Desmospray Nasal Spray

Warning!

• It is important that you avoid excessive fluid intake while having treatment with this medicine, as this can lead to a build up of fluid in the body. (This includes avoiding accidentally swallowing water if you go swimming.) Follow the instructions given by your doctor.
• If you are taking this medicine to diagnose diabetes insipidus or to test your kidney function, you should not drink more than 500ml fluid in the period starting one hour before your dose to eight hours after your dose. After the test you should only drink as much fluid as you need to satisfy your thirst.
• If you are taking this medicine for nocturia associated with multiple sclerosis, you should limit your fluid intake to a minimum, starting from one hour before each dose until eight hours after each dose.
• If you are taking this medicine to treat nocturia associated with multiple sclerosis, your blood pressure and weight should be regularly monitored to check for the possibility of fluid overload. If you suffer from vomiting or diarrhoea you should stop using this medicine until you feel better.
• If you experience signs or symptoms of water retention and/or decreased concentration of sodium in the blood (an unusually bad or prolonged headache, confusion, nausea and vomiting, unexplained weight gain and in severe cases, convulsions) you should stop taking this medicine and consult your doctor immediately.

Use with caution in

• Elderly people.
• Decreased kidney function.
• Disease involving the heart and blood vessels (cardiovascular disease).
• Cystic fibrosis.
• Imbalance of water and salt concentrations in the blood (fluid and electrolyte imbalance).
• People at risk of developing raised pressure inside the skull (intracranial pressure).
• Not to be used in
• Syndrome of inappropriate ADH secretion (SIADH).
• Low levels of sodium in the blood (hyponatraemia).
• History of heart failure.
• Any other condition treated with medicines that increase urine production (diuretics).
• Moderate to severely decreased kidney function.
• Abnormal intense thirst caused by mental disorders (psychogenic polydipsia).
• People who drink abnormally large amounts of fluid, including alcohol.
• When used to treat nocturia in multiple sclerosis, this medicine should also not be used in people aged over 65 years, or people with high blood pressure (hypertension) or cardiovascular disease.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

• Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
• This medicine should be used with caution during pregnancy, and only if the expected benefit is greater than any possible risk to the developing baby. Seek medical advice from your doctor. If this medicine is used during pregnancy, blood pressure monitoring is recommended due to an increased risk of pre-eclampsia.
• This medicine may pass into breast milk. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

• Headache.
• Stomach ache.
• Nausea and vomiting.
• Blocked nose (nasal congestion).
• Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose.
• Nosebleeds (epistaxis).
• Emotional disturbance in children (very rarely).

If taken without restricting fluid intake: retention of water in the body tissues (fluid retention), low blood sodium level (hyponatraemia) or seizures (convulsions).

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to ensure that the combination is safe.

The following medicines may increase the release of natural antidiuretic hormone in the body and may therefore increase the effect of desmopressin:

• carbamazepine
• chlorpromazine
• non-steroidal anti-inflammatory drugs (NSAIDs), eg indometacin
• SSRI antidepressants such as fluoxetine
• tricyclic antidepressants such as amitriptyline.

If you are taking desmopressin with any of these medicines you should carefully follow instructions about restricting your fluid intake, because these medicines may increase the risk of fluid retention and decreased concentration of sodium in the blood. Your doctor may want to monitor the level of sodium in your blood more frequently.

References:

https://www.epgonline.org/uk/drugs/desmospray/

https://www.netdoctor.co.uk/medicines/liver-kidney-urinary-system/a6543/desmospray-desmopressin/

https://www.medicines.org.uk/emc/product/5449/smpc

http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1505451129480.pdf

https://www.medicines.ie/medicines/desmospray-desmopressin-nasal-spray-31822/

https://www.drugs.com/uk/desmospray-10-micrograms-nasal-spray-leaflet.html