Desmopressin Stimate nose spray (1309)

ALERT: CALL 9-1-1 if your child has trouble breathing.

 How does IN DDAVP work?

Intranasal desmopressin, or IN DDAVP, is a medicine that helps stop bleeding in patients with von Willebrand disease, platelet function defects, and mild hemophilia A. These bleeding problems are caused by low amounts of clotting proteins in the blood or because platelets don’t work well. IN DDAVP helps release more proteins and helps platelets stick together. Then a blood clot can form and bleeding will stop.

The medicine starts to work about 30 minutes after it is given.  It has the greatest effect in 1 to 3 hours. The effect may last 8 to 12 hours or longer.
Patients with heart problems or a history of blood clots should not use IN DDAVP. 

What do I need to know about this medicine? 

• IN DDAVP comes as a prescription nose spray. 
• Get the medicine from the Versiti Comprehensive Center for Bleeding Disorders.  It will have 1.5 mg of Desmopressin in each ml of fluid and 150 mcg per spray. Other brands are not mixed the same and are used for different problems.
• Dose:  Only give IN DDAVP once every 24 hours.
• Give one spray for patients who weigh 44 to 110 pounds. 
• Give two sprays for patients who weigh more than 110 pounds. 
• Ask your doctor when you should give IN DDAVP for bleeding or injury.
• Never use IN DDAVP for more than 3 days in a row. If it is used too often in a short period of time your body may not respond to this medicine.
• IN DDAVP is normally given 30 to 60 minutes before surgery. 
• Fluids need to be limited for 24 hours after the dose of IN DDAVP. Drinking too much liquid after taking this can cause seizures.  Your health care provider will give you specific instructions on how much your child can drink. Your child should not have more than ______cups (_____oz.)  for 24 hours after each dose of IN DDAVP. 

How do I give IN DDAVP?

1. Check the label and expiration date before giving each dose. Do not give expired medicine.
2. If possible, children should blow their nose to clear out any mucus before getting IN DDAVP.
3. Tilt the bottle so the tube inside the bottle is in the medicine.
4. Before using the medicine for the first time, prime it by pumping it into the air. Do this about 3 or 4 times.  Point bottle away from face when priming. 
5. Give the correct number of sprays. If your child’s dose is more than one spray, give one spray into each nostril. 
6. Tell your child to sniff in as the medicine is sprayed into the nose.
7. Rinse the spray tip with hot water and dry with a clean cloth or tissue.
8. Be sure to write down how much you used on the log sheet that comes in the box.

Remember fluids must be limited for 24 hours after use.  

What are the side effects?

Common

• Fluid retention
•  Redness and warmth in the face or chest

Less often

• Runny or stuffy nose
• Headache
• Faster heart rate
• Nausea (upset stomach)
• Dizziness

Rare

• Slight increase or decrease in blood pressure
• Blood clots 
• Seizures

What else do I need to know?

• If your child has a nose bleed, give the medicine in the nostril that is not bleeding. If both nostrils are bleeding, IN DDAVP may not work. Desmopressin may need to be given in the vein (IV) to stop the bleeding.
• IN DDAVP may not work for all patients. Your health care provider may recommend a Stimate challenge test to see if it works. This is done by giving a dose and then testing the blood at different times.
• IN DDAVP should only be used for certain types of bleeding disorders as directed by your doctor.
• It is usually not prescribed for patients with heart disease, significant risk factors for heart disease, or who are at risk for blood clotting 
• Not all pharmacies have IN DDAVP. Check the bottle for the number of sprays it contains. Be sure to call the Versiti Comprehensive Center for Bleeding Disorders at (414) 257-2424 if you are running low so your prescription can be filled before you run out. 
• Store this medicine at room temperature and keep out of reach of children.