Desmopressin

SCOPE: this covers the page's primary indication and primary route — haemostatic cover, given SC or IV. The INTRANASAL route the page also lists is NOT covered: the product fetched is Octim Injection, and no nasal-spray posology appears anywhere in this bundle, so the page's intranasal figures have not been re-sourced. || §4.2 MILD TO MODERATE HAEMOPHILIA AND VON WILLEBRAND'S DISEASE, verbatim: 'By subcutaneous or intravenous administration. The dose for adults, children and infants is 0.3 micrograms per kilogram body weight, administered by subcutaneous injection or intravenous infusion. Further doses may be administered at 12 hourly intervals so long as cover is required. As some patients have shown a diminishing response to successive doses, it is recommended that monitoring of Factor VIII levels should continue. For intravenous infusion, the dose should be diluted in 50ml of 0.9% sodium chloride for injection and given over 20 minutes. This dose should be given immediately prior to surgery or following trauma.' || EXPECTED RESPONSE, §4.2: 'Increase of Factor VIII levels are dependent on basal levels and are normally between 2 and 5 times the pre-treatment levels. If results from a previous administration of desmopressin are not available then blood should be taken pre-dose and 20 minutes post-dose for assay of Factor VIII levels in order to monitor response.' || SURGERY, §4.2: 'Unless contraindicated, when surgery is undertaken tranexamic acid may be given orally at the recommended dose from 24 hours beforehand until healing is complete.' || A SECOND, DIFFERENT USE IN THE SAME §4.2 — FIBRINOLYTIC RESPONSE TESTING (a diagnostic test, not haemostatic cover): 'The dose for adults and children is 0.3 micrograms per kilogram body weight, administered by subcutaneous injection or intravenous infusion... A sample of venous blood should be taken 20 minutes after the administration. In patients with a normal response the sample should show fibrinolytic activity of euglobulin clot precipitate on fibrin plates of at least 240mm2.' Note §4.3 bars this test in hypertension, heart disease, cardiac insufficiency and conditions requiring diuretics. || NO MAXIMUM DOSE IS STATED ANYWHERE IN THIS SPC, so maxDose is empty. || ADMINISTRATION EFFECT, §4.2: 'During administration of intravenous desmopressin, vasodilation may occur resulting in decreased blood pressure and tachycardia with facial flushing in some patients.' §4.8 adds this 'is normally avoided by infusing the product over 20 minutes'.

THE SAME PER-DOSE FIGURE APPLIES ACROSS THE WHOLE PAEDIATRIC RANGE — §4.2, verbatim: 'The dose for adults, children and infants is 0.3 micrograms per kilogram body weight, administered by subcutaneous injection or intravenous infusion.' The SPC states one weight-based per-dose figure for adults, children and infants alike, with no age band, no weight band and no separate paediatric ceiling, which is why dosePerKg carries it. || NO MAXIMUM DOSE IS STATED, so maxDose is empty and the calculator applies no cap. || NO LOWER AGE OR WEIGHT CUT-OFF APPEARS IN ANY FETCHED SECTION of this SPC — the absence of one here is not evidence that none exists. || CONCENTRATION IS NULL: the strength of Octim Injection is not stated in any fetched section, so no mg/mL figure could be sourced and no volume can be derived here — read the strength off the ampoule. || FLUID RESTRICTION IS MANDATORY AROUND THE DOSE, §4.4 verbatim: 'When repeated doses are used to control bleeding in haemophilia or von Willebrand's disease, care should be taken to prevent fluid overload. Fluid should not be forced, orally or parenterally, and patients should only take as much fluid as they require to satisfy thirst. Intravenous infusions should not be left up as a routine after surgery.' || §4.8 records a paediatric-specific signal: 'Very rare cases of emotional disorders including aggression in children have been reported.' || Verify all under-18 dosing against a children's formulary before prescribing.