Desmopressin as an adjuvant to opioids or NSAIDs in treatment of renal colic: a nationwide register-based study.
OBJECTIVE
Desmopressin has been reported to be effective as an adjuvant to opioids or NSAIDs in management of pain in renal colic; however real-life data are lacking on the utilisation of desmopressin in this patient segment.


METHODS
The Danish National Prescription Registry data-linked with Danish National Patient Registry during a 3-year period from 2009 to 2011 was used to study prescriptions for desmopressin in renal colic.


RESULTS
We identified 888 desmopressin prescriptions for renal colic, dispensed to 95 patients. The mean treatment period was 159 days, with a large variation up to a maximum of 924 days. Approximately two thirds of patients received dosing instructions to administer the drug 4 times daily to provide 24-h antidiuretic coverage. Among concomitant opioids and NSAIDs, tramadol and ibuprofen were prescribed most frequently. Antidepressants and diuretics were also widely used. A clear sex difference was seen, with female renal colic patients having three times more prescriptions overall than males, and in particular receiving more antidepressants and psychotropic drugs. A total of 4 (4.2%) of the patients experienced hospital admissions because of hyponatraemia or polydipsia during the 3-year period. We confirmed a previous case report that nephrolithiasis could be at least an occasional complication of successful therapy of Central Diabetes Insipidus (CDI) with desmopressin, identifying 12 CDI patients in total, or 2.4% of all Danish CDI patients in that period, who were also treated for renal colic.


CONCLUSIONS
In summary, these real-life prescription data provide exact epidemiological measures on desmopressin utilisation in renal colic.
Ferring International PharmaScience Center, Copenhagen, Denmark.
Kristian V
KV
Juul
Aarhus University Hospital, Aarhus, Denmark.
Marie K
MK
Schroeder
Aarhus University Hospital, Aarhus, Denmark.
Søren
S
Rittig
Ferring International PharmaScience Center, Copenhagen, Denmark.
Jens Peter
JP
Nørgaard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D050034:Antidiuretic Agents / Q000008:administration & dosage; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D003718:Denmark; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012042:Registries; D056844:Renal Colic / Q000188:drug therapy*; D012737:Sex Factors; D013997:Time Factors
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
desmopressin; incidence; pharmacoepidemiology; prevalence; renal colic