Desmopressin (DDAVP) for Bleeding Disorders

These instructions are for Children's Hospital of Philadelphia (CHOP) patients who are prescribed intravenous (IV) desmopressin (DDAVP) for bleeding disorders.

Important information about desmopressin:

Desmopressin, also known as DDAVP, is used to help stop bleeding in patients with type I von Willebrand's disease or mild hemophilia A.

Desmopressin causes the release of von Willebrand's antigen, the protein that carries factor VIII. Increased amount of von Willebrand's antigen and factor VIII in the body makes blood clot faster. This stops bleeding more quickly.

Desmopressin is given intravenously (IV) over a period of 15 to 30 minutes in the clinic, short stay unit, or hospital. It is given 30 minutes before surgery or right away if bleeding occurs. A dose may be repeated if needed after 8 to 12 hours and may be given once daily thereafter. However, response to the medicine may be decreased if given more often than every 48 hours. The dose is specific to each patient and situation.

The medicine begins to work about 30 minutes after it is given and has a peak effect in 1-2 hours. The effect may last 8 to 12 hours or longer.

Common side effects include:

• Fluid retention

• Redness and warmth in face

Some patients experience:

• Runny or stuffy nose

• Headache

• Nausea (upset stomach)

• Dizziness

• Faster heart rate

• Pain, redness, or swelling at the IV site

Rare side effects include:

• Changes in blood pressure

• Blood clots

• Seizure

Instructions for desmopressin:

• Notify your hematology team if your child has ever had heart problems or a blood clot. Desmopressin should not be used by patients with these conditions.

• If your child has difficulty with the side effects from IV desmopressin, talk to your team. Many of the side effects that can occur with the IV form of desmopressin can be decreased by changing the dose or switching to the nasal form of desmopressin.

Instructions for fluids:

• After a dose of desmopressin, fluids need to be restricted up to 24 hours. If your child has more fluid than is allowed, their sodium levels can become dangerously low. This can cause seizures. There are no restrictions for solid food, so your child can continue to eat normally.

• The amount of fluids permitted is based on your child's weight. Adjust slightly for exercise, heat and thirst. Fluids include IV fluids given before or after surgery.

• Follow the guidelines below and contact your hematology team with any questions.

Contact your CHOP hematology team with questions, concerns or if your child has:

• Headaches or other pain not relived by acetaminophen (Tylenol ® )

• Faster heart rate

• Rapid weight gain

• Continued bleeding

• Dizziness

• Vision problems

• Confusion

• Seizures

Call 911 if your child has signs of an allergic reaction such as swelling of the face, lips, tongue or throat; trouble breathing, wheezing or chest tightness. If you are concerned the reaction is related to desmopressin, call your healthcare team after symptoms resolve to discuss a plan moving forward.

Division of Hematology

215-590-3535

Hemostasis and Thrombosis Center

For non-urgent issues, send your team a message in the MyCHOP portal.

Reviewed on July 1, 2023, by Marylou Macdermott, MSN, CRNP; Rebecca Kendsersky, PharmD, BCPPS