Desmopresina
Desmopressin
1-Deamino-8-D-Arginine Vasopressin
También conocido como: Stimate · DDAVP · Concentraid · D-Void · Defirin · Desmogalen · Desmospray · Desmotabs · Emosint · Minirin · Minurin · Nocutil · Octim · Octostim · Presinex · 1-Deamino-8-D-Arginine Vasopressin · Desmopressin Acetate
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| 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.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| 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.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| 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.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La desmopresina (DDAVP) es un análogo sintético de la hormona antidiurética natural de la hipófisis, la arginina vasopresina. Ha sido modificada estructuralmente para mejorar significativamente sus propiedades antidiuréticas, eliminando prácticamente su actividad vasopresora (aumento de la presión arterial).
En medicina veterinaria, se utiliza principalmente para dos propósitos clínicos distintos:
- Diabetes insípida central (DIC): Es el estándar de oro tanto para el diagnóstico (mediante pruebas de respuesta) como para el manejo a largo plazo de la DIC en perros y gatos, resolviendo eficazmente la poliuria y polidipsia severas.
- Enfermedad de Von Willebrand (vWD): Se utiliza en el periodo perioperatorio para aumentar transitoriamente los factores de coagulación en pacientes con subtipos específicos de vWD, aunque su corta duración de acción y el rápido desarrollo de resistencia (taquifilaxia) limitan su utilidad a largo plazo.
Perla clínica: Debido a que la biodisponibilidad oral es excepcionalmente baja en animales, la preparación humana de pulverización nasal se administra más comúnmente de forma tópica en el saco conjuntival de los pacientes veterinarios, proporcionando una vía de absorción fiable y no invasiva.
Mecanismo de acción
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.
Seguridad y advertencias
Contraindicaciones
- 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)
Efectos adversos
- Eye irritation (following conjunctival administration)
- Hypersensitivity reactions
- Fluid retention (with overdosage)
- Hyponatremia (with overdosage)
- Headache (reported in humans)
Precauciones
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.
Interacciones farmacológicas
May enhance the antidiuretic effects of desmopressin
May enhance the antidiuretic effects of desmopressin
May enhance the antidiuretic effects of desmopressin
Monitorización
- 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)
Farmacocinética
Absorción
Destroyed in the GI tract, resulting in very low oral bioavailability. Well absorbed via conjunctival, nasal, and parenteral routes.
Distribución
Distribution characteristics are not well described, but the drug does enter maternal milk.
Metabolismo
The metabolic fate is not well understood.
Eliminación
Terminal half-lives in humans after IV administration range from 0.4 to 4 hours.
Sobredosis
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.
Productos disponibles
Formulaciones
- 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
Etiquetado para humanos
- 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
Estado regulador
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
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.
Información para el cliente
- Técnica de administración: Para la diabetes insípida, es probable que se le indique colocar gotas del spray nasal humano directamente en el ojo de su mascota (saco conjuntival). Esto es normal y es la forma más eficaz para que las mascotas absorban el medicamento.
- Almacenamiento: Mantenga la solución refrigerada (2-8°C) siempre que sea posible para mantener su eficacia.
- Terapia de por vida: Entienda que, para la diabetes insípida central, este medicamento es un tratamiento, no una cura. El cumplimiento estricto del programa de dosificación diario es esencial para evitar que su mascota experimente sed severa y micción excesiva.
- Costo: Este medicamento puede ser costoso para un uso a largo plazo; hable con su veterinario sobre cualquier preocupación financiera.
- Ingesta de agua: Asegúrese de que su mascota siempre tenga acceso a agua, pero vigile si presenta signos de letargo o debilidad, lo cual podría indicar una intoxicación por agua si la dosis es demasiado alta.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.