Bone & endocrine

Desmopressin

A long-acting vasopressin analogue approved for central diabetes insipidus, bedwetting and mild bleeding disorders.

Strong evidenceApproved drugAdd to compare

What it is

Desmopressin (1-deamino-8-D-arginine vasopressin, DDAVP) is a synthetic nine-amino-acid analogue of vasopressin. Two structural changes make it long-acting and strip out most of the blood-pressure-raising effect: it acts mainly on the V2 receptor in the kidney. It is a prescription medicine available as tablets, nasal spray and injection.

How it works

1
Activates V2 receptors on the collecting ducts of the kidney, inserting aquaporin-2 channels and reabsorbing water without sodium.
2
Releases von Willebrand factor and factor VIII from endothelial storage pools.
3
Has little V1 activity, so it does not raise blood pressure the way natural vasopressin does.
4
Concentrates urine within about an hour of an effective dose.
5
Supports platelet function in some inherited disorders.

What it's studied for

Central (cranial) diabetes insipidus

Nocturnal enuresis in children

Mild haemophilia A and type 1 von Willebrand disease

Platelet function disorders before procedures

Diagnostic urine concentration testing

Reported and studied effects

Rapid fall in urine volume and rise in urine osmolality in central diabetes insipidus
Two- to four-fold rise in factor VIII and von Willebrand factor in responsive patients
Fewer night-time wettings in enuresis trials
Hyponatraemia when fluid intake is not restricted

Research protocol notes

Research context only

Research context only - prescription medicine. Dosing differs sharply between indications and between tablets, nasal spray and injection, for example 0.1 to 0.2 mg tablets in adults for diabetes insipidus versus weight-based intravenous dosing for haemostasis. Hyponatraemia risk depends on dose, fluid intake and age, and needs monitoring. Nothing here is a dosing suggestion.

These figures are described so you can understand what researchers did. They are not a dose, a schedule, or a suggestion — and they are not a substitute for a doctor.

Possible side effects and contraindications

Safety profile

Possible side effects

Hyponatraemia and water intoxication, which can cause headache, nausea, confusion and seizures
Fluid retention and peripheral oedema
Facial flushing and headache
Nasal irritation and rhinitis with the spray
Abdominal cramps
Rare allergic reactions

Contraindications and cautions

Known or past hyponatraemia
Polydipsia
Moderate to severe kidney impairment for diabetes insipidus use
Syndrome of inappropriate ADH secretion
Heart failure
Prior hypersensitivity

A side-effect list is never complete, and these are not the only situations that warrant caution. Anything unexpected, or anything you are unsure about, should be discussed with a doctor before use.

Evidence assessment

Strong evidenceReplicated, large human trials

Replicated, large human trials

Decades of controlled trials and clinical use across three distinct indications, with clear, measurable endocrine and haematological endpoints.

References

References link to published literature, regulator pages or literature indexes. Where a link points to a search, it collects the peer-reviewed work on that molecule rather than a single study.

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