Oral DDAVP (desmopressin acetate) for Bedwetting

These instructions are for Children’s Hospital of Philadelphia (CHOP) patients who have been prescribed DDAVP for bedwetting.

Important information about DDAVP:

• DDAVP may help decrease urine production. The hope is that it will concentrate the urine to a volume that the bladder can hold overnight.

• DDAVP is available as a tablet (pill).

• Some children use DDAVP to stay dry for special occasions like camping trips, vacations, and overnights. Some older children use it every night.

• Some children are dry when taking DDAVP. Other children have fewer wet nights but are not completely dry. Some children have no response.

How long can my child take DDAVP?

• Some older children use DDAVP every night. We recommend trying to decrease the dose of DDAVP every 3 to 6 months to see if the bedwetting has stopped. Recent research suggests that when DDAVP is stopped gradually, the good effects may continue. Your child’s healthcare provider will give you instructions about how to decrease the DDAVP dose.

• If your child continues to use DDAVP for bedwetting, we want to see them back for a follow-up appointment in one year.

Follow these instructions for giving DDAVP:

Before taking DDAVP:

On nights when DDAVP is used, your child should not have more than 8 ounces of fluid from 1 hour before the pill is given until morning. The medicine should not be used if the child cannot limit their fluid intake at bedtime.

Step 1 Give one 0.2 mg tablet (0.2 mg total) at bedtime for 1 week.

• If your child stays dry, continue to use 0.2 mg (do not proceed to step 2).

• If your child wets the bed, increase the dose in step 2.

Step 2 Give two 0.2 mg tablets (0.4 mg total) at bedtime the 2nd week.

• If your child stays dry, continue to use 0.4 mg (do not proceed to step 3).

• If your child wets the bed, increase the dose in step 3.

Step 3 Give three 0.2 mg tablets (0.6 mg total) at bedtime for the 3rd week.

• If your child stays dry, continue to use 0.6 mg.

• If your child wets the bed, discontinue the medicine. The maximum dose of DDAVP is three 0.2 mg. tablets (0.6mg).

Contact your child’s healthcare provider with questions or if your child experiences side effects.

Side effects are generally mild and include headache and nausea. A rare but serious side effect is a drop in the blood sodium level. This is unlikely to happen when DDAVP is used as a tablet. This is why fluid is limited on nights when DDAVP is used.

The following symptoms could be signs of a low blood sodium level. Contact your healthcare provider if your child has:

• Severe nausea

• Vomiting

• Fatigue

• Muscle cramps or weakness

Stop giving your child DDAVP if they:

• Develops an illness such as the flu (with fever, vomiting, diarrhea).

• Plan intense exercise (playing sports or field day).

• May be drinking a very large amount of water.

Reviewed on March 2023