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데스모프레신

Desmopressin

1-Deamino-8-D-Arginine Vasopressin

호르몬제 - 합성 바소프레신 유사체topical (conjunctival)SCIVPOintranasalIntranasalIM개고양이말

다른 이름: 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 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

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

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증용량경로빈도기간지역
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.

고양이

적응증용량경로빈도기간지역
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.

말

적응증용량경로빈도기간지역
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.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

​데스모프레신(DDAVP)​은 천연 뇌하수체 항이뇨 호르몬인 아르기닌 바소프레신의 합성 유사체입니다. 구조적으로 변형되어 혈압 상승 작용은 거의 제거된 반면 항이뇨 특성은 크게 강화되었습니다.

수의학에서는 주로 두 가지 임상 목적으로 사용됩니다:

  • ​중추성 요붕증(CDI):​ 개와 고양이의 CDI 진단(반응 시험을 통해) 및 장기 관리를 위한 표준 치료제로, 심각한 다뇨 및 다음 증상을 효과적으로 해결합니다.
  • ​폰 빌레브란트병(vWD):​ 특정 하위 유형의 vWD 환자에서 수술 전후 혈액 응고 인자를 일시적으로 높이기 위해 사용되지만, 작용 시간이 짧고 내성(빠른 내약성)이 빨리 발생하여 장기적인 유용성은 제한적입니다.

​임상 요점:​ 동물에서 경구 생체이용률이 매우 낮기 때문에, 수의학 환자에서는 인체용 비강 스프레이를 ​결막낭(눈)에 국소적으로 점안​하는 방식이 가장 흔하게 사용되며, 이는 신뢰할 수 있고 비침습적인 흡수 경로를 제공합니다.

작용 기전

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.

안전성·주의사항

금기사항

  • 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)

부작용

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

주의

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.

약물 상호작용

Chlorpropamide

May enhance the antidiuretic effects of desmopressin

Fludrocortisone

May enhance the antidiuretic effects of desmopressin

Urea

May enhance the antidiuretic effects of desmopressin

모니터링

  • 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)

약동학

흡수

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

분포

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

대사

The metabolic fate is not well understood.

배설

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

과다투여

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.

제품

제형

  • 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

인용의약품

  • 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

규제 현황

European Union✓ 승인됨처방전의약품EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 승인됨처방전의약품VMD
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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.

보호자 정보

  • ​투여 방법:​ 요붕증의 경우, 인체용 ​비강 스프레이​를 반려동물의 눈(결막낭)에 직접 점안하도록 안내받을 수 있습니다. 이는 정상적인 방법이며 반려동물이 이 약물을 흡수하는 가장 효과적인 방법입니다.
  • ​보관:​ 약효를 유지하기 위해 가능한 한 용액을 냉장(2-8°C) 보관하십시오.
  • ​평생 치료:​ 중추성 요붕증의 경우 이 약물은 완치제가 아닌 ​관리​를 위한 것임을 이해하셔야 합니다. 반려동물이 심한 갈증과 과도한 배뇨를 겪지 않도록 매일의 투약 일정을 엄격히 준수하는 것이 필수적입니다.
  • ​비용:​ 이 약물을 장기간 사용하면 비용이 많이 들 수 있습니다. 재정적인 우려가 있다면 수의사와 상의하십시오.
  • ​수분 섭취:​ 반려동물이 항상 물을 마실 수 있도록 하되, 무기력하거나 약해지는 증상이 없는지 관찰하십시오. 이는 복용량이 너무 높을 때 발생하는 수분 중독의 징후일 수 있습니다.

VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.