Clinical use of the
DDAVP (1-Deamino-8-D-Arginine Vasopressin) is now the first choice in treatment of
Central Diabetes Insipidus. It is an analogue of
Vasopressin with a higher antidiuretic potency, less vasopressor activity, and a longer duration of action. This
drug still presents some problems of administration route. A lot of studies were published about different administration routes of
DDAVP: sublingual
tablets, parenteral
solution, nose spray and suction de-epithelialized skin. Some authors have utilized the oral route (
solution or
tablets) with good results in short-term treatment. We think the formulation in
tablets of
DDAVP is an efficacious support of the
therapy in this disease also for long-treatment. In our study 3 patients with
Central Diabetes Insipidus (aged 22-56; 2 idiopathic and 1 post-surgery) previously treated with
DDAVP nasal
solution (10 micrograms/day; 36-156 months), have been submitted to a chronic treatment with
DDAVP tablets for a period of 24-36 months. The
DDAVP tables were administered at the dosage of 400-600 micrograms/day in 2-3 administrations. The patients were studied at intervals of 3-6 months, and on each occasion full blood count,
glucose,
azotaemia,
creatinine, liver function tests,
electrolytes, urine volume, density and osmolality were estimated. The long-treatment with oral
DDAVP was able to keep a good control of the disease in all patients. In case 1 we had a significant reduction of urine volume (p < 0.01) and a significant increase (p < 0.01) of urine osmolality in comparison with previous treatment with nasal
solution; in case 2 and 3 no significant changes were observed. No side effects were noted during this study. The
drug has been well tolerated and the compliance of patients was better during oral
DDAVP than nasal
solution. In our opinion the oral
DDAVP is an effective and safe
solution for the treatment of
Central Diabetes Insipidus, and give to the patients a better quality of life in comparison to the nasal
solution.