DESMOPRESSIN ACETATE

Primary nocturnal enuresis:

Children (from 5 years of age) and adults (up to 65 years of age) with normal urine concentrating ability who have primary nocturnal enuresis should take 200 micrograms at bedtime and only if needed should the dose be increased to 400 micrograms.

The need for continued treatment should be reassessed after 3 months by means of a period of at least 1 week without desmopressin tablets.

Treatment of diabetes insipidus:

Dosage is individual in diabetes insipidus but clinical experience has shown that the total daily dose normally lies in the range of 200 micrograms to 1200 micrograms. A suitable starting dose in adults and children is 100 micrograms three times daily.

This dosage regimen should then be adjusted in accordance with the patient's response. For the majority of patients, the maintenance dose is 100 micrograms to 200 micrograms three times daily.

Post-hypophysectomy polyuria/polydipsia:

The dose of desmopressin tablets should be controlled by measurement of urine osmolality.

Side effects include headache, stomach pain and nausea. Isolated cases of allergic skin reactions and more severe general allergic reactions have been reported. Very rare cases of emotional disorders including aggression in children have been reported.

Treatment with desmopressin without concomitant reduction of fluid intake may lead to water retention/hyponatraemia with accompanying symptoms of headache, nausea, vomiting, weight gain, decreased serum sodium and in serious cases, convulsions.

Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Care should be taken with patients who have reduced renal function and/or cardiovascular disease or cystic fibrosis. In chronic renal disease the antidiuretic effect of desmopressin tablets would be less than normal. When desmopressin tablets are used for the treatment of enuresis, fluid intake must be limited from 1 hour before taking the tablets at bedtime until the next morning and in any case for a minimum of 8 hours after administration.

Patients being treated for primary nocturnal enuresis should be warned to avoid ingesting water while swimming and to discontinue desmopressin tablets during an episode of vomiting and/or diarrhoea until their fluid balance is once again normal.

Precautions to prevent fluid overload must be taken in: - conditions characterised by fluid and/or electrolyte imbalance - patients at risk for increased intracranial pressure.

Lactose monohydrate:

Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Desmopressin tablets are contraindicated in cases of cardiac insufficiency and other conditions requiring treatment with diuretic agents. Before prescribing desmopressin tablets the diagnoses of psychogenic polydipsia and alcohol abuse should be excluded.

When used for the treatment of primary nocturnal enuresis, desmopressin tablets should be only be used in patients with normal blood pressure. Desmopressin should not be prescribed to patients over the age of 65 for the treatment of primary nocturnal enuresis.