Allgemeines Anwendungsbeispiel.

Desmopressin Acetate for Injection

Vials:1ml:xxμg / 1ml:xxμg

Indications and Usage:

A. Shortening or normalisation of prolonged bleeding time prior to an invasive therapeutic or diagnostic operation, or for therapeutic control of bleeding in patients with prolonged bleeding time as a consequence of congenital or substance-induced thrombocyte dysfunction, uremia, cirrhosis of the liver or in patients with prolonged bleeding time of unknown etiology.

B. For the therapeutic control of bleeding and bleeding prophylaxis in connection with minor surgical procedures in patients with mild haemophilia A and von Willebrand’s disease who respond positively to a test dose. In exceptional cases, even moderate forms of the disease can be treated. MINIRIN must not be used in patients with von Willebrand’s disease type IIB.

C. Treatment of central diabetes insipidus and for establishing renal concentration capacity testing.

Therapeutic indications:

A. For the dose upon 0.x µg/kg body weight, diluted in physiological saline to 50-100ml and given as an intravenous infusion over 15-30 minutes. If a positive effect is obtained, the initial dose may be repeated 1-2 times with intervals of 6-12 hours. Further repetition of the dose may result in a reduced effect. In patients with haemophilia A the desired increase of VIII:C is appraised by the same criterion as in the treatment with factor VIII-concentrate. If the MINIRIN infusion does not lead to the desired increase of the concentration of VIII:C in plasma, the treatment may be complemented with administration of factor VIII concentrate. Treatment of haemophilia patients should be conducted in consultation with each patient’s coagulation laboratory.

Determine the coagulation factors and bleeding time before desmopressin treatment. Plasma levels of VIII:C and vWF:Ag increase substantially after desmopressin administration. However, it has not been possible to establish any correlation between the plasma concentration of these factors and the bleeding time, either before or after desmopressin. The effect of desmopressin on the bleeding time should therefore, if possible, be tested in the individual patient. The bleeding time test should be as standardised as possible, e.g. with the use of Simplate II. Determination of bleeding time and plasma levels of the coagulation factors should be conducted in co-operation or consultation with the Coagulation Laboratories in the country. In connection with administration of this solution for injection the patient’s blood pressure must be monitored carefully.

B. Central diabetes insipidus

If the intranasal presentation is not available, desmopressin acetate for injection can be used. Dose adjusted according to patient’s urine volume and urine osmotic pressure.

Normal dose by intramuscular injection: Adults x-x µg, 1-2 times/day, for children above the age of 1 year, x-x µg, 1-2 times/day is recommended. For children below the age of 1 year, 0.x µg is recommended. Drip according to patient’s urine volume and electrolyte.

C. Kidney urine concentration test

Normal dose by intramuscular or subcutaneous injection: Adults 4µg (1ml), for children above the age of 1 year, x-x µg is recommended. For children below the age of 1 year, 0.x µg is recommended. For children it is recommended to use primarily the intranasal presentation. After administration of desmopressin acetate for injection any urine collected within one hour is discarded. During the next 8 hours 2 portions of urine are collected for measurement of osmolality. Fluid restriction should be observed.

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