Posterior Pituitary Hormones and Antagonists

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Posterior Pituitary Hormones

Specialist initiation (S1)

DESMOPRESSIN nasal spray

DESMOPRESSIN tablets

  • In patients taking desmopressin, measurement of plasma sodium at least twice a year and during intercurrent illness (especially vomiting and diarrhoea) guards against excessive water intake or loss.

Specialist use only (S2)

TERLIPRESSIN

Selective Vasopressin V2-Receptor Antagonist

Specialist use only (S2)

TOLVAPTAN tablets (Jinarc®)

  • Restrictions: To slow the progression of cyst development and renal insufficiency of autosomal dominant polycystic kidney disease (ADPKD) in adults with chronic kidney disease stage 1 to 3 at initiation of treatment with evidence of rapidly progressing disease.
  • Prescribing and monitoring of tolvaptan is via hospital only.
  • Tolvaptan (Samsca®) for the treatment of adult patients with hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) is not recommended for use in NHS Scotland by the SMC and is non-formulary.

Antidiuretic Hormone Antagonists

Specialist initiation (S1)

DEMECLOCYCLINE

  • Demeclocycline is indicated for chronic hyponatraemia associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) where fluid deprivation is unsuccessful.
  • Higher doses of demeclocycline may be associated with a decline in glomerular filtration. Creatinine should be monitored along with plasma sodium.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.