What are the benefits and adverse effects of desmopressin acetate for treatment of enuresis?

Updated: Mar 26, 2020
  • Author: Wm Lane M Robson, MA, MD, FRCP, FRCP(Glasg); Chief Editor: Marc Cendron, MD  more...
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Answer

The safety profile of desmopressin acetate is favorable, and many studies have documented low rates of adverse effects. For the tablet, the incidence of minor adverse events is not significantly different from that for a placebo.

The only serious adverse effect reported in patients with enuresis treated with desmopressin is the development of seizure or other central nervous system (CNS) symptoms due to water intoxication. A review of case reports of water intoxication associated with desmopressin confirmed that excess fluid intake was a feature in at least six of 11 individuals. [21]

This serious adverse effect can be prevented by educating the patient not to consume an excess of fluids on any evening in which desmopressin is administered. A maximum of 1 cup of fluid should be offered at the evening meal, no more than 1 cup between mealtime and bedtime, and no fluid at all within the 2 hours preceding bedtime. Early symptoms of water intoxication include headache, nausea, and vomiting. If these symptoms develop, the medication should be discontinued and the child promptly assessed by a physician.


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