, but an insignificant amount of D-Void is metabolized in the liver.

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Dosing and administration

The method of application and dosage of the drug depend on the purposes for which the drug is taken. Let's consider the main diseases that D-Void helps to fight and the methods of application and dosage of the drug.

• Diabetes insipidus – adults 10-20 mcg 2 times a day, in some cases the dose is selected individually. Children – 20 mcg 2 times a day, but if during the drug the above-described symptoms of overdose are noticed, then the use of the drug should be stopped.
• Primary nocturnal enuresis - up to 40 mcg, but the exact dose is selected individually by the doctor. In this case, the course of treatment should be at least three months.
• Tests for renal concentrating capacity - for adults 40 mcg, for infants 10 mcg, for children over one year 20 mcg.
  

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Use D-Void during pregnancy

Use during pregnancy has not been thoroughly studied. There have been no studies yet that would prove the safety of using the drug during pregnancy or lactation. Before using D-Void during pregnancy, it is necessary to soberly weigh all the pros and cons and realistically assess the possible risk of the drug for the future baby and the body of the pregnant woman.

The use of D-Void during pregnancy requires special caution. Thus, according to studies, the small amount of the drug that enters the baby's body with breast milk is much smaller than the amount that can affect diuresis.

Contraindications

Contraindications for use are based on individual intolerance to the components of the drug. And also in case of:

• Congenital or psychogenic polydipsia
• Fluid retention of any etiology
• Anurea and plasma hypoosmolality
• Hypersensitivity to the drug and heart failure.

Contraindications to the use of D-Void also exist in cases of renal failure, electrolyte and water imbalance, possible risk of increased intracranial pressure, bladder fibrosis. As well as during pregnancy and when prescribed to children under one year of age. Also, D-Void should be taken with special caution by patients with bronchial asthma, cardiovascular diseases, migraines and epilepsy.

D-Void is contraindicated for use by patients who are at risk. But if the drug is prescribed, then full control of the treatment period and use of the drug is necessary. The risk group includes: elderly patients over 65 years old, as there is a risk of side effects. When using D-Void, it is necessary to determine the concentration of sodium in the blood plasma, every three days after the start of taking the drug, and also monitor the treatment process.

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Side effects D-Void

Side effects of D-Void may be caused by individual intolerance to the components of the drug. Side effects:

• Dizziness, coma, headache, impaired consciousness.
• Vomiting, intestinal colic, nausea.
• Arterial hypotension.
• Swelling of the nasal mucosa and rhinitis.
• Oliguria.
• Hyponatrmemia, weight gain, water retention, hypomolality.
• Conjunctivitis, lacrimation disorders.
• Algomenorrhea.
• Allergic reactions, skin dermatitis, rash, itching.

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Overdose

Overdose can cause fluid retention, neurological and psychiatric symptoms, seizures, and hyponatremia and hypoosmolarity.

The first thing to do in case of an overdose is to stop taking the medicine. It is also recommended to limit fluid intake, in particularly severe cases to perform a slow infusion of furosemide and concentrated saline solutions.

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Interactions with other drugs

Interactions of D-Void with other drugs can cause an allergic reaction, complex irreversible symptoms and negate all treatment. Let's consider how D-Void interacts with other drugs.

• When used with selective inhibitors and tricyclic antidepressants, a syndrome of inappropriate hormone secretion, especially antidiuretic hormone, may occur. There is also a risk of fluid retention and hyponatremia.
• When used with anti-inflammatory drugs, there is a high risk of various kinds of side effects.

• When used with loperamide or desmopressins, a threefold increase in the latter in plasma may occur. Which in turn will cause fluid retention in the body and gynonatremia. Interactions of D-Void with drugs that slow peristalsis can cause similar side effects.

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Storage conditions

Storage conditions for D-Void must fully comply with the manufacturer's requirements. The medicine must be kept in a place protected from children, at a temperature of 15–25 °C.

The drug should also be protected from direct sunlight and freezing. The bottle with the drug should be in a vertical position.

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Shelf life

The shelf life of D-Void is set by the manufacturer and is 24 months. The medicine is packaged in 50 doses of 5 ml each, in a bottle with a dispenser. Each bottle is in a cardboard box.

As soon as the medicine begins to change its color or consistency, it must be disposed of. Since this is a sign that D-Void has lost its medicinal properties due to an expired shelf life or improper storage conditions.

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