[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Vasopressin and its analogues](https://durgical.com/en/pharmacology/classes/vasopressin-and-its-analogues/) › Desmopressin [Pharmacology](https://durgical.com/en/pharmacology/) · [Vasopressin and its analogues](https://durgical.com/en/pharmacology/classes/vasopressin-and-its-analogues/) # Desmopressin A synthetic antidiuretic hormone that makes the kidney hold water. Used for central diabetes insipidus, bedwetting and some bleeding disorders. Updated 2026-11-01 - Class: [Vasopressin and its analogues](https://durgical.com/en/pharmacology/classes/vasopressin-and-its-analogues/) - Receptor: Vasopressin V2 receptor - ATC code: H01BA02 - WHO Model List of Essential Medicines Also called: DDAVP (1-deamino-8-D-arginine vasopressin) ◎**Vasopressin V2 receptor**Desmopressin ⓘ The figure shows arginine vasopressin, the natural hormone (a peptide chain), bound to the human V2 receptor with its G protein; desmopressin is a modified vasopressin that binds the same site. **Target in 3D:** Vasopressin V2 receptor. PDB structure 7DW9 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7DW9) · Drag to rotate · pinch to zoom ## Mechanism of action Desmopressin is vasopressin with two changes (the first amino acid deaminated and D-arginine in place of L-arginine) that make it last longer and select the V2 receptor. In the collecting duct, V2 activation raises cAMP and inserts aquaporin-2 water channels, so water is reabsorbed and urine volume falls. It also raises factor VIII and von Willebrand factor levels by releasing them from endothelial stores, with little pressor effect. - Desmopressin activates V2 receptors in the renal collecting duct - Gs raises cAMP; aquaporin-2 channels move to the luminal membrane - Water is reabsorbed and urine becomes concentrated - In vessels it releases von Willebrand factor and factor VIII ## Pharmacokinetics **Absorption** Given by mouth, under the tongue, in the nose, IV or subcutaneously; oral absorption is low, so doses differ by route **Elimination** Mainly by the kidneys, so it accumulates in kidney failure **Half-life** Longer-acting than natural vasopressin ## Indications - Central (cranial) diabetes insipidus, including after head injury or pituitary surgery - Primary nocturnal enuresis (bedwetting) - Haemophilia A and type 1 von Willebrand disease with measurable factor VIII, to prevent or control bleeding ## Adverse effects ### Common - Headache - Nausea and abdominal cramps - Facial flushing - Nasal irritation with the spray ### Serious (rare, important) - Hyponatraemia from water retention, with headache, confusion, seizures and coma - Severe allergic reactions ## Contraindications - Hyponatraemia or a history of it - Moderate to severe kidney impairment - Syndrome of inappropriate antidiuretic hormone secretion (SIADH) - Polydipsia or excessive fluid intake - Use with loop diuretics or systemic or inhaled glucocorticoids ## Key interactions **Loop diuretics** Higher risk of severe hyponatraemia (combination contraindicated) **Systemic or inhaled glucocorticoids** Higher risk of severe hyponatraemia (combination contraindicated) **Drugs that promote water retention (for example tricyclic antidepressants, SSRIs, carbamazepine)** Additive risk of hyponatraemia ## What is monitored - Serum sodium, especially when starting or changing the dose - Urine volume and fluid intake - Body weight - Factor VIII and von Willebrand factor levels in bleeding disorders ## Administration and safety - Routes are not interchangeable: nasal, oral, sublingual and injectable products differ in potency - Fluid intake is limited as instructed around doses, especially at night for bedwetting - Look-alike risk with vasopressin: confirm the drug, product and route ## Nursing care - Check sodium before and during treatment; watch for headache, nausea, confusion or seizures - Record fluid intake, urine output and daily weight - Teach patients and parents the fluid limits around doses - In bleeding disorders, note the response with factor levels as ordered ## Pregnancy and breastfeeding Decades of use in pregnancy have not shown a drug-related risk of malformations; it is used for diabetes insipidus when needed. ## Memory aid DDAVP = «Don't Drink» And Very Potent at V2: holds water, so watch the sodium. ## Test yourself Think of the answer, then tap the question to see it. ## What is the most dangerous adverse effect of desmopressin and why does it happen? Hyponatraemia: V2 stimulation retains free water, which dilutes sodium, especially if the patient keeps drinking. ## Why is desmopressin useful before minor surgery in type 1 von Willebrand disease? It releases stored von Willebrand factor and factor VIII from the endothelium, raising their levels for a short time. ## Which two drug groups are contraindicated with desmopressin because of hyponatraemia risk? Loop diuretics and systemic or inhaled glucocorticoids. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/desmopressin/) ## Related drugs - [Vasopressin](https://durgical.com/en/pharmacology/vasopressin/) [← Back to the class: Vasopressin and its analogues](https://durgical.com/en/pharmacology/classes/vasopressin-and-its-analogues/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Desmopressin: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a608010.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - DESMOPRESSIN ACETATE injection, solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=539d7da2-72b8-45f9-836c-4e3351dd488e) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H01BA02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 37 (McGraw Hill, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/desmopressin/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/desmopressin/