Abstract
Although nasal administration of DDAVP is very efficient there are several situations where this route is not feasible. This work was undertaken to test the feasibility of oral DDAVP administration, in 10 children (3 to 17.5 yr) with DI of various etiologies previously treated with intranasal DDAVP. In the first part of this study patients were hospitalized and increasing doses of oral DDAVP tablets (12.5 to 800 ug) were given every 12 hrs. Urinary volume and osmolality (U Osm) were measured in order to establish a dose response curve. In a 2d part oral treatment was continued at home for 3 months with the efficient dose as determined initially.
Antidiuresis started 45 min after oral DDAVP and reached a maximum after 120 min. A log linear relationship was demonstrated between DDAVP dosage and duration of antidiuresis. A 9 to 11.5 hrs antidiuresis (U Osm 550 to 650m0sm) was obtained with larger doses. During the 2d period some children were treated with that amount administered twice a day but 7 of them were better treated with lower doses given 3 times a day. All patients and their parents prefered the oral route.
In conclusion. Oral administration of DDAVP is possible and offers an alternative to the intranasal administration when this route is not efficient (rhinitis essentially). This study demonstrates that a nonapeptide can be absorbed by the intestinal tract and retain its biological activity.
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Fjellestad, A., Rappaport, R. & Czernichow, P. 7 ORAL TREATMENT OF CENTRAL DIABETES INSIPIDUS (DI) IN CHILDREN BY DDAVP TABLETS. Pediatr Res 19, 604 (1985). https://doi.org/10.1203/00006450-198506000-00027
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DOI: https://doi.org/10.1203/00006450-198506000-00027