英文药名: Ddavp(Desmopressin Acetate Ampules)

中文药名: 醋酸去氨加压素注射剂

品牌药生产厂家: 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：4mcg/1ml 10支x1ml 

Medication name
Generic name: Desmopressin - Injection
Pronunciation: (dess-mow-PRESS-in)
Brand name(s): DDAVP
Uses
Desmopressin is used to control the amount of urine your kidneys make. Normally, the amount of urine you make is controlled by a certain substance in the body called vasopressin. In people who have "water diabetes" (diabetes insipidus) or certain kinds of head injury or brain surgery, the body does not make enough vasopressin. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. This medication helps to control increased thirst and too much urination due to these conditions, and helps prevent dehydration.Desmopressin is also used to control bleeding caused by surgery or injuries in people with certain bleeding problems (hemophilia A, type 1 von Willebrand's disease). It works by helping the body with normal blood clotting.
How to use
This medication is given by injection into a vein or under the skin by a health care professional.When this medication is used to control increased thirst and too much urination, it is usually given twice a day or as directed by your doctor. If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day. If you have any questions about using this medication properly, consult your doctor or pharmacist.Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid.Learn how to store and discard needles and medical supplies safely. Consult your pharmacist for more details.Limit drinking of water and other fluids while using this medication, especially in children and older adults. Consult your doctor for details. If you find that you are drinking more fluids than directed, tell your doctor immediately. Your treatment will need to be adjusted. (See also Side Effects section.)Dosage is based on your medical condition and response to treatment. Do not use more desmopressin or use it more often than prescribed.Tell your doctor if your condition does not improve or if this medication stops working well.
Precautions
Before using desmopressin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease, a low level of sodium in the blood (current or past hyponatremia).Before using this medication, tell your doctor or pharmacist your medical history, especially of: high or low blood pressure, heart disease (such as blocked blood vessels in the heart), conditions that may increase your risk of fluid/mineral imbalance (such as cystic fibrosis, heart failure), the urge to drink too much water without being thirsty, history of blood clots.If you have lost too much body water (become dehydrated), your doctor will correct that condition first before starting treatment with desmopressin.This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Alcohol can also interfere with how well desmopressin works.Tell the doctor immediately if you develop any illness that can cause water/mineral imbalance (including fever, diarrhea, vomiting, infections such as the flu) or if you experience conditions that require drinking more fluids (for example, exposure to very hot weather, strenuous exercise, persistent sweating). The doctor may need to stop or adjust desmopressin treatment, especially in children and older adults.Children may be more sensitive to the side effects of this drug, especially water/mineral imbalance and a low level of sodium in the blood.Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, older adults may be at greater risk for water/mineral imbalance and a low level of sodium in the blood while using this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
Drug interactions
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: lithium.Other medications besides desmopressin may also affect the balance of water and sodium in your body. Therefore, tell your doctor or pharmacist about all the products you take, including: narcotic pain relievers (such as morphine), nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen), psychiatric medicines (such as chlorpromazine), drugs to treat seizures (such as carbamazepine), SSRI antidepressants (such as sertraline), tricyclic antidepressants (such as amitriptyline), "water pills" (diuretics such as furosemide).This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
Side effects
Headache, nausea, upset stomach, flushing of the face, or redness/pain/swelling at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Infrequently, desmopressin may affect your blood pressure. It may cause an increase or decrease in your blood pressure. A temporary drop in your blood pressure may result in dizziness and a fast heartbeat. Ask your doctor for more details, especially if you have heart problems or high or low blood pressure. Tell your doctor promptly if changes in your blood pressure occur or if any of these symptoms occur.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Desmopressin can infrequently cause a low level of sodium in the blood, which can be serious and possibly life-threatening. Drinking too much water or other fluids increases the risk of having a low level of sodium in the blood. Therefore, follow your doctor's directions for limiting fluids. Seek immediate medical attention if you have any of these unlikely but serious symptoms of a low level of sodium in the blood: loss of appetite, severe nausea, vomiting, severe headache, muscle weakness/spasms/cramps, sudden weight gain, unusual tiredness, unusual severe drowsiness, mental/mood changes (such as confusion, hallucinations, irritability), loss of consciousness, seizures, slow/shallow breathing.Seek immediate medical attention if any of these rare but serious side effects occur: chest pain, weakness on one side of the body, slurred speech, sudden vision changes.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Missed dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: confusion, drowsiness, persistent/severe headache, sudden weight gain.
Notes
Do not share this medication with others.Laboratory and/or medical tests (such as urine tests, blood tests, blood pressure, pulse) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
Medical alert
Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
Storage
Store this medication in the refrigerator between 36-46 degrees F (2-8 degrees C). Do not freeze. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Photos by medication strength
Click the "Photos" link to see sample photographs for a specific medication strength.
Common strengths 
DDAVP 15 mcg/mL Injection No photos 
DDAVP 15 mcg/mL Injection
PrintThe photos shown are samples only. Not all photos of the drug may be displayed. Your medication may look different. If you have questions, ask your pharmacist.

DDAVP 4 mcg/mL Injection *Photos