Center straight pubis. Examination of kidney urinary ductility. Ensuring haemostasis in cases of minor surgical procedures and before performing invasive diagnostics in patients with mild haemophilia A and a mild form of von Willebrand disease, in whom a positive effect of the preparation after the test dose was obtained. In exceptional cases, the preparation can be used in patients with moderate forms of von Willebrand's disease.
Composition:
1 ml of solution contains 4 μg of desmopressin acetate.
Action:
Synthetic analog of vasopressin. Desmopressin does not contain oxytocin and other ballast proteins - impurities that occur when natural vasopressin is obtained. It has a much stronger and longer anti-diuretic action as well as minimal (100 times weaker than vasopressin) vasoconstriction. Desmopressin 0.3 μg / kg m.c. When given intravenously, it causes a 2-4-fold increase in the activity of coagulation factor VIII (VIII C), to a lesser extent an increase in von Willebrand factor antigen (vWF-Ag) and the release of tissue plasminogen activator (t-PA). At higher doses, desmopressin shortens or normalizes clotting time in patients with prolonged coagulation time in the course of uremia, cirrhosis, congenital or drug-induced platelet damage, and in patients with coagulation disorders of unknown aetiology. The hemostatic effect occurs approximately 30 minutes after the first intravenous administration and persists for 8-12 hours. Desmopressin is excreted in breast milk.
Contraindications:
Hypersensitivity to the components of the preparation. Habitual or psychogenic polydipsia, as a result of which the volume of urine produced exceeds 40 ml / kg m / day. Cardiovascular failure or other diseases that require diuretics. Unstable coronary disease in an interview. Hyponatremia. Patients with von Willebrand type II B disease
Precautions:
Carefully use in very young patients, in the elderly, in conditions with water-electrolyte imbalance and in patients at risk of increased intracranial pressure. Examination of kidney densification of urine in children up to 12 m should only be performed in a hospital under control. Special precautions should be taken in patients with moderate and severe renal insufficiency (creatinine clearance <50 ml / min).
Pregnancy and lactation:
There are no relevant data on the use of the drug during pregnancy. From data obtained from a limited number of applications of the drug during pregnancy in women with central diabetes insipidus, there is no apparent adverse effect of desmopressin on pregnancy or on the health of the fetus. Caution should be exercised when prescribing to pregnant women. Use with caution during breastfeeding (studies of desmopressin in breast milk at high doses treated with desmopressin - 300 μg intranasally, showed that its concentration is insufficient to produce an antidiuretic effect in breastfed babies).
Side effects:
Common (≥1 / 100, <1/10): nausea, abdominal pain; at high doses, transient decreases in blood pressure with tachycardia and facial flushing during treatment; headache, tiredness at high doses. Rare (≥1 / 10,000, <1/1000): dizziness at high doses. Very rare (<1 / 10,000): hyponatremia. The use of desmopressin without the simultaneous reduction of fluid supply can cause fluid retention, hyponatremia and, in more serious cases, convulsions. After injection of desmopressin, injection site reactions, allergic skin reactions and generalized allergic reactions of high severity (including anaphylaxis) have been reported very rarely.
Dosage:
Center straight pubis (intravenously, in a drip infusion, possibly intramuscularly or subcutaneously): adults 1-4 μg (0.25-1 ml) per day in 1-2 doses; children over 12 years of age 0.1-1.0 μg (0.025-0.25 ml) daily in 1-2 doses, children up to 12 months of age (data on the treatment of this age group are limited), usually recommended starting dose of 0.05 μg (0.0125 ml), further doses depend on the amount of diuresis and serum electrolytes.Testing urine compacting capacity (intramuscularly or subcutaneously): adults 4 μg (1 ml) per day; children over 12 years of age 1-2 μg (0.25-0.5 ml) per day, children up to 12 months 0.4 μg (0.1 ml).Ensuring hemostasis (intravenous infusion): 0.3 μg / kg m.c. The preparation should be diluted in 50-100 ml of physiological saline and infused over 15-30 minutes. Desmopressin should be used for 30 minutes to prevent bleeding. before the planned surgery; the dose can be repeated once or twice with an interval of 6-12 hours.
(C)
