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Ddavp Injection (Desmopressin Acetate) - Description and Clinical Pharmacology



DDAVP® Injection (desmopressin acetate) 4 µg/mL is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. It is chemically defined as follows:

Mol. Wt. 1183.34

Empirical Formula: C46H64N14O12S2·C2H4O2·3H2O

1-(3-mercaptopropionic acid)-8-D-arginine vasopressin monoacetate (salt) trihydrate.

DDAVP Injection 4 µg/mL is provided as a sterile, aqueous solution for injection.

Each mL provides:

Desmopressin acetate 4.0 µg

Sodium chloride 9.0 mg

Hydrochloric acid to adjust pH to 4

The 10 mL vial contains chlorobutanol as a preservative (5.0 mg/mL).


DDAVP Injection 4 µg/mL contains as active substance, desmopressin acetate, a synthetic analogue of the natural hormone arginine vasopressin. One mL (4 µg) of DDAVP (desmopressin acetate) solution has an antidiuretic activity of about 16 IU; 1 µg of DDAVP is equivalent to 4 IU.

DDAVP has been shown to be more potent than arginine vasopressin in increasing plasma levels of factor VIII activity in patients with hemophilia and von Willebrand's disease Type I.

Dose-response studies were performed in healthy persons, using doses of 0.1 to 0.4 µg/kg body weight, infused over a 10-minute period. Maximal dose response occurred at 0.3 to 0.4 µg/kg. The response to DDAVP of factor VIII activity and plasminogen activator is dose-related, with maximal plasma levels of 300 to 400 percent of initial concentrations obtained after infusion of 0.4 µg/kg body weight. The increase is rapid and evident within 30 minutes, reaching a maximum at a point ranging from 90 minutes to two hours. The factor VIII related antigen and ristocetin cofactor activity were also increased to a smaller degree, but still are dose-dependent.

  1. The biphasic half-lives of DDAVP were 7.8 and 75.5 minutes for the fast and slow phases, respectively, compared with 2.5 and 14.5 minutes for lysine vasopressin, another form of the hormone. As a result, DDAVP provides a prompt onset of antidiuretic action with a long duration after each administration.
  2. The change in structure of arginine vasopressin to DDAVP has resulted in a decreased vasopressor action and decreased actions on visceral smooth muscle relative to the enhanced antidiuretic activity, so that clinically effective antidiuretic doses are usually below threshold levels for effects on vascular or visceral smooth muscle.
  3. When administered by injection, DDAVP has an antidiuretic effect about ten times that of an equivalent dose administered intranasally.
  4. The bioavailability of the subcutaneous route of administration was determined qualitatively using urine output data. The exact fraction of drug absorbed by that route of administration has not been quantitatively determined.
  5. The percentage increase of factor VIII levels in patients with mild hemophilia A and von Willebrand's disease was not significantly different from that observed in normal healthy individuals when treated with 0.3 µg/kg of DDAVP infused over 10 minutes.
  6. Plasminogen activator activity increases rapidly after DDAVP infusion, but there has been no clinically significant fibrinolysis in patients treated with DDAVP.
  7. The effect of repeated DDAVP administration when doses were given every 12 to 24 hours has generally shown a gradual diminution of the factor VIII activity increase noted with a single dose. The initial response is reproducible in any particular patient if there are 2 or 3 days between administrations.

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