Desmopressin
1-Deamino-8-D-Arginine Vasopressin
Also known as: Stimate · DDAVP · Concentraid · D-Void · Defirin · Desmogalen · Desmospray · Desmotabs · Emosint · Minirin · Minurin · Nocutil · Octim · Octostim · Presinex · 1-Deamino-8-D-Arginine Vasopressin · Desmopressin Acetate
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Central diabetes insipidus | One drop placed in the conjunctival sac | topical | twice daily (or three times a day) | — | 🌎 NA |
| Central diabetes insipidus | 1-4 drops of the intranasal solution in the conjunctival sac | topical | once to twice daily | — | 🌎 NA |
| Central diabetes insipidus | 2-5 micrograms | SC | once to twice daily | — | 🌎 NA |
| Complete and partial central diabetes insipidus | 1-4 drops of the intranasal solution in the conjunctival sac | topical | once a day to twice a day | — | 🌎 NA |
| Central diabetes insipidus | 1-2 drops into the conjunctival sac or 0.01-0.05 mL | topical / SC | once a day to twice a day | — | 🌎 NA |
| Trial in place of water deprivation test | one-half to one 0.1 or 0.2 mg DDAVP tablet PO q8h or 1-4 drops of nasal spray from an eye dropper into the conjunctival sac every 12 hours | PO / topical | q8h (PO) or q12h (topical) | 5-7 days | 🌎 NA |
| Von Willebrand's disease (preoperative prophylaxis) | 1 microgram/kg | SC | one-half hour before surgery | — | 🌎 NA |
| Von Willebrand's disease (prevent or control bleeding with surgery) | 14 micrograms/kg | SC | Once | — | 🌎 NA |
- Central diabetes insipidus: Using one drop three times a day usually returns urine production to normal.
- Central diabetes insipidus: Using intranasal solution parenterally.
- Trial in place of water deprivation test: Decrease in PU/PD or >=50% increase in USG supports central DI diagnosis.
- Von Willebrand's disease (preoperative prophylaxis): Close monitoring needed. Transfusion should be readily available. Not effective for severe Types 2 and 3 vWD.
- Von Willebrand's disease (prevent or control bleeding with surgery): Intranasal product is given subcutaneously. Onset of activity occurs in 30 minutes and duration of effect is approximately 2 hours.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Differentiate central diabetes insipidus from nephrogenic form | 1 drop into the conjunctival sac | topical | twice daily | 2-3 days | 🌎 NA |
| Central diabetes insipidus | 1-2 drops into the conjunctival sac | topical | once or twice a day | — | 🌎 NA |
| Central diabetes insipidus | 1- 4 drops of the intranasal solution in the conjunctival sac | topical | once to twice daily | — | 🌎 NA |
| Central diabetes insipidus | 2-5 micrograms | SC | once to twice daily | — | 🌎 NA |
| Central diabetes insipidus (oral alternative) | 25-50 micrograms (total dose; 1/4th to 1/2 of a 100 microgram tablet) | PO | q12h | — | 🌎 NA |
- Differentiate central diabetes insipidus from nephrogenic form: Dramatic reduction in water intake or >=50% increase in urine concentration gives strong evidence for ADH deficit.
- Central diabetes insipidus: Duration of activity is 8-24 hours.
- Central diabetes insipidus: Using intranasal solution parenterally.
- Central diabetes insipidus (oral alternative): Dose and response may be variable.
Horses
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Diagnosis of diabetes insipidus | 20 micrograms | IV | Once | — | 🌎 NA |
| Diagnosis of diabetes insipidus | 0.05 micrograms/kg | IV | Once | — | 🌎 NA |
- Diagnosis of diabetes insipidus: Dilute the nasal spray formulation (0.1 mg/ml) in sterile water. Measure USG every 2 hours. Increase to >=1.025 within 2-7 hours is consistent with central DI.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Desmopressin (DDAVP) is a synthetic analogue of the natural pituitary antidiuretic hormone, arginine vasopressin. It has been structurally modified to significantly enhance its antidiuretic properties while virtually eliminating its vasopressor (blood pressure-raising) activity.
In veterinary medicine, it is primarily utilized for two distinct clinical purposes:
- Central Diabetes Insipidus (CDI): It is the gold standard for both the diagnosis (via response trials) and long-term management of CDI in dogs and cats, effectively resolving severe polyuria and polydipsia.
- Von Willebrand's Disease (vWD): It is used perioperatively to transiently boost clotting factors in patients with specific subtypes of vWD, though its short duration of action and the rapid development of resistance (tachyphylaxis) limit its long-term utility.
Clinical Pearl: Because oral bioavailability is exceptionally poor in animals, the human intranasal preparation is most commonly administered topically into the conjunctival sac of veterinary patients, providing a reliable and non-invasive route of absorption.
Mechanism of action
Desmopressin exerts its effects through two primary mechanisms based on its high affinity for specific receptors:
- Antidiuretic Action (Kidneys): Desmopressin selectively binds to V2 receptors on the basolateral membrane of cells in the renal distal tubules and collecting ducts. This binding activates adenylate cyclase → increases intracellular cAMP → triggers the translocation and insertion of aquaporin-2 (AQP2) water channels into the apical membrane. This dramatically increases water permeability, allowing water to be reabsorbed passively back into the bloodstream, thereby concentrating the urine and reducing urine volume.
- Hemostatic Action (Endothelium): Desmopressin binds to V2 receptors on vascular endothelial cells → stimulates the rapid exocytosis of Weibel-Palade bodies → releases stored von Willebrand factor (vWF) and Factor VIII into the plasma. It also increases plasminogen factor levels.
Safety & warnings
Contraindications
- Hypersensitivity to desmopressin
- Type IIB or platelet-type (pseudo) Von Willebrand's disease (may cause platelet aggregation and thrombocytopenia; notably seen in German Shorthair Pointers)
- Hyponatraemia (specifically for modified water deprivation test)
- Renal disease (specifically for modified water deprivation test)
- Dehydration (specifically for modified water deprivation test)
- Hypercalcaemia (specifically for modified water deprivation test)
Adverse effects
- Eye irritation (following conjunctival administration)
- Hypersensitivity reactions
- Fluid retention (with overdosage)
- Hyponatremia (with overdosage)
- Headache (reported in humans)
Precautions
Use with extreme caution in patients susceptible to thrombotic events. When used to stimulate von Willebrand factor, repeated administration will cause tachyphylaxis (diminishing efficacy) within 24 hours. Safe use during pregnancy is not fully established (FDA Category B), though animal studies at high doses showed no fetal harm. Likely safe during nursing.
Drug interactions
May enhance the antidiuretic effects of desmopressin
May enhance the antidiuretic effects of desmopressin
May enhance the antidiuretic effects of desmopressin
Monitoring
- Serum electrolytes (especially sodium)
- Urine osmolality and/or urine volume
- Bleeding times (when used for Von Willebrand's disease)
- Adrenocortical function (prior to water deprivation test)
- Serum sodium (Clinical Pearl)
- Urine specific gravity (Clinical Pearl)
- Bleeding times/vWF levels if used for bleeding disorders (Clinical Pearl)
Pharmacokinetics
Absorption
Destroyed in the GI tract, resulting in very low oral bioavailability. Well absorbed via conjunctival, nasal, and parenteral routes.
Distribution
Distribution characteristics are not well described, but the drug does enter maternal milk.
Metabolism
The metabolic fate is not well understood.
Elimination
Terminal half-lives in humans after IV administration range from 0.4 to 4 hours.
Overdose
Chronic oral doses of 0.2 mg/kg/day have been given to dogs for 6 months without significant toxicity. However, acute or severe overdosage may lead to fluid retention and hyponatremia (water intoxication).
Treatment: Employ dosage reduction and strict fluid restriction. Monitor serum electrolytes (especially sodium) closely to prevent neurological complications associated with hyponatremia.
Available products
Formulations
- Intranasal spray solution
- Injection solution
- Intranasal solution: 100 μg/ml
- Intranasal spray: 10 μg metered spray
- Injectable solution: 4 μg/ml
- Oral tablets: 100 μg, 200 μg
Human-labeled
- Desmopressin Acetate Intranasal Spray Solution: 0.1 mg/mL (10 micrograms/spray) and 1.5 mg/mL (150 micrograms/spray)
- Desmopressin Acetate Injection Solution: 4 micrograms/mL
- Desmopressin Acetate Oral Tablets: 0.1 mg & 0.2 mg
- DDAVP
- Desmospray
- Desmotabs
Regulatory status
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
The nasal solution should be refrigerated (2-8°C) and has an expiration date of one year after manufacture. It is stable at room temperature for 3 weeks in the unopened bottle. The injection product should be refrigerated (4°C); do not freeze.
Client information
- Administration Technique: For diabetes insipidus, you will likely be instructed to place drops of the human nasal spray directly into your pet's eye (conjunctival sac). This is normal and is the most effective way for pets to absorb the medication.
- Storage: Keep the solution refrigerated (2-8°C) whenever possible to maintain its effectiveness.
- Lifelong Therapy: Understand that for central diabetes insipidus, this medication is a treatment, not a cure. Strict compliance with the daily dosing schedule is essential to prevent your pet from experiencing severe thirst and excessive urination.
- Cost: This medication can be expensive for long-term use; discuss any financial concerns with your veterinarian.
- Water Intake: Ensure your pet always has access to water, but monitor for signs of lethargy or weakness, which could indicate water intoxication if the dose is too high.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.