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DDAVP spray

Common Name:

desmopressin nasal solution


How does DDAVP spray work? What will it do for me?

Desmopressin nasal solution belongs to 2 classes of medications: antidiuretics and antihemorrhagics. It can be used to treat central diabetes insipidus, a condition where the kidneys are unable to conserve water due to a lack of antidiuretic hormone (ADH). This condition causes frequent urination and thirst. It is also used to treat temporary increased thirst and urination that can occur after a head injury or certain types of brain surgery. For these uses, desmopressin nasal solution works by helping to reduce the amount of urine produced by the kidneys.

Desmopressin nasal solution may also be used to prevent bleeding for people with mild hemophilia A and mild von Willebrand’s disease type I. Desmopressin nasal solution works by increasing certain components involved in blood clotting.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does DDAVP spray come in?

Rhinyle Solution
Each mL contains 0.1 mg of desmopressin acetate in an isotonic, aqueous solution containing 0.5% chlorobutanol as a preservative. Nonmedicinal ingredients: sodium chloride and hydrochloric acid.


Each pre-compression, metered-dose spray pump contains desmopressin acetate 0.1 mg/mL in a buffered, isotonic, aqueous solution. Nonmedicinal ingredients: citric acid monohydrate, disodium hydrogen phosphate dehydrate, and benzalkonium chloride. Each depression delivers 10 µg of desmopressin acetate.

How should I use DDAVP spray?

For diabetes insipidus: The usual recommended dose for adults is 10 µg to 40 µg daily. The usual recommended dose for children 3 months to 12 years of age is 5 µg to 30 µg daily. The dose may be given as a single dose or divided into 2 or 3 doses. The lowest effective dosage should be used. Do not drink any fluids for at least 1 hour before taking desmopressin and for 8 hours after using desmopressin.

For preventing bleeding: The usual recommended dose is one 150 µg spray in each nostril, or one 150 µg spray in one nostril for people who weigh less than 50 kg (110 lbs). If it is being used to prevent bleeding related to surgery, it is given 2 hours before surgery.

Follow the instructions in the package insert on how to use this medication. If you are unsure of how to use this medication, talk to your pharmacist.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, administer it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

This medication comes in 2 forms: the spray and the rhinyle solution. Store the spray in an upright position at room temperature, protect it from light, and kept it out of the reach of children. Store the rhinyle solution in the refrigerator at 2°C to 8°C and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take DDAVP spray?

Do not use this medication if you:

  • are allergic to desmopressin or any ingredients of the medication
  • are known to have decreased levels of sodium in your blood
  • have habitual or psychogenic polydipsia (drinking excessive amounts of water)
  • have medical conditions that require treatment with diuretics (e.g., heart failure, high blood pressure)
  • have moderately or severely reduced kidney function
  • have primary nocturnal enuresis (bedwetting)
  • have Syndrome of Inappropriate ADH secretion (SIADH)
  • have type IIB or platelet type (pseudo) von Willebrand’s disease

What side effects are possible with DDAVP spray?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • aftertaste
  • headache
  • flushing or redness of skin
  • increased appetite
  • nasal discomfort
  • nausea
  • nosebleeds
  • stomach pain
  • stuffy nose

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • anorexia
  • chills
  • dizziness
  • low blood pressure
  • rash
  • redness in the whites of the eye
  • swelling of the face or hands
  • symptoms of low sodium in the blood (e.g., tiredness; weakness; confusion; achy, stiff, or uncoordinated muscles)
  • symptoms of too much fluid in the body (e.g., nausea, vomiting, weight gain)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • symptoms of a severe allergic reaction (e.g., difficulty breathing, wheezing, hives)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for DDAVP spray?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cystic fibrosis (CF): People with cystic fibrosis are susceptible to decreased levels of sodium in the body. Changes in fluids and electrolytes caused by desmopressin may cause worsening symptoms of CF. If you have CF, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Effectiveness: Desmopressin is not effective in controlling excessive urination caused by kidney disease, psychiatric conditions, low blood potassium, or high blood calcium.

Fluid and electrolyte balance: Fluid intake should be adjusted in order to reduce the possibility of water retention and low levels of sodium in the blood, especially in children and seniors. Talk to your doctor about how much fluid intake is appropriate for you or your child. People who are taking this medication should be closely monitored by their doctor. Stop taking this medication and get medical attention if you have symptoms of low sodium in the blood such as headache, nausea, or vomiting.

People who are dehydrated should wait until they are properly hydrated before taking desmopressin.

Heart failure: Imbalance in fluid and electrolytes can cause heart failure to worsen. If you have heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney and liver function: People with decreased kidney or liver function are at an increased risk for electrolyte and fluid imbalance. Desmopressin further increases the risk of developing low levels of sodium in the body. If you have decreased kidney or liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Nasal problems: People who have nasal conditions such as inflammation of the nose, scarring, or swelling may not completely absorb the medication. In these circumstances, the desmopressin nasal solution should not be used. Talk to your doctor about alternatives you can use.

Tolerance: There are reports of changes in response to the medication over time, usually when the medication has been used for longer than 6 months. Some people may experience decreased responsiveness, while others may experience a shortened duration of effect. If you notice this, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor.

Breast-feeding: It is not known if desmopressin nasal solution passes into breast milk. If you are a breast-feeding mother and are taking desmopressin nasal solution, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children younger than 3 months of age.

Seniors: People over the age of 65 years may be more sensitive to the effects of this medication.

What other drugs could interact with DDAVP spray?

There may be an interaction between desmopressin nasal solution and any of the following:

  • carbamazepine
  • chlorpromazine
  • chlorpropamide
  • clofibrate
  • corticosteroids (e.g., beclomethasone, budesonide, dexamethasone, hydrocortisone, fluticasone, prednisone)
  • fludrocortisone
  • lamotrigine
  • lithium
  • loop diuretics ("water pills"; e.g., bumetanide, furosemide)
  • loperamide
  • methadone
  • norepinephrine
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
  • selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine, paroxetine, sertraline)
  • tolvaptan
  • tramadol
  • tricyclic antidepressants (e.g., amitriptyline, nortriptyline)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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