Desmopressin lyophilisate for the treatment of central diabetes insipidus: first experience in very young infants.
BACKGROUND
In neonates and small infants, early diagnosis of central diabetes insipidus (CDI) and treatment with desmopressin in low doses (avoiding severe hypo- or hypernatremia) are important to prevent associated high morbidity and mortality in this particular age group.


METHODS
We described pharmacokinetic and pharmacodynamic results of the use of recently launched oral desmopressin lyophilisate (Minirin Melt®) in two infants with CDI, diagnosed at the age of 12 and 62 days, respectively. We observed that a starting dose of 60 μg of Minirin Melt® in the first case resulted in a pharmacokinetic profile largely exceeding the reference frame observed in children with nocturnal enuresis, while a dose of 15 μg in the second case resulted in acceptable concentrations. After initial dose adjustments, administration of sublingual lyophilisate resulted in rather stable serum sodium concentrations.


CONCLUSIONS
Using Minirin Melt® in infants with CDI appears to be effective, easy to use and well tolerated.
Department of Paediatric Endocrinology, University Hospital Ghent, Ghent, Belgium.
Kathleen
K
De Waele
Department of Paediatric Endocrinology, University Hospital Ghent, Ghent, Belgium.
Martine
M
Cools
Department of Pediatric Nephrology , University Hospital Ghent, Ghent, Belgium.
Ann
A
De Guchtenaere
Department of Pediatric Nephrology , University Hospital Ghent, Ghent, Belgium.
Johan
J
Van de Walle
Department of Pediatric Nephrology , University Hospital Ghent, Ghent, Belgium.
Ann
A
Raes
Department of Paediatric Endocrinology, University Hospital Ghent, Ghent, Belgium.
Sara
S
Van Aken
Department of Neonatology, University Hospital Ghent, Ghent, Belgium.
Kris
K
De Coen
Department of Neonatology, University Hospital Ghent, Ghent, Belgium.
Piet
P
Vanhaesebrouck
Department of Paediatric Endocrinology, University Hospital Ghent, Ghent, Belgium ; Department of Paediatric Endocrinology, University Hospital Brussels, Brussels, Belgium.
Jean
J
De Schepper
Desmopressin; Diabetes Insipidus; Hypernatremia; Infant