Minirin-Melt
Generic Name
Desmopressin
Manufacturer
Ferring Pharmaceuticals
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| minirin melt 120 mcg tablet | ৳ 114.00 | ৳ 1,140.00 |
Description
Overview of the medicine
Minirin-Melt contains desmopressin, a synthetic analogue of the natural pituitary hormone vasopressin. It is used to treat central diabetes insipidus, primary nocturnal enuresis, and nocturia associated with nocturnal polyuria in adults. The 'Melt' formulation is designed to dissolve quickly under the tongue.
Uses & Indications
Dosage
Adults
Central Diabetes Insipidus: Initial dose 60 mcg sublingually three times daily. Adjust individually to response; usual range 60-1200 mcg/day. Nocturia: Initial dose 60 mcg sublingually once daily at bedtime. If needed, may increase to 120 mcg, then 240 mcg at 1-week intervals.
Elderly
Not recommended for nocturia in patients over 65 years due to increased risk of hyponatremia. For other indications, use with caution and monitor serum sodium closely.
Renal_impairment
Contraindicated in moderate to severe renal impairment (creatinine clearance <50 mL/min). Use with caution in mild impairment with careful monitoring.
How to Take
Place the tablet under the tongue. It will dissolve quickly without the need for water. For nocturnal enuresis/nocturia, take at bedtime. Restrict fluid intake 1 hour before and for 8 hours after taking the dose.
Mechanism of Action
Desmopressin acts on V2 receptors in the renal collecting ducts, increasing water reabsorption and reducing urine output. This leads to increased urine osmolality and decreased plasma osmolality.
Pharmacokinetics
Onset
Antidiuretic effect typically begins within 30-60 minutes.
Excretion
Primarily excreted unchanged in urine.
Half life
Terminal elimination half-life is approximately 2-3 hours.
Absorption
Rapidly absorbed from the buccal mucosa. Absolute bioavailability is approximately 0.16% for the 120 mcg dose. Peak plasma concentrations (Tmax) are reached within 0.5-2 hours.
Metabolism
Not significantly metabolized by the liver. It is primarily degraded by peptidases.
Side Effects
Contraindications
- Hypersensitivity to desmopressin or any excipient
- Polydipsia (unusual thirst) of psychogenic or habitual origin
- Known hyponatremia
- Cardiac insufficiency and other conditions requiring diuretic treatment
- Moderate to severe renal impairment (CrCl < 50 mL/min)
- Syndrome of inappropriate ADH secretion (SIADH)
- Uncontrolled hypertension
Drug Interactions
Diuretics
Concomitant use with caution, may increase risk of hyponatremia.
Loperamide
May increase plasma concentrations of desmopressin.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May increase the risk of hyponatremia.
Tricyclic antidepressants, SSRIs, chlorpromazine, carbamazepine
May increase the risk of hyponatremia.
Storage
Store in the original blister pack to protect from moisture and light. Do not store above 30°C. Keep out of reach of children.
Overdose
Symptoms of overdose include hyponatremia (headache, nausea, vomiting, confusion, seizures), and fluid retention. Management involves discontinuing desmopressin, fluid restriction, and correcting hyponatremia with slow, careful intravenous administration of hypertonic saline if severe.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and potential benefits outweigh risks. Minimal amounts are excreted into breast milk; generally considered safe, but use with caution and monitor the infant.
Side Effects
Contraindications
- Hypersensitivity to desmopressin or any excipient
- Polydipsia (unusual thirst) of psychogenic or habitual origin
- Known hyponatremia
- Cardiac insufficiency and other conditions requiring diuretic treatment
- Moderate to severe renal impairment (CrCl < 50 mL/min)
- Syndrome of inappropriate ADH secretion (SIADH)
- Uncontrolled hypertension
Drug Interactions
Diuretics
Concomitant use with caution, may increase risk of hyponatremia.
Loperamide
May increase plasma concentrations of desmopressin.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May increase the risk of hyponatremia.
Tricyclic antidepressants, SSRIs, chlorpromazine, carbamazepine
May increase the risk of hyponatremia.
Storage
Store in the original blister pack to protect from moisture and light. Do not store above 30°C. Keep out of reach of children.
Overdose
Symptoms of overdose include hyponatremia (headache, nausea, vomiting, confusion, seizures), and fluid retention. Management involves discontinuing desmopressin, fluid restriction, and correcting hyponatremia with slow, careful intravenous administration of hypertonic saline if severe.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed and potential benefits outweigh risks. Minimal amounts are excreted into breast milk; generally considered safe, but use with caution and monitor the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
Approved (EU, US)
Patent Status
Off-patent (active ingredient, formulation may vary)
WHO Essential Medicine
YesClinical Trials
Desmopressin has undergone extensive clinical trials establishing its efficacy and safety for approved indications. Specific trials have validated the Minirin-Melt formulation's sublingual absorption and clinical performance.
Lab Monitoring
- Serum sodium levels (at initiation, with dose changes, and periodically, especially in elderly/at-risk patients)
- Urine output
- Blood pressure
Doctor Notes
- Emphasize strict fluid restriction for patients, particularly around the time of drug administration, to minimize the risk of hyponatremia.
- Monitor serum sodium levels closely at baseline, after dose adjustments, and periodically during long-term therapy, especially in elderly and pediatric populations.
- Educate patients and caregivers about the symptoms of hyponatremia (e.g., severe headache, nausea, confusion, seizures) and instruct them to seek immediate medical attention if these occur.
Patient Guidelines
- Strictly follow your doctor's instructions regarding fluid restriction, especially around the time of dose administration.
- Place the tablet under your tongue and let it dissolve completely. Do not chew or swallow it whole.
- Report any symptoms of severe headache, nausea, vomiting, unusual weight gain, or confusion to your doctor immediately.
- Do not drink large amounts of fluids when thirsty while on this medication, unless instructed by a healthcare professional.
Missed Dose Advice
If you miss a dose, take the next scheduled dose at your regular time. Do not take a double dose to make up for a missed one.
Driving Precautions
Minirin-Melt may cause dizziness or headache in some individuals. Patients should assess their reaction to the medication before driving or operating machinery.
Lifestyle Advice
- Maintain a healthy and balanced diet. If treating nocturnal enuresis or nocturia, ensure appropriate fluid restriction throughout the day, especially in the evening.
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