Subcutaneous injection of desmopressin (DDAVP): evaluation of a new, more concentrated preparation.
A more concentrated desmopressin (DDAVP) preparation (40 micrograms/ml), which required small injection volumes (less than 1 ml), was studied in a double-blind trial in 10 healthy volunteers, 12 patients with haemophilia A, and 8 patients with uraemic bleeding. DDAVP was administered by subcutaneous injection at a dose of 0.4 micrograms/kg body weight. In healthy subjects, peak levels of DDAVP ranging from 480 to 638 pg/ml were reached 1 h after the subcutaneous injection and DDAVP was eliminated with a mean half-life of 3.1 h. DDAVP produced a 2.5-fold (3.0-fold) increase of factor VIII:C (factor VIII:Ag) and a 1.9-fold (2.2-fold) increase of von Willebrand factor:Ag (ristocetin cofactor) over baseline levels. Additionally, a 2.1-fold increase of tissue-type plasminogen activator antigen was observed. Factor VIII and von Willebrand factor were rapidly eliminated with a half-life ranging from 1.3 to 5.7 h and from 1.1 to 11.4 h, respectively. In haemophilia A patients, DDAVP produced a 2.3-fold increase of factor VIII:C 1 h after the injection. DDAVP was given on 8 occasions for management of bleeding, and only in 1 patient did a wound haematoma (after herniotomia) occur. In 7 of the 8 patients with uraemia the bleeding time shortened, and in all patients an increase of platelet retention and a decrease of platelet count was observed (p less than 0.05). No serious local or systemic untoward side effects were observed.
Köhler
M
M
Department of Clinical Haemostaseology and Transfusion Medicine, University of the Saarland, Homburg/Saar, FRG.
Hellstern
P
P
Tarrach
H
H
Bambauer
R
R
Wenzel
E
E
Jutzler
G A
GA
D000328:Adult; D000941:Antigens / Q000032:analysis; D001760:Bleeding Time; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000209:etiology; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D004341:Drug Evaluation; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006467:Hemophilia A / Q000188:drug therapy; D006579:Heterozygote; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D014511:Uremia / Q000150:complications; D014841:von Willebrand Factor / Q000032:analysis
D000941:Antigens; D014841:von Willebrand Factor; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin