How to care for any patient who takes desmopressin (DDAVP)

Desmopressin (or DDAVP) is used to treat arginine vasopressin deficiency (AVPD) (previously known as cranial diabetes insipidus (DI)). People with this condition cannot reabsorb all the water filtered from the blood by the kidneys so have very high urine outputs without treatment. DDAVP comes as a nasal spray, oral tablet, sub-lingual tablet or IM injection

People with AVPD can become dehydrated and develop hypernatraemia very quickly if they do not take their desmopressin as prescribed.

DDAVP comes as a nasal spray, oral tablet, sub-lingual tablet and IM injection

Management

Please ensure DDAVP is administered on time and DO NOT OMIT without endocrine advice. If the patient does not have their own DDAVP and it is not available on the ward, the oncall pharmacist should be contacted to source it.
Careful fluid balance monitoring is required, especially for patients with poor oral intake and/or confusion/reduced consciousness.
Please check U+Es daily or more frequently if the patient has poor oral intake/ confusion/ sodium is outwith the normal range.

Please Contact Endocrinology Urgently if:

Sodium level is outwith the normal range and the patient normally takes DDAVP
A patient who normally takes DDAVP is unable to take their DDAVP by their normal route
There is a concern regarding fluid balance or the patient’s clinical condition

Please Contact Endocrinology Within Working hours if:

You have any concerns or questions
The patient is unsure of how to manage their DDAVP
The patient DOES NOT have a TRAK alert regarding their DDAVP as they will need one instating.