Using Desmopressin (DDAVP) to Treat Bedwetting 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 its potential side effects?

Uses

Desmopressin is used most often to treat bedwetting in children who are older than age 5. 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 (a rare disorder causing excessive thirst and frequent urination)
• Hemophilia A (a hereditary blood disorder causing a lack of clotting)
• Uremic bleeding (a disorder increasing the risk of bleeding)
• Type 1 von Willebrand disease (bleeding disorder associated with lower-than-normal levels of a certain factor in the blood)

How It Works

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 is ultimately transported into the bladder.

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

Who Should Not Use Desmopressin?

Desmopressin should not be used to treat bedwetting in children who are younger than 6 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 several 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 healthcare provider before you start to use it.

Common Side Effects

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

Potential Serious Reactions

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)

Safety Precautions and Monitoring

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. Once the disorder has been adequately treated, the medication needs to be slowly tapered off and should not be stopped abruptly.

If your child experiences any difficulties with the use of desmopressin, you should be in close contact with your primary healthcare provider.