Oral DDAVP is a good alternative therapy for patients with central diabetes insipidus: experience of five-year treatment.
We studied the efficacy and safety of oral 1-deamino-8-D-arginine-vasopressin (DDAVP) tablets in 9 patients, aged 17-36 years, with central diabetes insipidus (DI). The tablet contained 100 microg of desmopressin acetate. Maximum plasma concentration was obtained at 90 min after a single oral administration of 100 microg DDAVP with a mean plasma level of 14.7 +/- 5.4 (range: 5.3-50.9) pg/ml. The onset of action was observed 2 h after oral administration, while the maximum effect was obtained at 4 h. Mean urine volume in patients decreased significantly from 402 +/- 52 to 26 +/- 3 ml/hr and urine osmolality increased from 91 +/- 8 to 732 +/- 21 mosm/kg at 4 h after the intake of oral DDAVP. Plasma osmolality level and serum sodium concentration remained unchanged throughout the study. Long-term treatment for 5 years with oral DDAVP resulted in control of diuresis in 8 of the 9 patients. The average oral DDAVP dose required to obtain this control was 19 +/- 2 (range: 15-30) times more than that of prior intranasal treatment. No adverse effects were observed during this follow-up period. These results indicate that oral DDAVP is a safe therapeutic agent that may be a good alternative treatment of central DI, particularly in patients who have chronic rhinitis and visual disturbances.
Department of Medicine II, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
Izumi
I
Fukuda
Naomi
N
Hizuka
Kazue
K
Takano
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage* / Q000009:adverse effects; D020790:Diabetes Insipidus, Neurogenic / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D004231:Diuresis / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009994:Osmolar Concentration; D016896:Treatment Outcome
D003894:Deamino Arginine Vasopressin