Desmopressin (DDAVP) to Reduce Bedwetting in Children

The prescription medication desmopressin (sometimes called DDAVP) is a drug that mimics a naturally occurring hormone in the body and is used to treat nocturnal enuresis, or bedwetting, as well as other conditions. If behavioral treatments fail, desmopressin is the most effective drug to help children stop wetting the bed. What is desmopressin, how does it work, and what are the potential side effects?

Desmopressin is used most often to treat bedwetting in children who are six years or older. In this situation, the restriction of fluids must accompany the medication’s administration at bedtime. This restriction usually must extend from one hour prior to taking desmopressin until the next morning (or approximately eight hours after the medication is taken).

Desmopressin is also used to treat other less common conditions, including:

• Central diabetes insipidus (production of dilute urine)
• Hemophilia A
• Uremic bleeding
• Type 1 von Willebrand disease

Desmopressin is a drug that mimics a naturally occurring hormone in the body called antidiuretic hormone. It, therefore, is able to reduce diuresis or the production of urine in the kidneys that are ultimately transported into the bladder.

In addition, desmopressin increases chemicals in the blood called Factor VIII and von Willebrand factor, which are important to stop bleeding and develop clots. This explains its other roles beyond treating bedwetting.

Desmopressin should not be used to treat bedwetting in children who are younger than six years old. In addition, the medication should not be used during periods of illness that might affect fluid intake or the balance of electrolytes (such as in diarrhea or vomiting).

In addition, individuals with kidney problems, a history of low sodium (called hyponatremia), or with von Willibrand disease type IIB should not use desmopressin.

There are a number of other conditions in which desmopressin should be used only with caution, including coronary artery disease, high blood pressure (hypertension), fluid or electrolyte imbalance, polydipsia (excessive drinking), cystic fibrosis, clotting (thrombosis) risk, and in elderly patients.

Desmopressin has the potential to interact with many other drugs, so current medications should be carefully reviewed by your health care provider before you start to use it.

There are a handful of potential side effects with the use of desmopressin. Although an individual would not be expected to experience most side effects -- and may indeed not have any of them -- some that may commonly occur with desmopressin include:

• Flushing
• Chills
• Headache
• Dizziness
• Eye irritation (conjunctivitis)
• Nasal irritation (rhinitis)
• Nosebleeds (epistaxis)
• Cough
• Nausea
• Stomach pain

With the use of any drug, including desmopressin, there is a risk of serious side effects. These occur more rarely, but some that may occur with the use of desmopressin include:

• Low sodium (hyponatremia)
• Water intoxication
• Seizures
• Anaphylaxis (severe allergic reaction including difficulty breathing)
• Clotting (thrombosis)

As noted above, certain people should use desmopressin with caution or not at all. As the medication works in the kidneys, it is important to establish normal kidney function by measuring the creatinine in your blood prior to starting the medication.

If you experience any difficulties with the use of desmopressin, you should be in close contact with your primary health care provider.