Article: Desmopressin

Desmopressin (DDAVP^®, Stimate^®, Minirin^®) is a synthetic drug that mimics the action of antidiuretic hormone, also known as arginine vasopressin. It may be taken nasally, intravenously, or through a recently developed pill.

Chemistry

Desmopressin (1-desamino-8-d-arginine vasopressin) is a modified form of the normal human hormone arginine vasopressin, an octapeptide (a chain of eight amino acids).

Compared to vasopressin, desmopressin's first amino acid has been deaminated, and the arginine at the eighth position is in the levo rather than the dextro form (see stereochemistry).

Method of action

Desmopressin binds to V2 receptors in renal collecting ducts, increasing water resorption. It also stimulates release of factor VIII from platelets due to stimulation of the V1a receptor.

Desmopressin is degraded more slowly than recombinant vasopressin, and requires less frequent administration. In addition, it has little effect on blood pressure, while vasopressin may cause arterial hypertension.

Uses

Desmopressin is used to reduce urine production in central diabetes insipidus patients and to promote the release of von Willebrand factor and factor VIII in patients with coagulation disorders such as type I von Willebrand disease, mild hemophilia A, and thrombocytopenia. Desmopressin is not effective in the treatment of hemophilia B or severe hemophilia A.

It may also be prescribed to reduce frequent bedwetting episodes in children by decreasing noctural urine production.

It has also seen interest as a possible nootropic.

Side effects

• headaches
• facial flushing
• nausea

See also

• diabetes insipidus
• hemophilia A
• von Willebrand disease