Apo-Desmopressin

(desmopressin tablet)

DIN (Drug Identification Number)

 

How does Apo-Desmopressin work? What will it do for me?

The tablet form of desmopressin belongs to the class of medications known as antidiuretics. It is a hormone taken by mouth to control excessive urination during the night (bedwetting). It is also used to treat central diabetes insipidus, a condition where the kidneys are unable to conserve water due to a lack of antidiuretic hormone (ADH). This condition causes frequent urination and thirst. This medication works by acting on the kidneys to reduce the amount of urine they produce. It usually starts to work within an hour and lasts for 7 to 9 hours.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

 

How should I use Apo-Desmopressin?

For controlling excessive urination at night, the usual starting dose for oral tablets (i.e., taken by mouth and swallowed) is 0.2 mg to be taken one hour before bedtime. The usual starting dose for sublingual tablets (tablets that are placed under the tongue) is 120 µg taken one hour before bedtime. Depending on your response to this medication, your doctor may increase the dose up to 0.4 mg at bedtime for tablets or 360 µg at bedtime for sublingual tablets over several weeks. You should limit your fluid intake for a few hours before taking this medication. In addition, you should limit the amount of alcohol and caffeine you consume during evening hours.

For central diabetes insipidus, the usual starting dose for oral tablets is 0.1 mg 3 times daily. The usual starting dose for sublingual tablets is 60 µg 3 times daily. Your doctor will then adjust the dose depending on your response to this medication.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you are taking this medication for controlling excessive urination at night and you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you are taking this medication for central diabetes insipidus and you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does Apo-Desmopressin come in?

0.1 mg
Each white to off-white, round shaped, flat-faced, bevelled-edge, tablet engraved “APO” on one side and scored and engraved “DES” over “0.1” on the other side contains 0.1 mg desmopressin acetate. Nonmedicinal ingredients: anhydrous lactose, corn starch, and magnesium stearate.

0.2 mg
Each white to off-white, round shaped, flat-faced, bevelled-edge, tablet engraved “APO” on one side and scored and engraved “DES” over “0.2” on the other side contains 0.2 mg desmopressin acetate (on the anhydrous basis). Nonmedicinal ingredients: anhydrous lactose, corn starch, and magnesium stearate.

 

Who should NOT take Apo-Desmopressin?

Desmopressin tablets should not be taken by anyone who:

• is allergic to desmopressin or to any of the ingredients of the medication
• has low blood sodium levels, severe liver disease, impaired kidney function, heart failure, or conditions leading to low sodium in the blood (e.g., bulimia, anoerxia nervosa, chronic vomiting, diarrhea, and adrenal impairment)
• has type IIB or platelet type (pseudo) von Willebrand’s disease

What side effects are possible with Apo-Desmopressin?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• flushing or redness of skin
• stomach cramps
• upset stomach (nausea)

Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• chills
• confusion
• drowsiness
• fast heartbeat
• headache (continuing)
• shortness of breath, tightness in chest, trouble breathing, or wheezing
• skin rash, hives, or itching

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Apo-Desmopressin?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Fluid and electrolyte balance: Fluid intake should be adjusted in order to reduce the possibility of water retention and low levels of sodium in the blood, especially for very young people and for seniors. People who are dehydrated should wait until their water balance has been adequately restored before taking desmopressin. Seniors should be closely observed for possible water retention and low sodium in the blood due to excessive fluid intake. Talk to your doctor about adjusting the amount of fluid intake that is right for you. For control of nighttime urination, a restricted fluid intake is recommended a few hours before using this medication.

Medical conditions: Desmopressin is not effective in controlling excessive urination caused by kidney disease, diabetes, psychosomatic conditions, low blood potassium, or high blood calcium. People with severe bladder or voiding problems, and those with cystic fibrosis, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Tolerance: There are reports of changes in response over time, usually when the medication has been used for periods longer than 6 months. Some people may experience decreased responsiveness, while others may experience a shortened duration of effect.

Pregnancy: This medication has been used during pregnancy with no harm reported. However, no controlled studies have been done on its use by pregnant women. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if desmopressin from desmopressin tablets passes into breast milk. If you are a breast-feeding mother and are taking desmopressin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

 

What other drugs could interact with Apo-Desmopressin?

There may be an interaction between desmopressin and any of the following:

• anti-inflammatory medications (e.g., celecoxib, ibuprofen, naproxen)
• carbamazepine
• chlorpromazine
• clofibrate
• demeclocycline
• diuretics or “water pills” (e.g., furosemide, hydrochlorothiazide)
• fludrocortisone
• lithium
• loperamide
• norepinephrine
• selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram)
• tricyclic antidepressants (e.g., amitriptyline, nortriptyline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.