Synthetic copy of the body's antidiuretic hormone; FDA-approved since 1978 for diabetes insipidus, bedwetting, nocturia and mild bleeding disorders.
Also called DDAVP, Desmopressin acetate, 1-deamino-8-D-arginine vasopressin, Stimate, Nocdurna, Noctiva, Desmoda
When Desmopressin's status or evidence changes, it's in the next morning's email.
Desmopressin is a lab-made version of vasopressin, the hormone the pituitary releases to tell the kidneys to hold on to water. Two small changes to the molecule make it last longer and remove most of vasopressin's effect on blood pressure. It works on the V2 receptor in the kidney, so less urine is made, and it also releases clotting factor VIII and von Willebrand factor from blood vessel walls.
It has been an FDA-approved drug since 1978. DDAVP tablets and injection treat central diabetes insipidus, the tablets treat bedwetting in children 6 and older, and the injection and Stimate nasal spray (which Drugs@FDA lists as discontinued, though Ferring updated its label in July 2026) treat mild hemophilia A and type 1 von Willebrand disease before surgery or after an injury. Two low-dose products were approved for nocturia caused by making too much urine at night: Noctiva nasal spray in 2017 and Nocdurna tablets under the tongue in 2018. In 3-month trials they cut night-time trips to the toilet by about 0.2 to 0.4 more per night than placebo. FDA's database now lists both as discontinued.
The main danger is low blood sodium. Desmopressin makes the body keep water, and if a person keeps drinking, sodium gets diluted. The injection and nocturia labels carry a boxed warning: severe hyponatremia can cause seizures, coma and death. In an insurance-claims study of 3,137 adults, mean age 70, low sodium was 13 times more common on desmopressin than on oxybutynin. WADA lists desmopressin as a masking agent, banned at all times.
What it binds to, and what happens inside the body after that, step by step.
Desmopressin binds vasopressin V2 receptors in the kidney's collecting ducts, which makes the kidney pull more water back into the blood and produce less, more concentrated urine. Through a separate effect it raises blood levels of factor VIII and von Willebrand factor within 30 minutes, which helps blood clot in people with mild hemophilia A or type 1 von Willebrand disease. The structural changes from vasopressin give it a longer action and much less effect on blood pressure.
Human results and animal results are kept apart below. A result in rats tells you a mechanism is plausible. It does not tell you what happens in a person.
Desmopressin is a long-established drug backed by randomized trials for each labeled use. For nocturia the benefit is real but small: about 0.2 to 0.4 fewer night-time voids than placebo over 3 months. For bedwetting a 2025 Cochrane review found children on desmopressin were about 3 times as likely as on placebo to reach 14 dry nights in a row. In mild hemophilia A and von Willebrand disease about 71% of patients reach a useful factor level, and the drug's main harm, low blood sodium, is well documented.
385 men with 2 or more nocturnal voids, 3 months
50 mcg cut night voids by 0.37 more than placebo and delayed the first void by about 40 minutes; 2 men on 50 mcg and 9 on 75 mcg had sodium below 130 mmol/L.
Read the study261 women with 2 or more nocturnal voids, 3 months
25 mcg cut night voids by 0.22 more than placebo and delayed the first void by 49 minutes; sodium stayed above 125 mmol/L in all women.
Read the study95 trials, 8,473 children aged 5 to 16
Versus placebo, about 1.8 fewer wet nights a week and 3.18 times the chance of 14 dry nights in a row; no clear difference from a bedwetting alarm.
Read the study71 studies, 1,772 patients with bleeding disorders
The pooled share of patients with a complete or partial factor response was 71%, and the response depended mostly on baseline factor VIII or von Willebrand factor levels.
Read the study3,137 adults newly prescribed desmopressin, matched to 3,137 on oxybutynin, US claims data
Hyponatremia occurred at 146 vs 11 per 1,000 person-years, a 13-fold higher rate on desmopressin.
Read the study65 trials, 3,874 surgical patients without inherited bleeding disorders
Desmopressin made little or no difference to how many people needed a transfusion (risk ratio 0.96).
Read the studyPatients with mild or moderate hemophilia A and von Willebrand disease having dental or major surgery
Infusions raised factor VIII 2 to 6 fold, and eight patients had surgery, including cholecystectomy and tonsillectomy, without plasma concentrates.
Read the studyNo preclinical studies are listed as key studies here. The human data above carries the evidence.
When a new Desmopressin study in people is published, the daily email covers it.
These are questions the published research has not answered.
Drugs@FDA lists Noctiva (approved March 3, 2017) and Nocdurna (approved June 21, 2018) as discontinued, and Ferring's Stimate as discontinued, though generic desmopressin tablets, sprays and injections remain on the market. The DDAVP Injection and nocturia labels carry a boxed warning for hyponatremia and are contraindicated with loop diuretics, systemic or inhaled glucocorticoids, polydipsia, SIADH and an eGFR or creatinine clearance below 50 mL/min. WADA's 2026 list names desmopressin under S5 (diuretics and masking agents), prohibited in and out of competition.
When the FDA or WADA changes Desmopressin's status, it's in the next morning's email.
How much of Desmopressin is left after a single dose
Simple first-order model from the published half-life. Real clearance varies with dose, route, kidney and liver function and formulation. This is not a dosing schedule.
This table records the doses that trials and approved labels used, with the source for each row. It is a record of research, not a recommendation, and it is open to free members.
Which symptoms are expected and which mean stop and get help: side effects and red flags.
Tap a claim to see what the studies found.
It only helps when the kidneys make too much urine at night (nocturnal polyuria). In the Nocdurna and Noctiva trials, people went from about 3 trips a night to about 1.5 to 2, but placebo groups also improved, so the drug's own effect was about 0.2 to 0.4 fewer trips a night.
Even the low-dose nocturia products carry the boxed warning. In the Nocdurna trials about 4% of men 65 and older on 55.3 mcg had sodium of 129 mmol/L or lower, and 2 men on that dose had serious hyponatremia.
The labels tell patients to limit fluids from 1 hour before a dose until 8 hours after (24 hours for Stimate). Drinking while the drug is working is what dilutes the blood sodium.
It is labeled only for hemophilia A and type 1 von Willebrand disease with factor VIII above 5%. It is not for severe von Willebrand disease, and in type 2B it can cause clots. In surgery patients without a bleeding disorder, a Cochrane review found it did not reduce transfusions.
Not supplied as a powder. DDAVP Tablets: 20 to 25°C (68 to 77°F). DDAVP Injection: refrigerated at 2 to 8°C (36 to 46°F). Stimate spray: 20 to 25°C, upright. Noctiva: refrigerated before opening, then room temperature.
Not applicable; all forms are ready to use. Stimate is discarded 6 months after opening. For IV use, the injection is diluted in saline just before the infusion.
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