Desmopressin Disease Interactions

The use of desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min).

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Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

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Rare cases of thrombotic events (thrombosis, acute cerebrovascular thrombosis, and acute myocardial infarction) have been reported following desmopressin injection in patients predisposed to thrombus formation. Although a causal relationship has not been established, therapy with desmopressin should be administered cautiously in patients with a current or past history of thrombotic or thromboembolic disorders.

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The use of desmopressin, primarily in parenteral administration and/or in large doses, has been infrequently associated with changes in blood pressure, causing either slight elevations or transient decreases with a compensatory increase in heart rate. Therapy with desmopressin, regardless of route of administration, should be administered cautiously in patients with coronary artery insufficiency and/or hypertensive cardiovascular disease.

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