Synthetic vasopressin V2-receptor agonist analog (1-deamino-8-D-arginine vasopressin)
Desmopressin
Approvedaka DDAVP, 1-desamino-8-D-arginine vasopressin, Minirin, Stimate, Nocdurna, Noctiva
Desmopressin (DDAVP) is a long-established synthetic analog of the hormone vasopressin that concentrates urine and, at higher doses, raises factor VIII and von Willebrand factor to support clotting. It is approved by the FDA and TGA and authorized nationally across EU member states in nasal, oral, sublingual, and injectable forms. It is prohibited in sport by WADA as a masking agent.
Mechanism
In plain terms, desmopressin is a synthetic copy of a natural hormone that makes the kidneys hold onto water so the body produces less urine, and at higher doses it helps blood to clot. Technically, it is a synthetic analog of arginine vasopressin that is selective for the V2 receptor with minimal V1 (vasopressor) activity; V2 activation in the renal collecting ducts increases water reabsorption to produce antidiuresis, while it also releases stored factor VIII and von Willebrand factor from endothelium to support hemostasis.
Regulatory Status by Region
- United States (FDA)Approved. First approved in 1978 (DDAVP); labelled indications include central diabetes insipidus, hemostasis in mild hemophilia A and von Willebrand disease, primary nocturnal enuresis, and nocturia due to nocturnal polyuria (Nocdurna).
- Australia (TGA)Registered on the ARTG (Minirin and other brands; tablet, nasal spray, sublingual wafer, and injection) for indications including diabetes insipidus and nocturnal enuresis; prescription medicine.
- European Union (EMA)Authorized nationally across EU member states (not via a centralized EMA marketing authorisation).
- WADAProhibited at all times. Listed as a masking agent under Section S5 (Diuretics and Masking Agents) of the Prohibited List.
Key Studies
- Landmark study of DDAVP in haemophilia and von Willebrand disease; Mannucci PM et al. (opens in a new tab) (Lancet 1977;1(8017):869-872; DOI 10.1016/s0140-6736(77)91197-7; PMID 67283)
- Randomized double-blind placebo-controlled trial of low-dose desmopressin ODT for nocturia in men; Weiss JP et al. (opens in a new tab) (J Urol 2013;190(3):965-972; DOI 10.1016/j.juro.2012.12.112; PMID 23454402)
Related Clinical Trials
- Bedtime Device Restriction and Desmopressin in PMNE.N/A · Recruiting
- Randomized Controlled Clinical Study on the Prophylactic Intraoperative Use of Desmopressin in Complex Sellar Region TumorsPhase 4 · Enrolling By Invitation
- DDAVP for Pituitary AdenomaN/A · Recruiting
- DDAVP Effect by TEG6 in Cardiac SurgeryN/A · Not Yet Recruiting
- Transfusion Reduction in High-Bleeding-Risk Cardiac Surgery With DesmopressinPhase 3 · Not Yet Recruiting
- Bleeding Reduction in Acute and Chronic Kidney Patients Having Surgery (BRACKETS) Pilot TrialPhase 3 · Recruiting
- Effectiveness of Pelvic Floor Muscle Rehabilitation Combined With Desmopressin in Children With Primary Monosymptomatic Nocturnal EnuresisN/A · Recruiting
- Systematic Use of DDAVP to Prevent Serum Sodium Overcorrection in Severe HyponatremiaPhase 3 · Recruiting
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Common Questions
- What is Desmopressin?
- Desmopressin is a synthetic vasopressin V2-receptor analog first approved in 1978 for central diabetes insipidus, primary nocturnal enuresis, nocturia, and as a hemostatic agent in mild hemophilia A and von Willebrand disease. WADA prohibits it in sport at all times as a masking agent under Section S5.
- Is Desmopressin approved for medical use?
- Desmopressin is approved for one or more medical uses in at least one major jurisdiction. United States (FDA): Approved. First approved in 1978 (DDAVP); labelled indications include central diabetes insipidus, hemostasis in mild hemophilia A and von Willebrand disease, primary nocturnal enuresis, and nocturia due to nocturnal polyuria (Nocdurna). European Union (EMA): Authorized nationally across EU member states (not via a centralized EMA marketing authorisation). Australia (TGA): Registered on the ARTG (Minirin and other brands; tablet, nasal spray, sublingual wafer, and injection) for indications including diabetes insipidus and nocturnal enuresis; prescription medicine.
- How does Desmopressin work?
- In plain terms, desmopressin is a synthetic copy of a natural hormone that makes the kidneys hold onto water so the body produces less urine, and at higher doses it helps blood to clot. Technically, it is a synthetic analog of arginine vasopressin that is selective for the V2 receptor with minimal V1 (vasopressor) activity; V2 activation in the renal collecting ducts increases water reabsorption to produce antidiuresis, while it also releases stored factor VIII and von Willebrand factor from endothelium to support hemostasis.
- Is Desmopressin legal in Australia?
- Desmopressin in Australia (TGA): Registered on the ARTG (Minirin and other brands; tablet, nasal spray, sublingual wafer, and injection) for indications including diabetes insipidus and nocturnal enuresis; prescription medicine.
- Is Desmopressin banned in sport?
- Desmopressin under the World Anti-Doping Agency (WADA) code: Prohibited at all times. Listed as a masking agent under Section S5 (Diuretics and Masking Agents) of the Prohibited List.