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デスモプレシン

Desmopressin

1-Deamino-8-D-Arginine Vasopressin

ホルモン剤 - 合成バソプレシンアナログtopical (conjunctival)SCIVPOintranasalIntranasalIM犬猫馬

別名: Stimate · DDAVP · Concentraid · D-Void · Defirin · Desmogalen · Desmospray · Desmotabs · Emosint · Minirin · Minurin · Nocutil · Octim · Octostim · Presinex · 1-Deamino-8-D-Arginine Vasopressin · Desmopressin Acetate

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

1 microgram/kgSC· one-half hour before surgery
— 🐕

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
Central diabetes insipidusOne drop placed in the conjunctival sactopicaltwice daily (or three times a day)—🌎 NA
Central diabetes insipidus1-4 drops of the intranasal solution in the conjunctival sactopicalonce to twice daily—🌎 NA
Central diabetes insipidus2-5 microgramsSConce to twice daily—🌎 NA
Complete and partial central diabetes insipidus1-4 drops of the intranasal solution in the conjunctival sactopicalonce a day to twice a day—🌎 NA
Central diabetes insipidus1-2 drops into the conjunctival sac or 0.01-0.05 mLtopical / SConce a day to twice a day—🌎 NA
Trial in place of water deprivation testone-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 hoursPO / topicalq8h (PO) or q12h (topical)5-7 days🌎 NA
Von Willebrand's disease (preoperative prophylaxis)1 microgram/kgSCone-half hour before surgery—🌎 NA
Von Willebrand's disease (prevent or control bleeding with surgery)14 micrograms/kgSCOnce—🌎 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.

猫

適応用量経路頻度期間地域
Differentiate central diabetes insipidus from nephrogenic form1 drop into the conjunctival sactopicaltwice daily2-3 days🌎 NA
Central diabetes insipidus1-2 drops into the conjunctival sactopicalonce or twice a day—🌎 NA
Central diabetes insipidus1- 4 drops of the intranasal solution in the conjunctival sactopicalonce to twice daily—🌎 NA
Central diabetes insipidus2-5 microgramsSConce to twice daily—🌎 NA
Central diabetes insipidus (oral alternative)25-50 micrograms (total dose; 1/4th to 1/2 of a 100 microgram tablet)POq12h—🌎 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.

馬

適応用量経路頻度期間地域
Diagnosis of diabetes insipidus20 microgramsIVOnce—🌎 NA
Diagnosis of diabetes insipidus0.05 micrograms/kgIVOnce—🌎 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.

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

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概要

​デスモプレシン (DDAVP)​ は、天然の脳下垂体抗利尿ホルモンであるアルギニンバソプレシンの合成アナログです。構造が修飾されており、昇圧（血圧上昇）作用をほぼ排除しつつ、抗利尿作用を著しく増強しています。

獣医療では、主に以下の2つの臨床目的で使用されます：

  • ​中枢性尿崩症 (CDI)：​ 犬および猫のCDIの診断（反応試験による）および長期管理におけるゴールドスタンダードであり、重度の多尿および多飲を効果的に解消します。
  • ​フォン・ヴィレブランド病 (vWD)：​ 特定のサブタイプのvWD患者において、周術期に凝固因子を一時的に増加させるために使用されますが、作用時間が短く、耐性（タキフィラキシー）が急速に発現するため、長期的な有用性は限られています。

​臨床のポイント：​ 動物における経口バイオアベイラビリティは極めて低いため、獣医療ではヒト用の点鼻薬を​患者の結膜嚢（目）に局所投与​することが最も一般的であり、信頼性の高い非侵襲的な吸収経路を提供します。

作用機序

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.

安全性・警告

禁忌

  • 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)

有害事象

  • Eye irritation (following conjunctival administration)
  • Hypersensitivity reactions
  • Fluid retention (with overdosage)
  • Hyponatremia (with overdosage)
  • Headache (reported in humans)

注意事項

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.

医薬品相互作用

Chlorpropamide

May enhance the antidiuretic effects of desmopressin

Fludrocortisone

May enhance the antidiuretic effects of desmopressin

Urea

May enhance the antidiuretic effects of desmopressin

監視

  • 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)

薬物動態

吸収

Destroyed in the GI tract, resulting in very low oral bioavailability. Well absorbed via conjunctival, nasal, and parenteral routes.

分布

Distribution characteristics are not well described, but the drug does enter maternal milk.

代謝

The metabolic fate is not well understood.

消失

Terminal half-lives in humans after IV administration range from 0.4 to 4 hours.

過剰投与

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.

製品

製剤

  • 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

ヒト用医薬品

  • 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

規制ステータス

European Union✓ 承認済み処方箋医薬品EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 承認済み処方箋医薬品VMD
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

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.

飼主向け情報

  • ​投与方法：​ 尿崩症の場合、ヒト用の​点鼻スプレー​をペットの目（結膜嚢）に直接点眼するよう指示されることがよくあります。これは正常な使用法であり、ペットがこの薬を吸収するための最も効果的な方法です。
  • ​保管：​ 効果を維持するため、溶液は可能な限り冷蔵（2〜8°C）で保管してください。
  • ​生涯にわたる治療：​ 中枢性尿崩症の場合、この薬は​治療​であり、完治させるものではないことをご理解ください。ペットが激しい喉の渇きや過剰な排尿を経験するのを防ぐため、毎日の投薬スケジュールを厳守することが不可欠です。
  • ​費用：​ この薬の長期使用は高額になる可能性があります。経済的な懸念がある場合は獣医師にご相談ください。
  • ​水分摂取：​ ペットが常に水を飲めるようにしてください。ただし、投与量が多すぎる場合の水中毒を示す可能性があるため、無気力や脱力の兆候がないか観察してください。

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