Minirin-Melt
Generic Name
Desmopressin Acetate
Manufacturer
Ferring Pharmaceuticals
Country
Switzerland
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| minirin melt 60 mcg tablet | ৳ 68.00 | ৳ 680.00 |
Description
Overview of the medicine
Desmopressin is a synthetic analogue of the natural pituitary hormone vasopressin. It increases water reabsorption in the kidneys, primarily used for conditions like primary nocturnal enuresis and central diabetes insipidus.
Uses & Indications
Dosage
Adults
For central diabetes insipidus, the usual starting dose is 60 mcg three times daily, adjusted to individual response. For nocturia, initial dose is usually 60 mcg at bedtime, can be titrated up to 240 mcg.
Elderly
Increased risk of hyponatremia. Initial dose should be 60 mcg at bedtime, with careful monitoring of serum sodium levels. Not recommended for patients over 65 years with nocturia.
Renal_impairment
Contraindicated in moderate to severe renal impairment (creatinine clearance < 50 mL/min). Use with caution and reduced frequency in mild renal impairment; monitor serum sodium closely.
How to Take
Place the tablet under the tongue and allow it to dissolve completely without water. It should be taken at bedtime. Fluid intake should be restricted for 1 hour before and 8 hours after administration.
Mechanism of Action
Desmopressin acts on V2 receptors in the renal collecting ducts, increasing cyclic AMP, which leads to insertion of aquaporin-2 water channels into the apical membrane, thereby increasing water reabsorption and concentrating urine.
Pharmacokinetics
Onset
Antidiuretic effect usually begins within 1 hour after administration.
Excretion
Mainly excreted unchanged in the urine. Approximately 50% of the absorbed dose is excreted within 24 hours.
Half life
The terminal elimination half-life is approximately 2.5-3.3 hours for oral desmopressin.
Absorption
Rapidly absorbed orally. Oral bioavailability is low (0.16% to 0.18%). Food intake can significantly decrease absorption.
Metabolism
Minimally metabolized; hepatic metabolism is not considered significant. Primarily undergoes enzymatic degradation (desamination).
Side Effects
Contraindications
- Hypersensitivity to desmopressin or any excipients.
- Habitual or psychogenic polydipsia.
- Known or suspected cardiac insufficiency and other conditions requiring diuretic treatment.
- Moderate to severe renal impairment (creatinine clearance < 50 mL/min).
- Known hyponatremia or history of hyponatremia.
Drug Interactions
Loop diuretics
May increase the risk of hyponatremia.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May increase the risk of hyponatremia and fluid retention.
Tricyclic antidepressants, SSRIs (Selective Serotonin Reuptake Inhibitors), Chlorpromazine, Carbamazepine
May enhance the antidiuretic effect, increasing the risk of hyponatremia.
Storage
Store in the original package to protect from moisture. Do not store above 30°C. Keep out of the reach and sight of children.
Overdose
Symptoms of overdose include hyponatremia (headache, nausea, vomiting, weight gain, confusion, seizures, coma) and fluid retention. Management involves fluid restriction, discontinuing desmopressin, and if severe hyponatremia, cautious hypertonic saline administration.
Pregnancy & Lactation
Pregnancy Category B. Use with caution during pregnancy only if clearly needed. Excreted in breast milk in very small amounts; generally considered safe, but monitor the infant for any adverse effects.
Side Effects
Contraindications
- Hypersensitivity to desmopressin or any excipients.
- Habitual or psychogenic polydipsia.
- Known or suspected cardiac insufficiency and other conditions requiring diuretic treatment.
- Moderate to severe renal impairment (creatinine clearance < 50 mL/min).
- Known hyponatremia or history of hyponatremia.
Drug Interactions
Loop diuretics
May increase the risk of hyponatremia.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May increase the risk of hyponatremia and fluid retention.
Tricyclic antidepressants, SSRIs (Selective Serotonin Reuptake Inhibitors), Chlorpromazine, Carbamazepine
May enhance the antidiuretic effect, increasing the risk of hyponatremia.
Storage
Store in the original package to protect from moisture. Do not store above 30°C. Keep out of the reach and sight of children.
Overdose
Symptoms of overdose include hyponatremia (headache, nausea, vomiting, weight gain, confusion, seizures, coma) and fluid retention. Management involves fluid restriction, discontinuing desmopressin, and if severe hyponatremia, cautious hypertonic saline administration.
Pregnancy & Lactation
Pregnancy Category B. Use with caution during pregnancy only if clearly needed. Excreted in breast milk in very small amounts; generally considered safe, but monitor the infant for any adverse effects.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 3 years from the date of manufacture when stored correctly.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Expired
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of desmopressin for its approved indications, particularly in reducing bedwetting episodes in children with PNE.
Lab Monitoring
- Serum sodium levels (especially at treatment initiation, after dose adjustments, and in patients at increased risk of hyponatremia)
- Urine osmolality (for efficacy)
Doctor Notes
- Emphasize the critical importance of strict fluid restriction before and after administration to minimize the risk of hyponatremia.
- Monitor serum sodium levels, particularly at the initiation of therapy, following dose adjustments, and in patients at higher risk (e.g., elderly, those with comorbidities).
- Educate patients and caregivers on the signs and symptoms of hyponatremia and when to seek immediate medical attention.
Patient Guidelines
- Strictly restrict fluid intake for 1 hour before and 8 hours after taking the tablet to avoid fluid overload and hyponatremia.
- Place the tablet under the tongue and allow it to dissolve completely; do not chew or swallow it.
- Report any signs of hyponatremia (e.g., severe headache, confusion, nausea, vomiting, unusual weight gain) to your doctor immediately.
- Always take this medicine at bedtime.
Missed Dose Advice
If a dose is missed, skip the missed dose and continue with the next scheduled dose at the usual time. Do not take a double dose to make up for a missed one.
Driving Precautions
Minirin-Melt may cause dizziness as a side effect. Patients should exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain recommended fluid restriction as advised by your doctor. Avoid excessive fluid intake, particularly close to bedtime. Limit caffeine and alcohol intake.
- Follow a balanced diet and regular exercise for overall health.
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