deamino arginine vasopressin


Summary: A synthetic analog of the pituitary hormone, ARGININE VASOPRESSIN. Its action is mediated by the VASOPRESSIN receptor V2. It has prolonged antidiuretic activity, but little pressor effects. It also modulates levels of circulating FACTOR VIII and VON WILLEBRAND FACTOR.

Top Publications

  1. Lee H, Choo M, Lee J, Park C, Paick J, Lee J, et al. Desmopressin is an effective treatment for mixed nocturia with nocturnal polyuria and decreased nocturnal bladder capacity. J Korean Med Sci. 2010;25:1792-7 pubmed publisher
    ..001). The overall impression of patients about their quality of sleep improved. Adverse events occurred in 6 patients, including one asymptomatic hyponatremia. Desmopressin is an effective and well-tolerated treatment for mixed nocturia...
  2. Vande Walle J, Rittig S, Bauer S, Eggert P, Marschall Kehrel D, Tekgul S. Practical consensus guidelines for the management of enuresis. Eur J Pediatr. 2012;171:971-83 pubmed publisher
    ..e., checklists, diary templates, and quick-reference flowcharts) for complete evaluation and successful treatment of enuresis. ..
  3. De Guchtenaere A, Van Herzeele C, Raes A, Dehoorne J, Hoebeke P, Van Laecke E, et al. Oral lyophylizate formulation of desmopressin: superior pharmacodynamics compared to tablet due to low food interaction. J Urol. 2011;185:2308-13 pubmed publisher
    ..001). With meal combination desmopressin melt formulation has a superior pharmacodynamic profile to tablet, making it more suitable for the younger age group with a limited interval between meal and drug administration. ..
  4. Rittig S, Schaumburg H, Siggaard C, Schmidt F, Djurhuus J. The circadian defect in plasma vasopressin and urine output is related to desmopressin response and enuresis status in children with nocturnal enuresis. J Urol. 2008;179:2389-95 pubmed publisher
  5. Lottmann H, Baydala L, Eggert P, Klein B, Evans J, Norgaard J. Long-term desmopressin response in primary nocturnal enuresis: open-label, multinational study. Int J Clin Pract. 2009;63:35-45 pubmed publisher
    ..Early improvements in bedwetting of any appreciable magnitude may be rewarding, may facilitate compliance and enable good long-term response. ..
  6. Marschall Kehrel D, Harms T. Structured desmopressin withdrawal improves response and treatment outcome for monosymptomatic enuretic children. J Urol. 2009;182:2022-6 pubmed publisher
    ..Hence, desmopressin followed by structured withdrawal should be the standard. It is also superior to published outcomes of alarm treatment. ..
  7. Van Herzeele C, Alova I, Evans J, Eggert P, Lottmann H, Nørgaard J, et al. Poor compliance with primary nocturnal enuresis therapy may contribute to insufficient desmopressin response. J Urol. 2009;182:2045-9 pubmed publisher
    ..Decreased compliance was associated with a lower response rate. Patients should be encouraged to comply fully with treatment to achieve an optimal outcome. ..
  8. Van de Walle J, Van Herzeele C, Raes A. Is there still a role for desmopressin in children with primary monosymptomatic nocturnal enuresis?: a focus on safety issues. Drug Saf. 2010;33:261-71 pubmed publisher
  9. Evans J, Malmsten B, Maddocks A, Popli H, Lottmann H. Randomized comparison of long-term desmopressin and alarm treatment for bedwetting. J Pediatr Urol. 2011;7:21-9 pubmed publisher
    ..99). Desmopressin and alarm demonstrated comparable efficacy in the treatment of PNE. Withdrawal from the alarm group was high, indicating the importance of considering family motivation before selecting treatment, for optimal outcome. ..

More Information


  1. Hermo G, Turic E, Angelico D, Scursoni A, Gomez D, Gobello C, et al. Effect of adjuvant perioperative desmopressin in locally advanced canine mammary carcinoma and its relation to histologic grade. J Am Anim Hosp Assoc. 2011;47:21-7 pubmed publisher
    ..The present data suggest that DDAVP may be an excellent candidate as a surgical adjuvant in the management of aggressive cancers in small animals. More research in this field is warranted. ..
  2. Li C, Wang W, Rivard C, Lanaspa M, Summer S, Schrier R. Molecular mechanisms of angiotensin II stimulation on aquaporin-2 expression and trafficking. Am J Physiol Renal Physiol. 2011;300:F1255-61 pubmed publisher
    ..ANG II-induced AQP2 expression involves cAMP, PKC, PKA, and calmodulin signaling pathways via V2 and AT(1) receptors. ..
  3. Juul K, Klein B, Sandström R, Erichsen L, Nørgaard J. Gender difference in antidiuretic response to desmopressin. Am J Physiol Renal Physiol. 2011;300:F1116-22 pubmed publisher
    ..Areas for further research are proposed to uncover pathophysiological mechanism(s) behind these gender differences. ..
  4. Zong H, Yang C, Peng X, Zhang Y. Efficacy and safety of desmopressin for treatment of nocturia: a systematic review and meta-analysis of double-blinded trials. Int Urol Nephrol. 2012;44:377-84 pubmed publisher
    ..The adverse effects of desmopressin were similar to those observed in the placebo group. Administered desmopressin was an effective and well-tolerated treatment for nocturia. ..
  5. De Guchtenaere A, Raes A, Vande Walle C, Hoebeke P, Van Laecke E, Donckerwolcke R, et al. Evidence of partial anti-enuretic response related to poor pharmacodynamic effects of desmopressin nasal spray. J Urol. 2009;181:302-9; discussion 309 pubmed publisher
    ..Because of the documented prolonged action of desmopressin in some patients, increasing the dose without performing pharmacodynamic testing is no longer acceptable. ..
  6. Rembratt A, Norgaard J, Andersson K. Desmopressin in elderly patients with nocturia: short-term safety and effects on urine output, sleep and voiding patterns. BJU Int. 2003;91:642-6 pubmed
    ..Desmopressin was well tolerated in elderly patients with nocturia, but the results suggest that serum sodium should be measured before and after a few days of treatment. ..
  7. Lethagen S, Frick K, Sterner G. Antidiuretic effect of desmopressin given in hemostatic dosages to healthy volunteers. Am J Hematol. 1998;57:153-9 pubmed
    ..If desmopressin is repeated for a period of up to 48 hr, fluid intake should be restricted to 2 liters per day in adults. ..
  8. Pisitkun T, Bieniek J, Tchapyjnikov D, Wang G, Wu W, Shen R, et al. High-throughput identification of IMCD proteins using LC-MS/MS. Physiol Genomics. 2006;25:263-76 pubmed
    ..A 28-protein vasopressin signaling network was constructed using literature-based network analysis software focusing on the newly identified proteins, providing several new hypotheses for future studies. ..
  9. Kim R, Malattia C, Allen M, Moshang T, Maghnie M. Vasopressin and desmopressin in central diabetes insipidus: adverse effects and clinical considerations. Pediatr Endocrinol Rev. 2004;2 Suppl 1:115-23 pubmed
    ..Herein we review the adverse effects of DDAVP and its predecessor, vasopressin, as well as discuss important clinical considerations when using these agents to treat central diabetes insipidus. ..
  10. van Kerrebroeck P, Rezapour M, Cortesse A, Thüroff J, Riis A, Nørgaard J. Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol. 2007;52:221-9 pubmed
    ..Oral desmopressin tablets provide an effective and well-tolerated treatment for nocturia. Compared with placebo, nocturnal voiding frequency is reduced, duration of the first sleep period is increased, and sleep quality may be improved. ..
  11. Rittig S, Jensen A, Jensen K, Pedersen E. Effect of food intake on the pharmacokinetics and antidiuretic activity of oral desmopressin (DDAVP) in hydrated normal subjects. Clin Endocrinol (Oxf). 1998;48:235-41 pubmed
    ..It is possible that administration of desmopressin in the fasting state may prolong its duration of action. ..
  12. Lottmann H, Froeling F, Alloussi S, El Radhi A, Rittig S, Riis A, et al. A randomised comparison of oral desmopressin lyophilisate (MELT) and tablet formulations in children and adolescents with primary nocturnal enuresis. Int J Clin Pract. 2007;61:1454-60 pubmed
    ..Desmopressin MELT had similar levels of efficacy and safety at lower dosing levels than the tablet, and therefore facilitates early initiation of PNE treatment in children aged 5-6 years. ..
  13. Raes A, Dehoorne J, Van Laecke E, Hoebeke P, Vande Walle C, Vansintjan P, et al. Partial response to intranasal desmopressin in children with monosymptomatic nocturnal enuresis is related to persistent nocturnal polyuria on wet nights. J Urol. 2007;178:1048-51; discussion 1051-2 pubmed
  14. Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis. Neurourol Urodyn. 2004;23:302-5 pubmed
    ..7-15.1). Hyponatremia is a relatively common adverse effect of the use of desmopressin for the treatment of nocturia and caution and regular monitoring should be part of the use of this management option for nocturia in older adults. ..
  15. Ecelbarger C, Kim G, Terris J, Masilamani S, Mitchell C, Reyes I, et al. Vasopressin-mediated regulation of epithelial sodium channel abundance in rat kidney. Am J Physiol Renal Physiol. 2000;279:F46-53 pubmed
    ..Long-term increases in ENaC abundance should add to the short-term regulatory mechanisms (undefined in this study) to enhance sodium transport in the renal collecting duct...
  16. Rembratt A, Graugaard Jensen C, Senderovitz T, Norgaard J, Djurhuus J. Pharmacokinetics and pharmacodynamics of desmopressin administered orally versus intravenously at daytime versus night-time in healthy men aged 55-70 years. Eur J Clin Pharmacol. 2004;60:397-402 pubmed
    ..Despite low bioavailability, the pharmacodynamic effects of oral desmopressin were similar in magnitude to those after intravenous dose at night and during the first 6 h after daytime administration. ..
  17. Alonso D, Skilton G, Farias E, Bal de Kier Joffe E, Gomez D. Antimetastatic effect of desmopressin in a mouse mammary tumor model. Breast Cancer Res Treat. 1999;57:271-5 pubmed
    ..DDAVP may help to dissolve the protective fibrin shield of circulating tumor cells. Our data suggest, for the first time, that adjuvant DDAVP therapy may impair successful implantation of circulating mammary tumor cells. ..
  18. Vande Walle J, Bogaert G, Mattsson S, Schurmans T, Hoebeke P, Deboe V, et al. A new fast-melting oral formulation of desmopressin: a pharmacodynamic study in children with primary nocturnal enuresis. BJU Int. 2006;97:603-9 pubmed
    ..However, some patients might require a higher dose to obtain antidiuresis for the complete night. ..
  19. Kamperis K, Hagstroem S, Rittig S, Djurhuus J. Combination of the enuresis alarm and desmopressin: second line treatment for nocturnal enuresis. J Urol. 2008;179:1128-31 pubmed publisher
    ..02 compared to 0.86 +/- 0.05, not significant). Children needing the addition of desmopressin have a higher nocturnal urine production on wet nights but do not seem to differ in terms of bladder reservoir function characteristics. ..
  20. Vande Walle J, Van Laecke E. Pitfalls in studies of children with monosymptomatic nocturnal enuresis. Pediatr Nephrol. 2008;23:173-8 pubmed
    ..All these may lead to false positive and/or false negative results. In this commentary we try to tackle these different issues which might be relevant for the interpretation even of placebo-controlled studies like that of Ferrara et al. ..
  21. van Kerrebroeck P. Experience with the long-term use of desmopressin for nocturnal enuresis in children and adolescents. BJU Int. 2002;89:420-5 pubmed
  22. Mattiasson A, Abrams P, Van Kerrebroeck P, Walter S, Weiss J. Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int. 2002;89:855-62 pubmed
    ..Most adverse events were mild. Serum sodium levels were <130 mmol/L in 10 (4%) patients and this occurred during dose-titration. Orally administered desmopressin is an effective and well-tolerated treatment for nocturia in men. ..
  23. Das P, Carcao M, Hitzler J. DDAVP-induced hyponatremia in young children. J Pediatr Hematol Oncol. 2005;27:330-2 pubmed
    ..3 mug/kg. Fluid restriction, avoidance of hypo-osmolar fluid, and close monitoring of fluid and electrolytes for 12 to 24 hours after the administration of DDAVP in children younger than 3 years of age is recommended. ..
  24. Guesde R, Barrou B, Leblanc I, Ourahma S, Goarin J, Coriat P, et al. Administration of desmopressin in brain-dead donors and renal function in kidney recipients. Lancet. 1998;352:1178-81 pubmed
    ..Long-term graft survival was similar in the two groups (88 vs 87%). Desmopressin can be given to brain-dead donors to limit the harmful effects of diabetes insipidus without any substantial effects to graft function in recipients. ..
  25. Hvistendahl G, Frøkiaer J, Nielsen S, Djurhuus J. Gender differences in nighttime plasma arginine vasopressin and delayed compensatory urine output in the elderly population after desmopressin. J Urol. 2007;178:2671-6 pubmed
    ..The pharmacodynamics of desmopressin as an antidiuretic in the elderly population are different from those in young individuals. ..
  26. Iwasaki H, Koyama Y, Tanaka Y, Kawauchi A, Jodo E, Kayama Y, et al. Modulation by desmopressin of neuronal activity in brainstem micturition center. Urology. 2004;63:994-8 pubmed
    ..DDAVP seems to regulate bladder activity by affecting bladder-related neurons in the micturition center. ..
  27. Alaca R, Yilmaz B, Gunduz S. Anterior hypopituitarism with unusual delayed onset of diabetes insipidus after penetrating head injury. Am J Phys Med Rehabil. 2002;81:788-91 pubmed
    ..Our case is the latest onset of diabetes insipidus after traumatic brain injury that has been reported in the literature. ..
  28. Dehoorne J, Raes A, Van Laecke E, Hoebeke P, Vande Walle J. Desmopressin resistant nocturnal polyuria secondary to increased nocturnal osmotic excretion. J Urol. 2006;176:749-53 pubmed
    ..We investigated the role of increased solute excretion in children with desmopressin resistant nocturnal enuresis and nocturnal polyuria...
  29. Oliverio M, Delnomdedieu M, Best C, Li P, Morris M, Callahan M, et al. Abnormal water metabolism in mice lacking the type 1A receptor for ANG II. Am J Physiol Renal Physiol. 2000;278:F75-82 pubmed
    ..These studies demonstrate a critical role for the AT(1A) receptor in maintaining inner medullary structures in the kidney and in regulating renal water excretion...
  30. Giron S, Tejera A, Ripoll G, Gomez D, Alonso D. Desmopressin inhibits lung and lymph node metastasis in a mouse mammary carcinoma model of surgical manipulation. J Surg Oncol. 2002;81:38-44 pubmed
    ..DDAVP may be useful to reduce the risk of metastatic cell colonization both during and after surgical manipulation. ..
  31. Hermo G, Torres P, Ripoll G, Scursoni A, Gomez D, Alonso D, et al. Perioperative desmopressin prolongs survival in surgically treated bitches with mammary gland tumours: a pilot study. Vet J. 2008;178:103-8 pubmed
    ..Additional, large scale controlled trials are required to fully evaluate this adjuvant pharmacological protocol. ..
  32. Rembratt A, Riis A, Norgaard J. Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia. Neurourol Urodyn. 2006;25:105-9 pubmed
    ..Patients with a baseline serum sodium concentration below normal range should not be treated. ..
  33. Osterberg O, Savic R, Karlsson M, Simonsson U, Nørgaard J, Walle J, et al. Pharmacokinetics of desmopressin administrated as an oral lyophilisate dosage form in children with primary nocturnal enuresis and healthy adults. J Clin Pharmacol. 2006;46:1204-11 pubmed
    ..The main difference in the pharmacokinetics between children and adults was the absorption delay. The pharmacokinetic difference was minor and presumably of no clinical relevance. ..
  34. Perianayagam A, Sterns R, Silver S, Grieff M, Mayo R, Hix J, et al. DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol. 2008;3:331-6 pubmed publisher
    ..Desmopressin acetate is effective in preventing and reversing inadvertent overcorrection of hyponatremia. ..
  35. Müssig K, Beschorner R. [Rare differential diagnosis of diabetes insipidus]. Dtsch Med Wochenschr. 2008;133:2159-60 pubmed publisher
  36. Beladi Mousavi S, Beladi Mousavi M, Hayati F, Talebzadeh M. Effect of intranasal DDAVP in prevention of hypotension during hemodialysis. Nefrologia. 2012;32:89-93 pubmed publisher
    ..29 and 1.28 without any differences between them (p=0.896). These results indicate that Compared with placebo, Vasopressin is significantly associated with a decreased incidence of intradialytic hypotension episodes during hemodialysis. ..
  37. Kita D, Hayashi Y, Sano H, Takamura T, Hayashi Y, Tachibana O, et al. Postoperative diabetes insipidus associated with pituitary apoplexy during pregnancy. Neuro Endocrinol Lett. 2012;33:107-12 pubmed
    ..Postoperative DI associated with pituitary apoplexy during pregnancy should be treated by DDAVP, which is not affected by placental vasopressinase secretion. ..
  38. Esposito S, Deventer K, T sjoen G, Vantilborgh A, Van Eenoo P. Doping control analysis of desmopressin in human urine by LC-ESI-MS/MS after urine delipidation. Biomed Chromatogr. 2013;27:240-5 pubmed publisher
    ..9). The applicability of the method was proven by the analysis of real urine samples obtained after intravenous, oral and intranasal administration of desmopressin, achieving unambiguous detection of the peptide in all the cases. ..
  39. Franco I, Von Gontard A, De Gennaro M. Evaluation and treatment of nonmonosymptomatic nocturnal enuresis: a standardization document from the International Children's Continence Society. J Pediatr Urol. 2013;9:234-43 pubmed publisher
    ..We do, however, intend to present what evidence there is, and to give preference to this rather than to experience-based medicine, whenever possible. ..
  40. Bockenhauer D, Carpentier E, Rochdi D, Van t Hoff W, Breton B, Bernier V, et al. Vasopressin type 2 receptor V88M mutation: molecular basis of partial and complete nephrogenic diabetes insipidus. Nephron Physiol. 2010;114:p1-10 pubmed publisher
    ..Our results provide a rational basis for treatment trials with vasopressin analogues in combination with pharmacologic chaperones in patients with this recurrently identified mutation. ..
  41. Valavi E, Ahmadzadeh A, Hooman N, Aminzadeh M. Clinical correlation between hypercalciuria and nocturnal enuresis. Saudi J Kidney Dis Transpl. 2011;22:976-81 pubmed
    ..We conclude that these results suggest that hypercalciuria has a significant association with NE and does not interfere with the desmopressin therapy. ..
  42. Benck U, Gottmann U, Hoeger S, Lammert A, Rose D, Boesebeck D, et al. Donor desmopressin is associated with superior graft survival after kidney transplantation. Transplantation. 2011;92:1252-8 pubmed publisher
    ..7% vs. 84.8%, P=0.37) abrogated the survival advantage. Donor DDAVP seems to improve renal allograft survival. Combined use of donor DDAVP and low-dose dopamine should receive further evaluation. ..
  43. Fransén N, Bredenberg S, Björk E. Clinical study shows improved absorption of desmopressin with novel formulation. Pharm Res. 2009;26:1618-25 pubmed publisher
    ..The sublingual tablet has a beneficial means of production and may be further developed by decreasing its disintegration time. ..
  44. Yu C, Cho J, Jung H, Lim J, Jin M, Kwon O, et al. A case of transient central diabetes insipidus after aorto-coronary bypass operation. J Korean Med Sci. 2012;27:1109-13 pubmed publisher
    ..It is also possible that cardiac standstill altered the left atrial non-osmotic receptor function and suppressed ADH release. Therefore, we suggest that central DI is a possible cause of polyuria after CPB. ..
  45. Perucca J, Bichet D, Bardoux P, Bouby N, Bankir L. Sodium excretion in response to vasopressin and selective vasopressin receptor antagonists. J Am Soc Nephrol. 2008;19:1721-31 pubmed publisher
    ..In view of their proposed use in several human disorders, the respective influence of selective (V2) or mixed (V1a/V2) receptor antagonists on sodium handling in humans needs reevaluation. ..
  46. Kiriyama K, Tachibana K, Nishimura N, Takeuchi M, Kinouchi K. [Perioperative management of a child with central diabetes insipidus who underwent two surgeries before and after desmopressin administration]. Masui. 2013;62:358-61 pubmed
    ..Desmopressin was proved to be effective to treat excessive urine output and to maintain good perioperative water balance. ..
  47. Barkin J. Nocturia: diagnosis and management for the primary care physicians. Can J Urol. 2016;23:16-9 pubmed
  48. Tauris L, Andersen R, Kamperis K, Hagstroem S, Rittig S. Reduced anti-diuretic response to desmopressin during wet nights in patients with monosymptomatic nocturnal enuresis. J Pediatr Urol. 2012;8:285-90 pubmed publisher
    ..0. The anti-enuretic response to desmopressin seems to be dependent upon the degree of reduction in nocturnal urine production. Research on desmopressin bioavailability in children is needed. ..
  49. Alonso D, Ripoll G, Garona J, Iannucci N, Gomez D. Metastasis: recent discoveries and novel perioperative treatment strategies with particular interest in the hemostatic compound desmopressin. Curr Pharm Biotechnol. 2011;12:1974-80 pubmed
    ..DDAVP is therefore an interesting lead compound to develop novel synthetic peptide analogs with enhanced antitumor properties. ..
  50. Rosner M, Ronco C. Dysnatremias in the intensive care unit. Contrib Nephrol. 2010;165:292-8 pubmed publisher
    ..Recent data demonstrates that proper correction of hyponatremia is associated with improved short- and long-term outcomes. ..
  51. Warren O, Simon B. Massive, fatal, intracardiac thrombosis associated with prothrombin complex concentrate. Ann Emerg Med. 2009;53:758-61 pubmed publisher
    ..Thrombogenic complications of treatment with prothrombin complex concentrate have been reported before. Caution should be used when using prothrombin complex concentrates for reversal of anticoagulation. ..
  52. Chen X, Huang X, Qiu Y, Chen H, Fu Y, Li X. A case of thymic Langerhans cell histiocytosis with diabetes insipidus as the first presentation. Front Med. 2013;7:143-6 pubmed publisher
    ..In screening for LCH lesions, attention should be attached to rarely involved sites in addition to commonly involved organs. Follow-up and imageological examination are very important to a final diagnosis. ..
  53. Oiso Y, Robertson G, Nørgaard J, Juul K. Clinical review: Treatment of neurohypophyseal diabetes insipidus. J Clin Endocrinol Metab. 2013;98:3958-67 pubmed publisher
    ..Desmopressin can provide effective and safe therapy for all patients with neurohypophyseal or gestational DI if given in doses and by a route that takes into account the determinants of fluid intake. ..