{"id":"desmopressin","name":"Desmopressin","aliases":["DDAVP","Minirin","Nocdurna","Noctiva","1-deamino-8-D-arginine vasopressin"],"url":"https://lyoresearch.com/compounds/desmopressin","class":{"id":"endocrine-medicines","name":"Bone and endocrine peptide medicines","url":"https://lyoresearch.com/classes/endocrine-medicines"},"summary":"Desmopressin is a synthetic analogue of the antidiuretic hormone vasopressin that concentrates urine without raising blood pressure. It is approved for diabetes insipidus, bedwetting, nocturia and some bleeding disorders. A Cochrane review of 14 trials found it reduces night-time voids by a little under one per night in men. Its serious risk is hyponatraemia — low blood sodium — in about 7.6% of older adults, which is why sodium is monitored. It is on WADA's list as a masking agent.","overall_grade":"A","overall_grade_meaning":"established in humans","human_trials":"Cochrane review (14 RCTs, n=2,966) + decades of use","regulatory_status":"Approved (Rx)","molecule":{"formula":"C46H64N14O12S2","molecular_weight":"1069.2","cas":"16679-58-6","pubchem_cid":5311065,"note":null},"pharmacokinetics":{"basis":"label","route":"Intravenous or subcutaneous injection; also tablets, melt tablets and nasal spray","half_life":"About 2.8 hours","licensed_regimen":"Haemophilia A / von Willebrand type 1: 0.3 mcg/kg (max 20 mcg) IV over 15-30 min; central diabetes insipidus: 2-4 mcg daily in 1-2 divided doses SC or IV","product":"DDAVP injection","source":{"title":"DDAVP injection prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=651f6fee-a2c7-431b-8d5d-58b156c72244"}},"outcomes":[{"outcome":"Nocturia (night-time voids)","grade":"A","grade_meaning":"established in humans","effect_size":"small","adverse":false,"human_studies":"Cochrane review, 14 RCTs (n=2,966 men)","evidence":"About 0.85 fewer voids per night at three to twelve months against placebo, with low-quality evidence; little difference at under three months. A separate meta-analysis in women found 0.41 fewer.","references":[{"citation":"Han J, Jung JH, Bakker CJ, Ebell MH, Dahm P. Desmopressin for treating nocturia in men.","where":"Cochrane Database Syst Rev, 2017","url":"https://pubmed.ncbi.nlm.nih.gov/29055129/"},{"citation":"Cai X, et al. Efficacy and safety of desmopressin in women with nocturia: a systematic review and meta-analysis of randomized controlled trials.","where":"Int Urol Nephrol, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31352583/"}],"verbatim":{"text":"For intermediate-term follow-up (three to 12 months), desmopressin may reduce the number of nocturnal voids in an appreciable number of participants (MD -0.85, 95% CI -1.17 to -0.53; low-quality evidence).","citation":"Han J, Jung JH, Bakker CJ, Ebell MH, Dahm P. Desmopressin for treating nocturia in men.","url":"https://pubmed.ncbi.nlm.nih.gov/29055129/"}},{"outcome":"Hyponatraemia (older adults)","grade":"A","grade_meaning":"established in humans","effect_size":"moderate","adverse":true,"human_studies":"Meta-analysis, 7 studies","evidence":"Pooled incidence of low sodium 7.6% in older adults treated for nocturia — the reason for sodium checks before and during treatment and for the boxed warning on the US nasal product.","references":[{"citation":"Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis.","where":"Neurourol Urodyn, 2004","url":"https://pubmed.ncbi.nlm.nih.gov/15227644/"}],"verbatim":{"text":"The pooled estimate for the incidence of hyponatremia was 7.6% (95% CI 3.7-15.1).","citation":"Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis.","url":"https://pubmed.ncbi.nlm.nih.gov/15227644/"}},{"outcome":"Central diabetes insipidus","grade":"A","grade_meaning":"established in humans","effect_size":"large","adverse":false,"human_studies":"Decades of use; the original indication","evidence":"Replaces the missing hormone; the standard treatment since the 1970s. Older trials, not modern RCTs, but the effect is unambiguous.","references":[{"citation":"Hahn D, et al. Desmopressin for nocturnal enuresis in children.","where":"Cochrane Database Syst Rev, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/40728007/"}]},{"outcome":"Nocturnal enuresis in children","grade":"A","grade_meaning":"established in humans","effect_size":"moderate","adverse":false,"human_studies":"Cochrane review (2025 update)","evidence":"Reduces wet nights during treatment; relapse on stopping is common, and alarm training has more durable effect.","references":[{"citation":"Hahn D, et al. Desmopressin for nocturnal enuresis in children.","where":"Cochrane Database Syst Rev, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/40728007/"}]}],"regions":[{"region":"European Union","status":"Approved, prescription-only","note":"Nationally authorised products (Minirin, Nocdurna and generics) across member states."},{"region":"United States","status":"Approved, prescription-only","note":"DDAVP and generics; Nocdurna (2018) and Noctiva nasal spray (2017) for nocturia, the latter with a boxed warning for hyponatraemia."},{"region":"United Kingdom","status":"Licensed, prescription-only","note":"Licensed for diabetes insipidus, enuresis, nocturia and haemophilia A / von Willebrand disease."},{"region":"Australia","status":"Registered, Schedule 4","note":"Minirin and generics on the ARTG."},{"region":"Canada","status":"Authorised, prescription-only","note":"DDAVP and generics."},{"region":"Sport (WADA)","status":"Prohibited at all times","note":"Listed under S5 (diuretics and masking agents) since 2011, because it dilutes urine and can mask other substances."}],"faq":[{"q":"Is desmopressin a peptide?","a":"Yes — nine amino acids in a disulfide ring, a modified copy of the hormone vasopressin."},{"q":"Why is desmopressin banned in sport?","a":"It concentrates urine and lets an athlete drink to dilute a sample, which can hide other substances. WADA lists it as a masking agent, not for any performance effect."},{"q":"What is the main risk?","a":"Low blood sodium. In older adults treated for nocturia the pooled rate is about 7.6%; severe cases cause confusion and seizures. Sodium is checked before treatment and again after starting."}],"references":[{"cite":"Han J, Jung JH, Bakker CJ, Ebell MH, Dahm P. Desmopressin for treating nocturia in men.","where":"Cochrane Database Syst Rev, 2017","url":"https://pubmed.ncbi.nlm.nih.gov/29055129/","note":"14 studies, 2,966 men."},{"cite":"Cai X, et al. Efficacy and safety of desmopressin in women with nocturia: a systematic review and meta-analysis of randomized controlled trials.","where":"Int Urol Nephrol, 2019","url":"https://pubmed.ncbi.nlm.nih.gov/31352583/","note":"7 trials."},{"cite":"Weatherall M. The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis.","where":"Neurourol Urodyn, 2004","url":"https://pubmed.ncbi.nlm.nih.gov/15227644/","note":"Pooled incidence 7.6%."},{"cite":"Hahn D, et al. Desmopressin for nocturnal enuresis in children.","where":"Cochrane Database Syst Rev, 2025","url":"https://pubmed.ncbi.nlm.nih.gov/40728007/"}],"last_reviewed":"2026-09-23","literature_searched_to":"2026-09-23","changelog":[{"date":"2026-09-23","note":"Initial publication. Grade A; small nocturia effect, hyponatraemia quantified, WADA S5 status recorded."}],"license":"CC BY 4.0 — cite as “LYO Research” with a link.","methodology":"https://lyoresearch.com/methodology"}