H-desmopressin spray 10

The drug, which is a synthetic analogue of vasopressin, is available as a convenient nasal spray. 

[1], [2], [3], [4], [5], [6]

Indications H-desmopressin spray 10

H-desmopressin spray is used in the complex therapy of nonspecific diabetes insipidus - a disease in which there is a disruption of water reabsorption in the renal tubules, pathologically large volumes of fluid are excreted from the body through the bladder.

It can also be used as an additional drug for urinary incontinence in children and adults, with residual polyuria due to surgical treatment of the pituitary gland, with the syndrome of an isolated pituitary gland. H-desmopressin spray is used in the diagnosis of functional disorders of the kidneys.

Indication for the use of H-desmopressin spray may be stopping nasal bleeding in patients with uncomplicated form of hemophilia A. This effect is achieved due to the fibrinolytic properties of the drug. 

[7], [8],

Release form

Composition: Desmopressin acetate 0.1 mg / ml, isotonic sodium chloride aqueous solution, benzalkonium chloride (preservative), citric acid, sodium phosphate and purified water.

H-desmopressin spray is an individual dosed 0.01% spray for the nasal cavity. Produced in two volumes: 2.5 ml and 5 ml (respectively, 25 and 50 doses, 10 μg desmopressin acetate per dose). A flask with a dispensing cap-dropper and an adapter.

[9]

Pharmacodynamics

H-desmopressin spray (I-diamine-8D-arginine-vasopressin), a synthetic derivative of antidiuretic hormone (ADH).

Strengthens the permeability of the tissues of the renal tubules and restores the function of the reverse absorption of water. Has the property of activating the process of blood clotting in patients with hereditary hemophilia. Has an insignificant effect on the smooth muscles of the vascular wall and abdominal organs. It increases the osmotic pressure of the blood plasma, which leads to a reduction in the amount of urge to urinate and to stop the problem of lack of fluid in the body. 

[10], [11], [12], [13]

Pharmacokinetics

When using H-desmopressin spray in the nasal cavity, about 25% desmopressin acetate is adsorbed, the antidiuretic effect is manifested and increases for 1 hour and lasts up to 20 hours, the maximum concentration of the drug in the blood is observed within the first five hours after application.

Receiving the tablet form of H-desmopressin allows to achieve the effect as quickly, but the duration of the drug is reduced to 8 hours. At oral intake, only 5% of the drug substance is absorbed, since H-desmopressin decomposes under the influence of gastric juice enzymes. Therefore, sublingual administration of the tablet form of the drug is recommended, or, more appropriately, the use of H-desmopressin spray.

[14], [15], [16]

Dosing and administration

There are two main methods of using desmopressin: intranasal and tableted.

 H-desmopressin spray is used in strictly individual dosages as prescribed by the doctor. One drop of the drug contains 5 μg of active substance. The usual dosage is 1-4 drops of 0.1% desmopressin acetate solution intranasally for every 12 hours. In severe forms of the disease, every 8 hours is possible.

 For the treatment of primary enuresis, use 1 drop just before bedtime.

We apply H-desmopressin spray and in the study of the concentration function of the kidneys: children are prescribed 1 drop, and adults - 2 drops once. 

[20], [21], [22]

Use H-desmopressin spray 10 during pregnancy

There is no scientifically confirmed information on the use of H-desmopressin spray during pregnancy and during lactation.

Specialized clinical studies on the use of this drug have not been conducted, the presence of teratogenic effect is not proven.

At the moment there are more than 50 cases of H-desmopressin spray application in pregnant women: no harm was found to the fetus and the expectant mother.

Usual dosages that do not exceed the norm do not penetrate the placental barrier. Examinations of reproductive capacity in rabbits and rats did not reveal pathological abnormalities in the fetuses against the background of the use of H-desmopressin spray.

In any case, the administration of the drug should be prescribed and monitored by the doctor, determining the possible degree of risk to the woman and her future child. 

Contraindications

Obvious contraindications to the use of H-desmopressin spray are heart failure (especially in the stage of decompensation), coronary heart disease, severe hypertension, heart rhythm disturbances, epilepsy, complete anuria.

Precautions are recommended when using edemas of various etiologies, hypersensitivity to ADH analogues, as well as in the treatment of elderly people and children.

It should be noted that in patients with various forms of rhinitis, the absorption of the drug substance may be impaired. In such cases, sublingual administration is recommended. 

Side effects H-desmopressin spray 10

Like any other drug, H-desmopressin spray may have some side effects on the body, although they are rarely seen and usually disappear after drug withdrawal or dosage reduction.

 Possible side effects of the cardiovascular system:

• hypertension;
• falling heart rate;
• signs of heart failure - chest pain, dyspnea, cyanosis.

 From the digestive system:

• nausea, eructation;
• hypofunction of the salivary glands;
• pain in the stomach and intestines;
• increased peristalsis, spasms.

 From the central nervous system:

• a headache of a different nature;
• dizziness.

 There may also occur rhinitis, conjunctivitis, redness of the skin, allergic reactions.

 If side effects occur, stop taking the medication and consult a doctor immediately.

[17], [18], [19],

Overdose

Conducting a survey of the concentration function of the kidneys in infants should be conducted exclusively in specialized clinics due to the high risk of overdose of H-desmopressin spray.

When using the drug in quantities exceeding 800 μg, it is necessary to control the osmotic pressure and water balance, especially in childhood and adolescence, in order to prevent hyperhydration of the body, as well as control of diuresis, blood pressure and heart rate. For elderly patients, especially those with severe metabolic disorders, there is a danger of increased intracranial pressure due to improperly selected dosages.

[23], [24]

Interactions with other drugs

The effect of constriction of the lumen of the blood vessels and the stimulating effect on the tone of the uterus are enhanced when combined with methylergometrin and oxytocin. The simultaneous use of H-desmopressin spray and cardiac drugs that reduce the number of heartbeats can cause serious bradycardia.

The interaction of H-desmopressin spray with indomethacin, chlorpramide, clofibrate enhances the antidiuretic effect of desmopressin, and carbamazepine and glybutide on the contrary oppress it.

H-desmopressin spray accelerates the effect of other drugs that increase blood pressure. 

[25]

Storage conditions

The most suitable storage conditions for H-desmopressin spray are in a dry, dry, cool place, for example in a refrigerator. Storage temperature from +2 to +10 C. Categorically not subject to freezing!

When stored at room temperature, the drug should be used within a month. Be sure to hide drugs in places that are inaccessible to children.

[26], [27]

Shelf life

Shelf Life H-desmopressin spray 2 years from the date of release, subject to the necessary storage conditions. At a storage temperature of + 25C, the drug is suitable for 1 month.

Do not use H-desmopressin spray after the expiration date.

[28], [29]