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MINIRIN NASAL SPRAY (DESMOPRESSIN ACETATE): PRECAUTIONS

General

Minirin (Desmopressin) Nasal Spray at high dosage has infrequently produced a slight elevation of blood pressure, which disappeared with a reduction in dosage. The drug should be used with caution in patients with coronary artery insufficiency and/or hypertensive cardiovascular disease because of possible rise in blood pressure.

Minirin (Desmopressin Acetate) should be used with caution in patients with conditions associated with fluid and electrolyte imbalance, such as cystic fibrosis, because these patients are prone to hyponatremia.

Rare severe allergic reactions have been reported with desmopressin acetate. Anaphylaxis has been reported with intravenous administration of desmopressin acetate injection, but not with Minirin nasal spray.

Central Cranial Diabetes Insipidus

Since Minirin (Desmopressin Acetate) is used intranasally, changes in the nasal mucosa such as scarring, edema, or other disease may cause erratic, unreliable absorption in which case intranasal Minirin should not be used. For such situations, desmopressin acetate injection should be considered.

Primary Nocturnal Enuresis

If changes in the nasal mucosa have occurred, unreliable absorption may result. Minirin Nasal Spray (Desmopressin) should be discontinued until the nasal problems resolve.

Information for Patients

Patients should be informed that the Minirin Nasal Spray (Desmopressin Acetate) bottle accurately delivers 50 doses of 10 ėg each. Any solution remaining after 50 doses should be discarded since the amount delivered thereafter may be substantially less than 10 ėg of drug. No attempt should be made to transfer remaining solution to another bottle. Patients should be instructed to read accompanying directions on use of the spray pump carefully before use.


Laboratory Tests

Laboratory tests for following the patient with central cranial diabetes insipidus or post-surgical or head traumarelated polyuria and polydipsia include urine volume and osmolality. In some cases plasma osmolality measurements may be required. For the healthy patient with primary nocturnal enuresis, serum electrolytes should be checked at least once if therapy is continued beyond 7 days.

Drug Interactions

Although the pressor activity of Minirin (Desmopressin) Nasal Spray is very low compared to the antidiuretic activity, use of large doses of intranasal Minirin with other pressor agents should only be done with careful patient monitoring.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Studies with Minirin (Desmopressin Acetate) spray nasal have not been performed to evaluate carcinogenic potential, mutagenic potential or effects on fertility.

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