Clinical assessment of efficacy and safety of DDAVP

Abstract

Most adverse reactions were mild and no serious adverse drug reactions were either observed or reported by the subjects. We identified significant changes of heart rate, blood pressure and leucocytes after conduct of the DDAVP test. The value of these findings has to be investigated in later prospective randomized studies. Further research on identification of prospective parameter is currently ongoing.

Side effects of desmopressin in patients with bleeding disorders

“…A relatively high number of patients reported other side effects, often associated with preexisting complaints prior to infusion. This is a phenomenon also shown by Miesbach et al [4]. Therefore, we focused on patients without complaints at T0 to study the incidence of desmopressin-related side effects.…”

“…Despite this instruction we observed that 34% of patients drank more than 1.5 L. These patients did not differ with regard to laboratory values and vital signs or self‐reported side effects when compared to patients who drank <1.5 L. Lethagen et al . have used fluid restriction up to 2 L without severe side effects being reported . Patients tilted during infusion because of low BP or self‐reported dizziness, showed similar vital signs and water balance parameters after desmopressin to non‐tilted patients, suggesting that tilting is not indicative of hypotension or hyponatraemia after desmopressin.…”

“…This is a phenomenon also shown by Miesbach et al . . Therefore, we focused on patients without complaints at T0 to study the incidence of desmopressin‐related side effects.…”

“…Indeed frequencies in our population were higher than what is reported with subcutaneous (30% flush) or intranasal (3% flush, 4% headache, 2% dizziness) administration and are in line with findings by Miesbach et al . who also specifically studied side effects of intravenously administered desmopressin . Based upon the severity classification of side effects by Leissinger et al .…”

“…Desmopressin selectively stimulates the vasopressin-2 receptors, hence causing a transient decrease in blood pressure and an antidiuretic effect [10]. As a result, reported side effects are headache, flushing, nausea [4,5,11]. Multiple case reports have been published describing severe side effects in patients with bleeding disorders receiving desmopressin, giving the impression that desmopressin use often results in potential dangerous situations [12][13][14][15][16][17][18][19][20][21][22].…”