英文药名: Ddavp (Desmopressin Acetate Tablets)

中文药名: 醋酸去氨加压素片

生产厂家: Ferring Pharmaceuticals Inc

药品名称

药品名称: 醋酸去氨加压素,去氨加压素,弥凝
英文名: Desmopressin, Minirin,Ddavp
药理作用

醋酸去氨加压素为天然精氨盐加压素的结构类似物，系对天然激素的化学结构进行两处改动而得，即1-半胱氨酸脱去氨基和以8-D-精氨酸取代8-L-精氨酸。静脉或皮下给予去氨加压素0.3ug/kg体重，可使血浆中凝血因子VIII（VIII：C）的活力增加2-4倍；也使Von Willebrand因子抗原（VWF：AG）的含量增加，但强并稍小。同时，释放出组织型纤维蛋白溶酶原激活因子（t-PA）。皮下注射的生物利用度约为静脉注射生物利用度的85%，按体重0.3ug/kg给药的最大血药浓度在给药后约60分钟达到峰值，平均值约为600pg/ml，血浆半衰期3-4小时，止血效果取决于血浆中VIII：C的半衰期，约8-12小时。去氧加压素能使因尿毒症、肝硬化、先天性或药源性血小板功能不良等，以及未知病因的出血时间过长患者的出血时缩短或政党化，IIB型血管性血友病患者身上的VIII因子异常，使用去氧加压素可引致血小板发生凝聚或血小板减少症。使用城乡差别氨加压素可避免因使用VIII因子浓缩物而导致爱滋病病毒或肝炎病毒传染的危险。

适应症

本品能使临床侵入性治疗或诊断性手术时过长的出血时间缩短或正常化，或使因尿毒症、肝硬化、先天性或药源性血小板功能不良，以及未知病因的出血时间过长患者的血现象得到控制。本品可用于试验剂量呈阳性反应的轻度甲型血友病患者及血管血友病患者进行小型手术时出血的控制或预防。对非凡病例，甚至可用于治疗和预防中度病情患者。
尿崩症：成人20～40ug/d；儿童10～20ug/d，分1～3次服用。
遗尿症：10～40ug／d，睡前用。
肾浓缩功能试验：成人40ug，1岁以上儿童10～20ug。
治疗性控制出血或手术前预防出血：静注0.3ug/kg。
 
用法用量

控制大出血或侵入性手术前预防大出血：0.3ug/kg体重，皮下给药或用生理盐水稀释至50-100ml，在15-30分钟内静脉滴注。若疗效呈阳性，可按起始剂量间隔6-12小时重复给药1-2次，进一步重复给药可能会使疗效降低。
血友病患者VIII：C的浓度达到预期值按与使用VIII因子浓缩物相同的原则进行估计，用药期间应定期对VIII：C的浓度进行跟踪监测，因为对某些闰例，重复给药后疗效反南昌降低。假如静脉滴注本药并没有使血浆中VIII；C的浓度达到预期的增加，应加用VIII因子浓缩物进行治疗。对血友病患者的治疗，应参考对每病人凝血试验的结果确定治疗方案。
剂量因人而异，应区分调整。
治疗中枢性尿崩症：一般成人和儿童的初始适宜剂量为为每次0.1毫克，每日三次。再根据患者的疗效调整剂量。根据临床经验，每天的总量在0.2-1.2毫克之间。对多数患者的适宜剂量为每次0.1-0.2毫克，每日三次。
治疗夜间遗尿症：初始适宜剂量为睡前服用0.2毫克，如疗效不显著可增至0.4毫克，连续使用三个月后停用此药至少一周，以便评估是否需要继续治疗。治疗期间需限制饮水，详见“注意事项”。
任何疑问，请遵医嘱！

不良反应

疲惫、头痛、恶心和胃痛。一过性血压降低，伴有反射性心动过速及面部潮红。眩晕。治疗时若有对水分摄入进行限制，则有可能导致水潴溜，并有伴发症状，如血钠降低、体重增加、严重情形下可发生痉挛。

注意事项

超量会增加水潴留和低钠血症的危险性。对低钠血症的处理因人而异。非症状性低钠血症的患者，应停用去氨加压素和限制液体摄入量，对伴有症状的低钠血症患者，宜在滴注时加入等渗或高渗氯化钠。水潴留严重时（痉挛及失去知觉），应加用呋噻米进行治疗。
习惯性或精神性燥渴；不稳定性心绞痛；代谢失调性心脏功能有全；IIB型血管性血友病患者。应注重水潴留的危险性。液体的摄入量应尽可能降低到量小量，并应定期检查体重。
假如体重逐渐增加，血钠降低到130mmol/L以下或血浆渗透压低于270mosm/kg，液体的摄入量应剧减，并停用去氨加压素。
太年幼或年老；需用利尿剂治疗体液和/或解质失衡的其它疾病患者；颅内压有增高危险的患者慎用。
使用本药前应测定凝血因子和出血时间，给药后血浆中VIII：C和VWF：AG的浓度会大量增加，但还不可能在用药前后对些因子的血浆水平和出血时间之间建立起相关关系。因此可能的话，去氨加压素对个别患难与共者出血时间的作用应进行试验测定。出血时间测定应尽量标准化验，如采用Simplate II方法。
对妊娠和哺乳的影响按人体用药剂量一百多倍对大鼠和兔子给药的生殖试验表明，去氨加压素对胚胎没有损害。有一研究人员曾报道了三例尿崩症孕妇在怀孕期间使用去氨加压素所生小儿发生畸形的病例，但超过一百二十全病例的其它报导显示，怀孕期间使用过去氨加压素的妇女所生婴儿正常。此外，大量资料的研究证实，在整个怀孕期间使用过去氨加压素的孕妇所生的29个婴儿的出生畸形率并没有增加。对接受大剂量（鼻内给药300ug）治疗的哺乳期妇女的乳汁进行分析，结果表明传给婴儿的去氨加压素的量大大低于能影响利尿及止血所需要的量。
制剂: 消炎痛可能会加强患者对去氨加压素的反应，但不会延长其作用的时间。一些已知可释放抗利尿激素的物质，如三环抗抑郁药，氯丙嗪和卡马西平，会增强抗利尿作用。增加水潴留的危险性。
药物相互作用

一些可引起释放抗利尿激素的药物，如三环类抗抑郁剂、氯丙嗪、卡马西平等，可增加抗利尿作用和水潴留的危险。
吲哚美辛(消炎痛)可增加醋酸去氨加压素的尿浓缩作用，但不会影响其药效的持续时间。该作用可能没有任何临床意义。

药物过量

超量使用会增加水潴留和低钠血症的危险性。
治疗：治疗低钠血症时应依情况而定，可采用以下建议，对无症状的低钠血症患者，除停用醋酸去氨加压素外应限制饮水；对有症状的患者，应加用滴注等渗或高渗的氯化钠溶液；当体液潴留症状严重（抽搐或神志不清时）需加服呋塞米。
 
规格

醋酸去氨加压素注射剂 4mcg/1ml;
醋酸去氨加压素喷鼻剂 10mcg X 2.5ml, 5ml;
醋酸去氨加压素片 0.1mg, 0.2mg; 60UG; 120UG.

Desmopressin Acetate Nasal spray, solution

What is this medicine?

DESMOPRESSIN (des moe PRESS in) is a man made hormone. It helps to control urination and thirst. This medicine is used to treat central diabetes insipidus. It is used in patients after a head injury or some surgeries. This medicine is also used to treat or prevent bleeding in patients with Hemophilia A and von Willebrand's Disease.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•blood clot in the past
•congestion, injury, swelling of the nose
•cystic fibrosis
•heart disease
•high blood pressure
•kidney disease
•low levels of sodium in the blood
•an unusual or allergic reaction to desmopressin, vasopressin, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

This medicine is for use in the nose. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take your medicine more often than directed. Make sure that you are using your nose spray correctly. Ask you doctor or health care provider if you have any questions.
 
Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for selected conditions, precautions do apply.
 
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

Do not take the missed dose. Take only the next dose according to your normal schedule. Do not take double or extra doses.

What may interact with this medicine?

•alcohol
•demeclocycline
•medicines for asthma, breathing problems, and colds
•medicines for low blood pressure

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular check ups. You may need to get some lab tests done while taking this medicine.

Talk with your doctor about how many glasses of fluid you need to drink a day. Too much or not enough water can cause harm.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•change in blood pressure
•chest pain, tightness
•difficulty breathing
•fast heart rate
•infection
•retaining water
•seizure
•sudden weight gain
•unusual bleeding, bruising
•unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•cough, sore throat
•flushing, reddening of the skin
•headache
•nausea, vomiting
•nosebleed
•runny or stuffy nose
•stomach cramps

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

DDAVP Brand Nasal Spray: Store at room temperature, between 20 and 25 degrees C (68 and 77 degrees F). Store bottle in upright position.

Stimate Brand Nasal Spray: Store in the refrigerator, between 4 and 8 degrees C (36 and 46 degrees F). When traveling, you can store at room temperature, 22 degrees C (72 degrees F) for up to 3 weeks.

Keep track of the number of doses that you use. Throw away the bottle when you have used the number of doses on the bottle label. Do not transfer any medicine into another bottle. Throw away any unused medicine after the expiration date.

注：以下产品不同规格和不同价格，购买时请以电话为准！

Ddavp包装规格：

Ddavp品牌药
0.1mg 30 片
   
0.2mg 30 片
   
120mcg 30 快速熔片
   
240mcg 30 快速熔片
   
60mcg 30 快速熔片
   
Ddavp普通药
 
0.1mg 90 片
   
0.2mg 90 片