DDAVP Spray (desmopressin acetate) is a high-purity synthetic analogue of vasopressin, specifically engineered for the management of central diabetes insipidus and selected bleeding disorders. As a nasal spray formulation, it offers precise, non-invasive delivery directly through the nasal mucosa, ensuring rapid systemic absorption and consistent therapeutic effect. Its targeted mechanism of action reduces urine output, alleviates profound thirst, and restores fluid-electrolyte balance with a well-established safety profile. This product represents a cornerstone of endocrine therapy, providing predictable control where endogenous antidiuretic hormone is deficient or dysregulated.

Features

• Contains desmopressin acetate, a synthetic vasopressin analogue with enhanced antidiuretic potency and prolonged duration
• Nasal spray delivery system for direct absorption via nasal mucosa, bypassing gastrointestinal degradation
• Precisely calibrated metered-dose pump (10 mcg per spray) ensuring consistent dosing
• Clear dosage indicator and ergonomic design for ease of use, particularly in patients with dexterity limitations
• Stable at room temperature after initial use; does not require refrigeration
• Manufactured under strict pharmaceutical standards to ensure sterility, purity, and batch-to-batch consistency

Benefits

• Effectively reduces excessive urination and unrelenting thirst associated with central diabetes insipidus
• Helps maintain normal plasma osmolality and sodium levels, preventing dangerous electrolyte imbalances
• Non-invasive administration improves patient compliance compared to injectable alternatives
• Rapid onset of action with effects lasting between 8 to 12 hours, allowing for flexible dosing schedules
• Minimizes risk of water intoxication through dose-dependent antidiuretic effect when used as directed
• Provides reliable hemostatic control in mild to moderate hemophilia A and von Willebrand disease (Type I)

Common use

DDAVP Spray is primarily indicated for the management of central (cranial) diabetes insipidus, a condition characterized by the inability to concentrate urine due to deficient antidiuretic hormone (ADH) secretion. It is also used perioperatively or in emergency settings to control bleeding in patients with mild hemophilia A or Type I von Willebrand disease. Off-label uses may include managing nocturnal enuresis in specific pediatric cases or polyuria-polydipsia syndrome post-pituitary surgery, though these require careful specialist supervision.

Dosage and direction

Dosage must be individualized based on patient response, urine output, and serum sodium levels. For diabetes insipidus: adults typically start with 0.1 mL (10 mcg) once or twice daily, titrated to achieve desired antidiuretic effect. Pediatric dosing is weight-based and requires careful monitoring. Administer by inserting tip gently into nostril, pressing firmly on pump to deliver spray while breathing normally. Avoid deep inhalation. Prime pump before first use by pressing several times until a fine mist appears. Alternate nostrils if dosing more than once daily to minimize mucosal irritation.

Precautions

Monitor serum sodium levels regularly, especially in elderly patients, those with low serum sodium, or patients with conditions predisposing to fluid retention. Use caution in patients with hypertension, cardiovascular disease, or cystic fibrosis due to potential fluid overload risks. Avoid overhydration; advise patients to limit fluid intake to thirst-guided consumption only. Nasal pathology such as rhinitis, nasal polyps, or mucosal atrophy may impair absorption—consider alternative formulations if present. Not recommended during pregnancy unless clearly needed; limited data suggest low fetal risk but requires benefit-risk assessment.

Contraindications

Hypersensitivity to desmopressin acetate or any component of the formulation. Patients with moderate to severe renal impairment (CrCl <50 mL/min). Hyponatremia or history of hyponatremia. Patients with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Congestive heart failure or uncontrolled hypertension. Use with extreme caution (if at all) in patients prone to thrombus formation.

Possible side effects

• Headache (most common, usually transient)
• Mild nasal congestion, irritation, or epistaxis
• Nausea or abdominal cramps
• Hyponatremia (with excessive fluid intake or overdose)
• Flushing or mild increase in blood pressure
• Rarely: allergic reactions, thrombotic events (particularly in predisposed patients)

Drug interaction

Concomitant use with loop diuretics (e.g., furosemide) or glucocorticoids may increase risk of water retention and hyponatremia. NSAIDs may potentiate antidiuretic effect and increase hyponatremia risk. Tricyclic antidepressants, SSRIs, and carbamazepine can enhance ADH effect. Use cautiously with other pressor agents due to potential additive hypertensive effects. Monitor patients on lithium (can cause nephrogenic DI) closely if switching to DDAVP.

Missed dose

If a dose is missed, administer as soon as remembered unless it is nearly time for the next dose. Do not double the dose. For twice-daily regimens, if missed for more than 3 hours, skip and resume at next scheduled time. Adjust fluid intake accordingly and monitor for polyuria. Maintain a dosing diary to track adherence and response.

Overdose

Symptoms include headache, nausea, vomiting, hyponatremia (confusion, drowsiness, seizures), and weight gain due to water retention. In severe cases, cerebral edema may occur. Treatment involves discontinuation of DDAVP, fluid restriction, and symptomatic management. Severe hyponatremia may require hypertonic saline infusion under hospital supervision. Dialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (20–25°C/68–77°F). Keep spray upright. Do not freeze. After initial priming, use within 30 days. Keep cap tightly closed when not in use. Protect from light and excessive humidity. Do not expose to temperatures above 40°C (104°F). Keep out of reach of children.

Disclaimer

This information is for educational purposes and does not replace professional medical advice. Diagnosis and treatment should be determined by a qualified healthcare provider. Dosage and indications may vary based on individual patient factors and regional prescribing guidelines. Always refer to the local approved prescribing information.

Reviews

“DDAVP Spray transformed my management of post-operative diabetes insipidus. The dosing is consistent, and patients appreciate the non-invasive route.” – Endocrinologist, 12 years of use
“Reliable and predictable. The metered spray reduces dosing errors compared to the nasal tube.” – Pediatric Nephrologist
“Essential in our hemophilia clinic for minor procedures. Rapid onset and easy administration.” – Hematology Specialist
“Some elderly patients developed hyponatremia; requires vigilant monitoring but effective when managed correctly.” – Geriatrician
“Superior patient compliance over tablets in children with cranial DI.” – Pediatric Endocrinologist