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去氨加壓素

Desmopressin

1-Deamino-8-D-Arginine Vasopressin

荷爾蒙製劑 - 合成血管加壓素類似物topical (conjunctival)SCIVPOintranasalIntranasalIM狗貓馬

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

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

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

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
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.

貓

適應症劑量途徑頻次療程地區
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

適應症劑量途徑頻次療程地區
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.

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

​去氨加壓素 (DDAVP)​ 是一種天然腦下垂體抗利尿激素（精氨酸血管加壓素）的合成類似物。其結構經過修飾，顯著增強了抗利尿特性，同時幾乎消除了血管加壓（升高血壓）的作用。

在獸醫學中，它主要用於兩個不同的臨床目的：

  • ​中樞性尿崩症 (CDI)：​ 它是診斷（透過試驗治療）和長期管理犬貓 CDI 的黃金標準，能有效解決嚴重的多尿和多渴症狀。
  • ​溫韋伯氏疾病 (vWD)：​ 用於圍手術期，短暫提升特定亞型 vWD 患畜的凝血因子，但其作用時間短且容易快速產生抗藥性（快速耐受），限制了其長期效用。

​臨床要點：​ 由於動物口服的生物利用度極差，人類用的鼻腔噴霧劑在獸醫臨床上最常被​局部滴入患畜的結膜囊（眼睛）​中，提供了一種可靠且非侵入性的吸收途徑。

作用機制

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.

安全性與警告

禁忌症

  • 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)

不良反應

  • 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.

藥物相互作用

Chlorpropamide

May enhance the antidiuretic effects of desmopressin

Fludrocortisone

May enhance the antidiuretic effects of desmopressin

Urea

May enhance the antidiuretic effects of desmopressin

監測

  • 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)

藥物動力學

吸收

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

分佈

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

代謝

The metabolic fate is not well understood.

排除

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

過量

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.

可用產品

劑型

  • 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

人用標示

  • 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

各地核准狀態

European Union✓ 已核准處方藥EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 已核准處方藥VMD
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

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.

飼主須知

  • ​給藥技巧：​ 對於尿崩症，獸醫師可能會指示您將人類用的​鼻腔噴霧劑​直接滴入寵物的眼睛（結膜囊）中。這是正常的，也是寵物吸收此藥物最有效的方式。
  • ​儲存方式：​ 盡可能將藥液冷藏（2-8°C）以保持其藥效。
  • ​終身治療：​ 請了解對於中樞性尿崩症，此藥物是​控制​而非治癒。嚴格遵守每日給藥時間表對於防止寵物出現嚴重口渴和過度排尿至關重要。
  • ​費用：​ 長期使用此藥物的費用可能較高；如有財務考量，請與您的獸醫師討論。
  • ​水分攝取：​ 確保您的寵物隨時有水可喝，但請觀察是否有嗜睡或虛弱的跡象，這可能表示劑量過高導致水中毒。

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