Subcutaneous injection of desmopressin (DDAVP): evaluation of a new, more concentrated preparation

A more concentrated desmopressin (DDAVP) preparation (40 micrograms/ml), which required small injection volumes (less than 1 ml), was studied in a double-blind trial in 10 healthy volunteers, 12 patients with haemophilia A, and 8 patients with uraemic bleeding. DDAVP was administered by subcutaneous...

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Bibliographic Details
Published inHaemostasis Vol. 19; no. 1; p. 38
Main Authors Köhler, M, Hellstern, P, Tarrach, H, Bambauer, R, Wenzel, E, Jutzler, G A
Format Journal Article
LanguageEnglish
Published Switzerland 1989
Subjects
Adult
Antigens - analysis
Bleeding Time
Blood Coagulation Disorders - drug therapy
Blood Coagulation Disorders - etiology
Deamino Arginine Vasopressin - administration & dosage
Drug Evaluation
Factor VIII - analysis
Female
Hemophilia A - drug therapy
Heterozygote
Humans
Injections, Subcutaneous
Male
Middle Aged
Uremia - complications
von Willebrand Factor - analysis
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Summary:A more concentrated desmopressin (DDAVP) preparation (40 micrograms/ml), which required small injection volumes (less than 1 ml), was studied in a double-blind trial in 10 healthy volunteers, 12 patients with haemophilia A, and 8 patients with uraemic bleeding. DDAVP was administered by subcutaneous injection at a dose of 0.4 micrograms/kg body weight. In healthy subjects, peak levels of DDAVP ranging from 480 to 638 pg/ml were reached 1 h after the subcutaneous injection and DDAVP was eliminated with a mean half-life of 3.1 h. DDAVP produced a 2.5-fold (3.0-fold) increase of factor VIII:C (factor VIII:Ag) and a 1.9-fold (2.2-fold) increase of von Willebrand factor:Ag (ristocetin cofactor) over baseline levels. Additionally, a 2.1-fold increase of tissue-type plasminogen activator antigen was observed. Factor VIII and von Willebrand factor were rapidly eliminated with a half-life ranging from 1.3 to 5.7 h and from 1.1 to 11.4 h, respectively. In haemophilia A patients, DDAVP produced a 2.3-fold increase of factor VIII:C 1 h after the injection. DDAVP was given on 8 occasions for management of bleeding, and only in 1 patient did a wound haematoma (after herniotomia) occur. In 7 of the 8 patients with uraemia the bleeding time shortened, and in all patients an increase of platelet retention and a decrease of platelet count was observed (p less than 0.05). No serious local or systemic untoward side effects were observed.
ISSN:0301-0147
DOI:10.1159/000216097