Synthetic version of antidiuretic hormone. Used in central diabetes insipidus, nocturnal enuresis, nocturia due to nocturnal polyuria, and some clotting disorders (mild hemophilia A, von Willebrand disease).
Regulatory status
Approved (FDA / EMA)
Family
Synthetic vasopressin analog (V2 agonist)
Scientific evidence
High
Number of findings
1
Where it acts
Heart and blood · Hormones and metabolism
Also known as
desmopressin, DDAVP, Minirin, Nocdurna, Noctiva
Regulatory status
FDA (US): Approved (1978, DDAVP) for central diabetes insipidus and other uses; Nocdurna (2018) for nocturia due to nocturnal polyuria in adults, with a different dose for women and men
EMA (EU): No centralized authorization; authorized through national procedures in the EU and in Spain (e.g., Minirin, Nocdurna)
Dose
Nocturia (Nocdurna, sublingual, 1 h before bedtime): 27.7 µg/day in women and 55.3 µg/day in men (FDA label 2018). Other indications: according to the label of each formulation.
Safety
Main risk: hyponatremia (low sodium), which can be severe (seizures, coma). The US label carries a boxed warning. Fluids must be restricted at night and sodium monitored, especially in people over 65. Contraindicated if loop diuretics or systemic or inhaled corticosteroids are used. Requires a prescription and medical monitoring.
Interactions
Loop diuretics and corticosteroids (contraindicated with Nocdurna); drugs that promote hyponatremia: SSRI and tricyclic antidepressants, carbamazepine, chlorpromazine, NSAIDs.
Differences between women and men
Women are more sensitive to the antidiuretic effect: in a four-dose trial, the action lasted longer in women than in men, and the authors estimated that a man needs about 58 µg to match the effect of 25 µg in a woman. That is why the approved Nocdurna dose is half as high in women (27.7 µg) as in men (55.3 µg), which aims for a lower risk of hyponatremia. View the study →
Effect by goal · level of evidence
Nocturia: fewer awakenings to urinate
reducesModerateRCT (AA)in people
Lower optimal dose in women
In 116 patients aged 55–75, doses of 25, 50, and 100 µg significantly reduced nighttime awakenings to urinate versus placebo at 28 days. Women responded to lower doses.
It activates V2 receptors in the kidney and makes the kidney reabsorb more water, so less urine is produced. It has almost no effect on blood vessels. It also releases factor VIII and von Willebrand factor, which helps with clotting.
What the evidence says
In people
Nocturia: fewer wake-ups to urinate. In 116 patients aged 55–75, doses of 25, 50, and 100 µg significantly reduced nighttime awakenings to urinate versus placebo at 28 days. Women responded to lower doses. PubMed 23046147