Beclomethasone
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Desmopressin
Synthetic vasopressin (V2) analogue (antidiuretic) · Hemostatic
Also known as Desmopressin acetate
START
Central DI: intranasal 10 mcg or oral 0.1 mg, titrate to urine output/sodium; enuresis 0.2 mg PO nocte + fluid restriction
TYPICAL MAX
Enuresis 0.4 mg/day; DI titrate to response
STOP IF
Hyponatraemia/symptoms, fluid overload, intercurrent illness with fluid disturbance (temporarily stop enuresis use)
WATCH
Serum sodium (baseline + during titration, illness), strict fluid restriction (enuresis/nocturia), avoid excess water intake
CDSCO approvedSchedule HATC H01BA02
KDIGO 2024 + manufacturer label
- ONSET
- 1h · antidiuretic onset
- PEAK
- 1.5h · peak effect
- t½
- 3h · plasma t½
- DURATION
- 8h · antidiuretic duration
EXCRETION
Peptidase; renal
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
May be used for diabetes insipidus in pregnancy (resistant to placental vasopressinase) — generally considered acceptable
FDA category + note
Top interactionssee all 12 →
- BeclomethasoneSevereDatabaseDDInter
- BetamethasoneSevereDatabaseDDInter
- BudesonideSevereDatabaseDDInter
- BumetanideSevereDatabaseDDInter
Available in India
10 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Selective V2-receptor agonist increasing renal water reabsorption (antidiuresis) without significant V1 pressor effect; also releases von Willebrand factor and factor VIII from endothelium (haemostatic).
Indications
Central (cranial) diabetes insipidusPrimary nocturnal enuresis (selected, with fluid restriction)Nocturia in adultsMild haemophilia A and von Willebrand disease (type 1) — bleeding prophylaxis/treatment
Dosing
- Adult
- Central DI: intranasal 10–40 mcg/day (1–4 sprays, divided) or oral 0.1–0.8 mg/day divided; injection 1–4 mcg/day. Nocturnal enuresis: 0.2 mg PO at bedtime (max 0.4 mg) with fluid restriction. Haemostasis: 0.3 mcg/kg IV/SC.
- Pediatric
- Enuresis ≥5 years: 0.2 mg PO nocte (max 0.4 mg); DI weight-based (specialist).
- Renal adjustment
- Contraindicated for enuresis/nocturia if CrCl <50; DI use with caution/monitoring.
- Hepatic adjustment
- No specific adjustment.
- Geriatric
- High hyponatraemia risk — avoid for nocturia unless sodium monitored; lowest dose.
- Max dose
- Enuresis 0.4 mg/day PO; DI titrated to response (intranasal ≤40 mcg/day typical)
Pharmacokinetics
Onset
Antidiuresis ~1 h; haemostatic factor rise ~30–60 min
Peak effect
~1–2 h
Duration
Antidiuresis 6–14 h (route-dependent); haemostatic ~6 h
Half-life
~3 h (intranasal/IV terminal ~2.8 h)
Bioavailability
Intranasal ~3–5%; oral ~0.1–0.2% (very low — hence mg oral vs mcg parenteral)
Protein binding
Low
Metabolism
Limited; peptidase
Excretion
Renal
Contraindications
- Hyponatraemia or history of hyponatraemia
- Moderate–severe renal impairment (CrCl <50 mL/min — enuresis/nocturia)
- SIADH; habitual/psychogenic polydipsia
- Heart failure / conditions needing diuretics
- Hypersensitivity to desmopressin
Side effects
Common
HeadacheNauseaNasal congestion/irritation (intranasal)Facial flushingMild abdominal cramps
Serious
- Severe hyponatraemia → seizures, cerebral oedema, death (esp. excess fluid intake, elderly, children)
- Water intoxication
- Thrombotic events (rare, haemostatic use in at-risk patients)
- Hypertension/anginal exacerbation (rare)
Pregnancy & lactation
Pregnancy
May be used for diabetes insipidus in pregnancy (resistant to placental vasopressinase) — generally considered acceptable
Lactation
Compatible — minimal milk transfer/oral infant absorption
Drug interactions
Betamethasone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Budesonide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bumetanide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ciclesonide
Severe
Database
Clinical effect not specified
Source: DDInter
Deflazacort
Severe
Database
Clinical effect not specified
Source: DDInter
Dexamethasone
Severe
Database
.
Source: DDInter
Drugs Causing Hyponatraemia
Severe
Database
Additive water retention → severe hyponatraemia
Avoid/monitor sodium closely; counsel fluid restriction
Source: Kimi deep-research + Cla
Etacrynic Acid
Severe
Database
Clinical effect not specified
Source: DDInter
Fludrocortisone
Severe
Database
Clinical effect not specified
Source: DDInter
Flunisolide
Severe
Database
Clinical effect not specified
Source: DDInter
Fluticasone
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Fluid and electrolyte management in diabetes
RSSDI · Endocrinology · 2025
Diabetes management in chronic kidney disease
KDIGO · Nephrology · 2022
Primary prevention of cardiovascular disease
AHA · Cardiology · 2019
Diabetes management during Ramadan
ADA · Endocrinology · 2025
Vaccination in adults with diabetes
RSSDI · Endocrinology · 2024
Ask House about Desmopressin
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19