DDAVP

Manufacturer
Ferring Pharmaceuticals Inc.
Effective date
2022-09-28
Label type
HUMAN PRESCRIPTION DRUG LABEL
Version
15
Source
full-release
Hydrated at
2026-05-31 20:43:56

Label at a glance#

ProductDDAVP
Active ingredientDESMOPRESSIN ACETATE
Label structure18 sections

Boxed warning

DDAVP can cause hyponatremia. Severe hyponatremia can be life-threatening, leading to seizures, coma, respiratory arrest, or death [see Warnings and Precautions (5.1) ] . DDAVP is contraindicated in patients at increased risk of severe hyponatremia, such as patients with excessive fluid intake, illnesses that can cause fluid or electrolyte imbalances, and in those using loop diuretics or systemic or inhaled glucoc...

Indications and uses

DDAVP Injection is indicated as antidiuretic replacement therapy in the management of central (cranial) diabetes insipidus and for the management of the temporary polyuria and polydipsia following head trauma or surgery in the pituitary region. Limitations of Use: DDAVP is ineffective and not indicated for the treatment of nephrogenic diabetes insipidus. DDAVP Injection is indicated for patients with hemophilia A ...

Dosage and administration

Diabetes Insipidus Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Intermittently during treatment, assess serum sodium, urine volume and osmolality or plasma osmolality. Hemophilia A Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. Also assess serum sodium and aPTT prior to tr...

Storage and handling

DDAVP Injection is available as a sterile solution supplied as 4 mcg/mL in cartons of ten 1 mL single-dose, type 1 glass ampules (NDC 55566-2200-0) and 40 mcg/10 mL (4 mcg/mL) in 10 mL multiple-dose vials, type 1 glass vial with rubber stopper and a flip off seal, (NDC 55566-2300-0), each containing 4 mcg DDAVP per mL. Store refrigerated 2° to 8°C (36° to 46°F).

Label contents#

Full prescribing information#

WARNING: HYPONATREMIA

BOXED WARNING SECTION

DDAVP can cause hyponatremia. Severe hyponatremia can be life-threatening, leading to seizures, coma, respiratory arrest, or death [see Warnings and Precautions (5.1)].

DDAVP is contraindicated in patients at increased risk of severe hyponatremia, such as patients with excessive fluid intake, illnesses that can cause fluid or electrolyte imbalances, and in those using loop diuretics or systemic or inhaled glucocorticoids [see Contraindications (4) and Warnings and Precautions (5.1)].

Ensure the serum sodium concentration is normal before starting or resuming DDAVP. Measure serum sodium within 7 days and approximately 1 month after initiating therapy, and periodically during treatment. More frequently monitor serum sodium in patients 65 years of age and older and in patients at increased risk of hyponatremia [see Dosage and Administration (2.1) and Warnings and Precautions (5.1)].

If hyponatremia occurs, DDAVP may need to be temporarily or permanently discontinued [see Warnings and Precautions (5.1)].

1 INDICATIONS AND USAGE

INDICATIONS & USAGE SECTION

1.1 Central Diabetes Insipidus

SPL UNCLASSIFIED SECTION

DDAVP Injection is indicated as antidiuretic replacement therapy in the management of central (cranial) diabetes insipidus and for the management of the temporary polyuria and polydipsia following head trauma or surgery in the pituitary region.

SPL UNCLASSIFIED SECTION

Limitations of Use:

DDAVP is ineffective and not indicated for the treatment of nephrogenic diabetes insipidus.

1.2 Hemophilia A

SPL UNCLASSIFIED SECTION

DDAVP Injection is indicated for patients with hemophilia A with factor VIII coagulant activity levels greater than 5% without factor VIII antibodies to:

  • Maintain hemostasis during surgical procedures and postoperatively
  • Reduce bleeding with episodes of spontaneous or traumatic injuries such as hemarthroses, intramuscular hematomas, or mucosal bleeding.

1.3 von Willebrand's Disease (Type I)

SPL UNCLASSIFIED SECTION

DDAVP Injection is indicated for patients with mild to moderate von Willebrand's disease (Type I) with factor VIII levels greater than 5% to:

  • Maintain hemostasis during surgical procedures and postoperatively
  • Reduce bleeding with episodes of spontaneous or traumatic injuries such as hemarthroses, intramuscular hematomas, or mucosal bleeding.
SPL UNCLASSIFIED SECTION

Limitations of Use

DDAVP is not indicated for the treatment of severe von Willebrand's disease (Type I) and when there is evidence of an abnormal molecular form of factor VIII antigen [see Warnings and Precautions (5.2)].

2 DOSAGE AND ADMINISTRATION

DOSAGE & ADMINISTRATION SECTION

2.1 Pretreatment Testing and On-Treatment Monitoring

SPL UNCLASSIFIED SECTION

SPL UNCLASSIFIED SECTION

Diabetes Insipidus

Prior to treatment with DDAVP, assess serum sodium, urine volume and osmolality. Intermittently during treatment, assess serum sodium, urine volume and osmolality or plasma osmolality.

SPL UNCLASSIFIED SECTION

Hemophilia A

Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. Also assess serum sodium and aPTT prior to treatment. In certain clinical situations, it may be justified to try DDAVP in patients with factor VIII levels between 2% to 5%; however, these patients should be carefully monitored.

SPL UNCLASSIFIED SECTION

von Willebrand's Disease (Type I)

Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude severe von Willebrand's disease (Type I) and presence of abnormal molecular form of factor VIII antigen.

During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved.

SPL UNCLASSIFIED SECTION

For All Patients Receiving Repeated Doses: Restrict free water intake and monitor for hyponatremia.

Ensure that serum sodium is normal prior to initiating or resuming treatment with DDAVP Injection.

2.3 Preparation and Administration for Patients with Hemophilia A and von Willebrand's Disease (Type I)

SPL UNCLASSIFIED SECTION

Prepare the solution for infusion using aseptic technique. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Withdraw the necessary volume of DDAVP Injection from the vial and dilute by adding to the infusion bag of 0.9% Sodium Chloride Injection, USP per Table 1. Dilute DDAVP Injection in sterile 0.9% Sodium Chloride Injection, USP and infuse slowly over 15 minutes to 30 minutes.

The volume of diluent is weight-based. See Table 1 for volume of diluent to use.

Table 1: Volume of Diluent Required
Patient WeightVolume of 0.9% Sodium Chloride Injection, USP for dilution
10 kg or less10 mL
More than 10 kg50 mL

Monitor blood pressure and pulse during infusion.

2.4 Switching Between Desmopressin Acetate Formulations

SPL UNCLASSIFIED SECTION

DDAVP is also available as nasal spray and tablet dosage forms.

When switching between formulations, the below text is meant as guidance for starting dose. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient.

When switching from DDAVP Nasal Spray to DDAVP Injection, the starting dose is one-tenth times the DDAVP Nasal Spray dose.

When switching from DDAVP Tablets to DDAVP Injection, titrate dose individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) due to the large variability in both PK and PD. Monitor patients closely during the initial dose titration period.

3 DOSAGE FORMS AND STRENGTHS

DOSAGE FORMS & STRENGTHS SECTION

Injection: DDAVP is a sterile, aqueous, colorless solution available as:

  • 4 mcg/mL in single-dose ampule
  • 40 mcg/10 mL (4 mcg/mL) in multiple-dose vial

4 CONTRAINDICATIONS

CONTRAINDICATIONS SECTION

DDAVP Injection is contraindicated in patients with known hypersensitivity to desmopressin acetate or to any of the components of DDAVP Injection [see Warnings and Precautions (5.4), Adverse Reactions (6), Description (11)].

DDAVP Injection is contraindicated in patients with the following conditions due to an increased risk of hyponatremia:

DDAVP Injection is contraindicated in patients with the following conditions because fluid retention increases the risk of worsening the underlying condition:

  • Heart failure
  • Uncontrolled hypertension

5 WARNINGS AND PRECAUTIONS

WARNINGS AND PRECAUTIONS SECTION

5.1 Hyponatremia

SPL UNCLASSIFIED SECTION

DDAVP Injection can cause hyponatremia. Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated, leading to seizures, coma, respiratory arrest, or death [see Boxed Warning].

DDAVP Injection is contraindicated in patients with hyponatremia (or a history of hyponatremia), with excessive fluid intake (e.g., polydipsia), using loop diuretics or systemic or inhaled glucocorticoids, with known or suspected SIADH, and/or illnesses that can cause fluid or electrolyte imbalances [see Contraindications (4), Drug Interactions (7)]. Avoid concomitant treatments that also cause hyponatremia.

Prior to starting or resuming DDAVP Injection, ensure that the serum sodium concentration is normal. Limit fluid intake to a minimum from 1 hour before administration until 8 hours after administration. Use of DDAVP Injection without concomitant reduction of fluid intake may lead to fluid retention and hyponatremia.

Monitor the serum sodium concentration within 1 week and approximately 1 month of initiating DDAVP Injection, and periodically thereafter [see Dosage and Administration (2.1)]. Base the frequency of serum sodium monitoring on the patient's risk of hyponatremia.

Patients with conditions associated with fluid and electrolyte imbalance (i.e., cystic fibrosis, heart failure, and renal disorders), geriatric and pediatric patients, patients receiving concomitant treatments that also cause hyponatremia (i.e., tricyclic antidepressants, selective serotonin reuptake inhibitors, nonsteroidal anti-inflammatory drugs, chlorpromazine, opiate analgesics, carbamazepine, lamotrigine, thiazide diuretics and chlorpropamide), and patients with habitual or psychogenic polydipsia who may drink excessive amounts of water, may be at increased risk of hyponatremia [see Contraindications (4)].

If hyponatremia occurs, DDAVP Injection may need to be temporarily or permanently discontinued and treatment for the hyponatremia instituted, depending on the clinical circumstances, including the duration and severity of the hyponatremia.

5.2 Hypotension and Hypertension

SPL UNCLASSIFIED SECTION

DDAVP may cause hypotension (with compensatory increase in heart rate) or hypertension. Monitor blood pressure during DDAVP administration, particularly in patients with a history of coronary artery insufficiency and/or hypertensive cardiovascular disease [see Adverse Reactions (6), Drug Interactions (7.2)]

5.3 Increased Risk of Thrombosis in Patients with von Willebrand's Disease Type IIB

SPL UNCLASSIFIED SECTION

Use of DDAVP in patients with Type IIB von Willebrand's disease may result in platelet aggregation, thrombocytopenia, and possibly thrombosis.

5.4 Hypersensitivity Reactions

SPL UNCLASSIFIED SECTION

Hypersensitivity reactions including anaphylaxis have been reported with intravenous and intranasal DDAVP, including cases of fatal anaphylaxis with intravenous DDAVP. DDAVP Injection is contraindicated in patients with known hypersensitivity to desmopressin acetate or to any of the components of DDAVP Injection [see Contraindications (4)]. It is not known whether antibodies to DDAVP Injection are produced after repeated injections. Monitor patients for signs or symptoms of hypersensitivity reactions during administration, interrupt treatment should a reaction occur, and manage medically. Permanently discontinue for serious hypersensitivity reaction [see Adverse Reactions (6)].

5.5 Fluid Retention

SPL UNCLASSIFIED SECTION

DDAVP Injection can cause fluid retention, which can worsen underlying conditions that are susceptible to volume status. Patients with heart failure or uncontrolled hypertension may be at increased risk. DDAVP Injection is not recommended in patients at risk for increased intracranial pressure or those with a history of urinary retention. Advise patients to limit fluid intake [see Patient Counseling Information (17)].

6 ADVERSE REACTIONS

ADVERSE REACTIONS SECTION

The following clinically significant adverse reactions are described elsewhere in the labeling:

The following adverse reactions have been identified during post-approval use of DDAVP Injection. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cardiovascular: Hypertension, hypotension, tachycardia, thrombotic events, fluid retention
Digestive: Nausea, abdominal cramps
Immune: Hypersensitivity reactions
Integumentary: Erythema, swelling, burning pain, facial flushing
Laboratory: Hyponatremia
Nervous: Headache, hyponatremic seizures

7 DRUG INTERACTIONS

DRUG INTERACTIONS SECTION

7.1 Other Drugs that may Increase Risk of Hyponatremia

SPL UNCLASSIFIED SECTION

The concomitant administration of DDAVP Injection with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine), requires more frequent serum sodium monitoring. Monitor serum sodium more frequently in patients taking DDAVP Injection concomitantly with these drugs and when doses of these drugs are increased [see Contraindications (4), Warnings and Precautions (5.1), Drug Interactions (7.1), Use in Specific Populations (8.4, 8.5)].

7.2 Other Vasoconstrictors

SPL UNCLASSIFIED SECTION

DDAVP Injection can elevate blood pressure. Use of DDAVP Injection with other vasoconstrictors may require a reduction of the DDAVP Injection dosage [see Warnings and Precautions (5.2), Adverse Reactions (6)].

8 USE IN SPECIFIC POPULATIONS

USE IN SPECIFIC POPULATIONS SECTION

8.1 Pregnancy

PREGNANCY SECTION

SPL UNCLASSIFIED SECTION

Risk Summary

Prolonged experience with DDAVP Injection in pregnant women over several decades, based on the available published literature and case reports, have not identified a drug associated risk of major birth defects, miscarriage or other adverse maternal or fetal outcomes.

In addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin. No adverse developmental outcomes were observed in animal reproductive and developmental studies following administration of desmopressin acetate during organogenesis to pregnant rats and rabbits, at doses 130- and 110- times, respectively, the recommended dose of 18 mcg for a 60 kg patient, based on body surface area (mg/m2).

The estimated background risk of major birth defects and miscarriage for the indicated population are unknown. In the US general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.

SPL UNCLASSIFIED SECTION

Clinical Considerations

SPL UNCLASSIFIED SECTION

Disease Associated Maternal and Embryo-fetal Risk:

Pregnant women with Hemophilia A or von Willebrand's disease may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery. An affected newborn may also be at risk of bleeding diatheses.

SPL UNCLASSIFIED SECTION

Data

SPL UNCLASSIFIED SECTION

Animal Data

In a developmental toxicity study in rats, desmopressin acetate was administered intravenously at doses of 9.68, 48.4, or 241 mcg/kg/day during the period of organogenesis (gestations days 7 to 17). Laparohysterectomy for fetal examinations were conducted on gestation day 20 for twenty females in each group; the remaining 10 females were allowed to litter in order to determine any postnatal effects that might be attributable to pre-natal treatment. No effects were seen on maternal and fetal survival, growth and morphology or post-natal offspring survival, growth, development, behavior and reproductive performance up to 241 mcg/kg/day (130 times the 18 mcg dose received by a 60 kg patient based on body surface area).

In an embryo-fetal development study and a pre- and postnatal development study in rabbits, desmopressin acetate was administered subcutaneously at doses of 2, 20 or 200 mcg/kg/day (embryo-fetal development) and 0.1, 1 or 10 mcg/kg/day (pre- and postnatal development) during the period of organogenesis (gestation days 6 to 18). No effects on maternal and fetal survival or morphology were observed in both studies at doses of up to 200 mcg/kg/day (215× the 18 mcg dose received by a 60 kg patient based on body surface area) nor were there effects in the pre- and postnatal development study on parturition, postnatal survival, growth, development or behavior, up to the highest dose tested of 10 mcg/kg/day (11 times the 18 mcg dose received by a 60 kg patient, based on body surface area).

8.2 Lactation

LACTATION SECTION

SPL UNCLASSIFIED SECTION

Risk Summary

Breastfeeding is not expected to result in clinically relevant exposure of the infant to desmopressin following maternal administration. Desmopressin is poorly transferred into human breastmilk at negligible amounts (see Data). There is no information on the effects of desmopressin on the breastfed child or on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for DDAVP Injection and any potential adverse effects on the breastfed child from DDAVP Injection or from the underlying maternal condition.

SPL UNCLASSIFIED SECTION

Data

The breast milk of lactating women was collected over 8 hours following administration of 300 mcg desmopressin nasal spray. The expected area under the plasma concentration time curve (AUC) of desmopressin following 300 mcg nasal spray is 2.4-fold higher to that of 4 mcg DDAVP injection. Based on the measured concentrations of desmopressin following intranasal administration, the amounts of desmopressin that may be transferred to a breastfed infant correspond to 0.0001-0.005% of the dose administered.

8.4 Pediatric Use

PEDIATRIC USE SECTION

The safety and effectiveness of DDAVP have been established in pediatric patients 3 months of age and older with hemophilia A and von Willebrand's disease and pediatric patients aged 12 years and older with diabetes insipidus. The safety and effectiveness of DDAVP have not been established in infants less than 3 months of age with hemophilia A or von Willebrand's disease or pediatric patients under 12 years of age with diabetes insipidus. Use in infants and pediatric patients will require careful fluid intake restriction to prevent possible hyponatremia and water intoxication. Fluid restriction should be discussed with the patient and/or guardian [see Warnings and Precautions (5.1)].

8.5 Geriatric Use

GERIATRIC USE SECTION

Clinical studies of DDAVP Injection did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. DDAVP is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min) [see Contraindications (4), Use in Specific Populations (8.6), Clinical Pharmacology (12.3)].

Use of DDAVP injection in geriatric patients will require careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. Fluid restriction should be discussed with the patient [see Warnings and Precautions (5.1)].

8.6 Renal Impairment

RENAL IMPAIRMENT SUBSECTION

Desmopressin acetate is substantially excreted by the kidney, and the risk of adverse reactions may be greater in patients with renal impairment than patients with normal renal function. DDAVP is contraindicated in patients with estimated CLcr by Cockcroft-Gault equation less than 50 mL/min [see Contraindications (4), Clinical Pharmacology (12.3)].

10 OVERDOSAGE

OVERDOSAGE SECTION

Overdosage of DDAVP Injection leads to prolonged duration of action with an increased risk of water retention and hyponatremia. Signs of overdose may include headaches, abdominal cramps, nausea, facial flushing, confusion, drowsiness, problems with passing urine and rapid weight gain due to fluid retention [see Warnings and Precautions (5.1)]. In case of overdosage, the dosage should be reduced, frequency of administration decreased, or the drug withdrawn according to the severity of the condition, serum sodium assessed, and hyponatremia treated appropriately.

There is no known specific antidote for desmopressin acetate or DDAVP Injection 4 mcg/mL.

11 DESCRIPTION

DESCRIPTION SECTION

DDAVP Injection (desmopressin acetate) is a synthetic vasopressin analog for intravenous or subcutaneous use. It is chemically defined as follows:

Mol. Wt. 1183.34

Empirical Formula: C46H64N14O12S2∙C2H4O2∙3H2O

Chemical StructureChemical Structure

1-(3-mercaptopropionic acid)-8-D-arginine vasopressin monoacetate (salt) trihydrate.

DDAVP solution for injection is a sterile solution in a 1 mL single-dose ampule: Each mL contains 4 mcg of desmopressin acetate which is equivalent to 3.6 mcg of desmopressin free base. The inactive ingredients are sodium chloride, hydrochloric acid and water for injection. Sodium chloride is used to adjust tonicity. Hydrochloric acid is used to adjust pH.

DDAVP solution for injection is a sterile solution in a 10 mL multiple-dose vial: Each mL contains 4 mcg of desmopressin acetate which is equivalent to 3.6 mcg of desmopressin free base. The inactive ingredients are sodium chloride, chlorobutanol (5 mg per mL), hydrochloric acid and water for injection. Sodium chloride is used to adjust tonicity. Hydrochloric acid is used to adjust pH.

12 CLINICAL PHARMACOLOGY

CLINICAL PHARMACOLOGY SECTION

12.1 Mechanism of Action

MECHANISM OF ACTION SECTION

Desmopressin acetate increases plasma levels of factor VIII activity in patients with hemophilia and von Willebrand's disease Type I.

The antidiuretic effects of desmopressin acetate are mediated by stimulation of vasopressin 2 (V2) receptors, thereby increasing water re-absorption in the kidney, and hence reducing urine production. Desmopressin acetate is a replacement hormone for antidiuretic hormone in the treatment of central diabetes insipidus. The change in structure of arginine vasopressin to desmopressin acetate resulted in increased duration of action and a decreased vasopressor action and decreased actions on visceral smooth muscle relative to the enhanced antidiuretic activity, so that clinically effective antidiuretic doses were usually below threshold levels for effects on vascular or visceral smooth muscle.

12.2 Pharmacodynamics

PHARMACODYNAMICS SECTION

The response to DDAVP of factor VIII activity and plasminogen activator is dose-related, with maximal plasma levels of 300 to 400 percent change from baseline obtained after infusion of 0.4 mcg/kg. The increase of factor VIII is rapid and evident within 30 minutes, reaching a maximum at a point ranging from 90 minutes to two hours. The duration of the hemostatic effect depends on the half-life for VIII:C which is about 8-12 hours. The percentage increase of factor VIII levels in patients with mild hemophilia A and von Willebrand's disease was not significantly different from that observed in normal healthy individuals when treated with 0.3 mcg/kg of DDAVP infused over 10 minutes.

The use of DDAVP Injection in patients with central diabetes insipidus reduces urinary output, increases urine osmolality, and decreases plasma osmolality.

12.3 Pharmacokinetics

PHARMACOKINETICS SECTION

SPL UNCLASSIFIED SECTION

Elimination

The geometric mean terminal half-life is 2.8 hours.

SPL UNCLASSIFIED SECTION

Metabolism

Desmopressin is not metabolized by human CYP450 system.

SPL UNCLASSIFIED SECTION

Excretion

After intravenous administration of 2 mcg, 52% of the dose was recovered in the urine within 24 hours as unchanged desmopressin.

SPL UNCLASSIFIED SECTION

Drug Interaction Studies

In vitro studies in human liver microsome preparations have shown that desmopressin does not inhibit the human CYP450 system. No in vivo interaction studies have been performed with DDAVP Injection.

SPL UNCLASSIFIED SECTION

Specific Populations

SPL UNCLASSIFIED SECTION

Patients with Renal Impairment

A pharmacokinetic study was conducted in subjects with normal renal function and patients with mild, moderate, and severe renal impairment (n=24, 6 subjects each group) with a single 2 mcg dose of desmopressin acetate intravenous injection. The geometric mean terminal half-life was 2.8 hours in subjects with normal renal function, and 4, 6.6, and 8.7 hours in patients with mild, moderate, and severe renal impairment, respectively. In patients with mild, moderate and severe renal impairment, mean desmopressin area under the plasma drug concentration time curve (AUC) was 1.5 fold, 2.4 fold and 3.6 fold higher, respectively compared to that of subjects with normal renal function.

13 NONCLINICAL TOXICOLOGY

NONCLINICAL TOXICOLOGY SECTION

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY SECTION

Studies with desmopressin have not been performed to evaluate carcinogenic potential. Desmopressin was not mutagenic in bacterial mutagenicity (Ames) and mouse lymphoma assays.

16 HOW SUPPLIED/STORAGE AND HANDLING

HOW SUPPLIED SECTION

16.1 How Supplied

SPL UNCLASSIFIED SECTION

DDAVP Injection is available as a sterile solution supplied as 4 mcg/mL in cartons of ten 1 mL single-dose, type 1 glass ampules (NDC 55566-2200-0) and 40 mcg/10 mL (4 mcg/mL) in 10 mL multiple-dose vials, type 1 glass vial with rubber stopper and a flip off seal, (NDC 55566-2300-0), each containing 4 mcg DDAVP per mL.

16.2 Storage and Handling

STORAGE AND HANDLING SECTION

Store refrigerated 2° to 8°C (36° to 46°F).

17 PATIENT COUNSELING INFORMATION

INFORMATION FOR PATIENTS SECTION

SPL UNCLASSIFIED SECTION

Hyponatremia and Fluid Restriction

  • Inform patients that DDAVP may cause severe hyponatremia, which may be life-threatening, if it is not promptly diagnosed and treated [see Warnings and Precautions (5.1)].
  • Inform them about the signs and symptoms associated with hyponatremia, to undergo recommended serum sodium measurements, and to inform their health care provider about new medications.
  • Advise patients to contact a healthcare provider if symptoms of hyponatremia occur.
  • Discuss adjustment of fluid intake and monitoring of urine output with patients.

SPL UNCLASSIFIED SECTION

Manufactured for:
FERRING PHARMACEUTICALS INC.
PARSIPPANY, NJ 07054 USA

PRINCIPAL DISPLAY PANEL - 10 mL Vial Carton

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

NDC 55566-2300-0

Rx ONLY

DDAVP®
Injection

desmopressin
acetate

40 mcg/10 mL
(4 mcg/mL)

For Intravenous and
Subcutaneous Use Only

One 10 mL
multiple-dose vial

FERRING
PHARMACEUTICALS

PRINCIPAL DISPLAY PANEL - 10 mL Vial Carton
PRINCIPAL DISPLAY PANEL - 10 mL Vial Carton

PRINCIPAL DISPLAY PANEL - 1 mL Ampule Carton

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

NDC-55566-2200-0

Rx ONLY

DDAVP®
Injection

desmopressin
acetate

4 mcg/mL

PRESERVATIVE FREE
For Intravenous and Subcutaneous
Use Only

Ten x 1 mL single-dose
ampules. Discard unused
portion.

FERRING
PHARMACEUTICALS

PRINCIPAL DISPLAY PANEL - 1 mL Ampule Carton
PRINCIPAL DISPLAY PANEL - 1 mL Ampule Carton

DailyMed RxNorm Mappings#

RxCUI, RxNorm string, TTY table
RxCUIRxNorm stringTTYSPL version
849503DDAVP 4 MCG/ML Injectable SolutionPSN15
1723234DDAVP 40 MCG in 1 ML InjectionPSN15
1723232desmopressin acetate 4 MCG in 1 ML InjectionPSN15
849501desmopressin acetate 4 MCG/ML Injectable SolutionPSN15
17232341 ML desmopressin acetate 0.004 MG/ML Injection [DDAVP]SBD15
849503desmopressin acetate 0.004 MG/ML Injectable Solution [DDAVP]SBD15
17232321 ML desmopressin acetate 0.004 MG/ML InjectionSCD15
849501desmopressin acetate 0.004 MG/ML Injectable SolutionSCD15
849503DDAVP 0.004 MG/ML Injectable SolutionSY15
849503DDAVP 4 MCG/ML Injectable SolutionSY15
1723234DDAVP 40 MCG per 1 ML InjectionSY15
1723232desmopressin acetate 4 MCG per 1 ML InjectionSY15
849501desmopressin acetate 4 MCG/ML Injectable SolutionSY15

DailyMed Pharmacologic Classes#

Class, Version, Type table
ClassVersionTypeEffective
DESMOPRESSIN Pharmacologic Class Indexing2Indexing - Pharmacologic Class20180813

DailyMed Product Concepts#

Product concept, Relation, Version table
Product conceptRelationVersionEffective
bde14c5d-9a3e-43bd-a8e6-0fb00287bdacProduct name620250127
64db728f-18f9-4c58-ba09-60fd6f75f709Product name220190613
aa3ade84-795a-4f84-bfdf-ebe397f656f5Product name120190402
d8c9f9fc-e302-45b4-9b21-a802f2592402Product name120180810
4bbcef53-5c79-462a-b7ba-cff48fe1fb5aProduct name120171129
74cda04a-3bd1-4535-800b-d9b9265e3211Product name220171129
50d55b09-49b8-f134-6bdc-eb6402b911dcProduct name120140508

DailyMed Package Descriptions#

Package NDC, Product, Description table
Package NDCProductDescriptionFormQuantityStrengthSPL version
55566-2200-0DDAVP1 mL in 1 AMPULEINJECTION115
55566-2200-0DDAVP10 in 1 CARTONINJECTION1015
55566-2300-0DDAVP1 in 1 CARTONINJECTION115
55566-2300-0DDAVP10 mL in 1 VIAL, MULTI-DOSEINJECTION1015

DailyMed Dashboard NDC Coverage#

NDC, Dashboard title, SPL version table
NDCDashboard titleSPL versionValidationDashboard ZIP
55566-2200DDAVP (DESMOPRESSIN ACETATE) INJECTION [FERRING PHARMACEUTICALS INC.]15Current NDC, Legacy NDC, 2 package rows20221002_651f6fee-a2c7-431b-8d5d-58b156c72244.zip
55566-2300DDAVP (DESMOPRESSIN ACETATE) INJECTION [FERRING PHARMACEUTICALS INC.]15Current NDC, Legacy NDC, 2 package rows20221002_651f6fee-a2c7-431b-8d5d-58b156c72244.zip

DailyMed Billing Units#

Package NDC, Billing unit, Product NDC table
Package NDCBilling unitProduct NDCDailyMed indexing SPLSPL versionEffective
55566-2300-0ML - Milliliter55566-2300fe1f867c-5d0f-48c8-a469-fc2666c883c912015-05-05
55566-2200-0ML - Milliliter55566-2200162b14ee-9ae7-4811-8daf-96ae3e069f1712015-05-05

DailyMed Socrata Ingredients#

Ingredient, Type, UNII table
IngredientTypeUNIISPL versionUploaded
Desmopressin AcetateACTIVE INGREDIENTXB13HYU18U1
desmopressinACTIVE MOIETYENR1LLB0FP1
ChlorobutanolINACTIVE INGREDIENTHM4YQM8WRC1
Hydrochloric AcidINACTIVE INGREDIENTQTT17582CB1
Sodium ChlorideINACTIVE INGREDIENT451W47IQ8X1

Products#

Every source-derived product name is available through these pages.

DailyMed product names page 1 of 1 · 6 matching rows.

NDC Codes#

Product NDC, Package NDC table
Product NDCPackage NDC
55566-230055566-2300-0
55566-220055566-2200-0

Ingredients#

Every source-derived ingredient row is available through these pages.

DailyMed ingredient rows page 1 of 1 · 8 matching rows.

Source Document#

Source XML

Inactive ingredient matches#

Inactive Ingredient Database values describe FDA-listed use contexts. The match method and ambiguity count are shown because ingredient names, routes, and dosage forms are not always unique. Browse recovered IID releases and source provenance.

Inactive ingredient links page 1 of 1 · 12 matching rows.

DailyMed ingredient, IID ingredient, UNII table
DailyMed ingredientIID ingredientUNIIDosage form / routePotencyMaximum daily exposureMatch
ChlorobutanolCHLOROBUTANOLHM4YQM8WRCINJECTION / INTRAVENOUS60 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Hydrochloric AcidHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Sodium ChlorideSODIUM CHLORIDE451W47IQ8XINJECTION / INTRAVENOUS28773 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
ChlorobutanolCHLOROBUTANOLHM4YQM8WRCINJECTION / INTRAVENOUS60 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
ChlorobutanolCHLOROBUTANOLHM4YQM8WRCINJECTION / INTRAVENOUS60 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Hydrochloric AcidHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Sodium ChlorideSODIUM CHLORIDE451W47IQ8XINJECTION / INTRAVENOUS28773 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Hydrochloric AcidHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Hydrochloric AcidHYDROCHLORIC ACIDQTT17582CBINJECTION / INTRAVENOUS720 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
ChlorobutanolCHLOROBUTANOLHM4YQM8WRCINJECTION / INTRAVENOUS60 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Sodium ChlorideSODIUM CHLORIDE451W47IQ8XINJECTION / INTRAVENOUS28773 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates
Sodium ChlorideSODIUM CHLORIDE451W47IQ8XINJECTION / INTRAVENOUS28773 mgExact identifier — unii+route+dosage form
4 equally ranked IID candidates

Orange Book application contexts#

All distinct exact application/product contexts derived from this label’s complete NDC list are paginated below.

Orange Book application contexts page 1 of 1 · 1 matching rows.

Source provenance: Browse the complete Orange Book source catalog · source snapshot 44.

Orange Book products#

Current product rows page 1 of 1 · 2 matching rows.

Application-product, Trade name, Ingredient table
Application-productTrade nameIngredientStrengthDosage form / routeTE codesRLD / RSApproval date
N018938-001DDAVPDESMOPRESSIN ACETATE0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30
N018938-002DDAVPDESMOPRESSIN ACETATE0.015MG/MLINJECTABLE / INJECTION1995-04-25

Therapeutic equivalence codes#

Current TE-code rows page 1 of 1 · 1 matching rows.

Application-product, TE code table
Application-productTE code
N018938-001AP

Observed Orange Book product history#

Observed FDA ZIP history: Each table is queried independently by exact application/product key from successfully parsed Orange Book snapshots. Capture times identify archived source observations; absence or a change between snapshots is not inferred. FDA publication files that were not recoverable as structured ZIP data are not represented as states.

Product history page 1 of 3 · 88 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTrade nameStrengthDosage form / routeProduct TE source textRLD / RSApproval dateSource SHA-256
2026-10-15 13:18:302026-09N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30c2088c7a36db…
2026-10-15 13:18:302026-09N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25c2088c7a36db…
2026-09-14 22:38:342026-08N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-3084e616aacf4f…
2026-09-14 22:38:342026-08N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-2584e616aacf4f…
2026-08-18 06:07:402026-07N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30caaa826d4ba7…
2026-08-18 06:07:402026-07N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25caaa826d4ba7…
2026-02-19 14:30 UTC2026-02N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30011fe1cb6892…
2026-02-19 14:30 UTC2026-02N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-3031067a03dcf5…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-2531067a03dcf5…
2025-08-23 18:47 UTC2025-08N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-306a471c1ec25d…
2025-08-23 18:47 UTC2025-08N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-256a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30fd3edfee7708…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30b8a1b40f171c…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-3003ed91905a0d…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-2503ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-302680178bc6a6…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-252680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-305bbf6a4d5a75…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-255bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30d8e5a09893c0…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25d8e5a09893c0…
2024-10-29 15:01 UTC2024-10N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30d06236e962d9…
2024-10-29 15:01 UTC2024-10N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-3079d66fd596c7…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-2579d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-30301d65b070ca…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-25301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-301e350fbaab3a…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-251e350fbaab3a…
2024-05-31 18:47 UTC2024-05N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-308072bd15b7f6…
2024-05-31 18:47 UTC2024-05N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-258072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-305c6f7cd8ea54…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-255c6f7cd8ea54…
2022-04-08 23:34 UTC2022-04N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-305d02ea3f76ae…
2022-04-08 23:34 UTC2022-04N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-255d02ea3f76ae…
2022-04-04 05:41 UTC2022-04N018938-001DDAVP0.004MG/MLINJECTABLE / INJECTIONAPRLD, RS1984-03-304b0b4de00fa7…
2022-04-04 05:41 UTC2022-04N018938-002DDAVP0.015MG/MLINJECTABLE / INJECTION1995-04-254b0b4de00fa7…

Observed Orange Book normalized TE history#

Normalized TE history page 1 of 2 · 44 observed states.

Captured, Edition, Application-product table
CapturedEditionApplication-productTE codeOrderSource SHA-256
2026-10-15 13:18:302026-09N018938-001AP1c2088c7a36db…
2026-09-14 22:38:342026-08N018938-001AP184e616aacf4f…
2026-08-18 06:07:402026-07N018938-001AP1caaa826d4ba7…
2026-02-19 14:30 UTC2026-02N018938-001AP1011fe1cb6892…
2025-12-14 10:44 UTC · 2 captures of this ZIP2025-12N018938-001AP131067a03dcf5…
2025-08-23 18:47 UTC2025-08N018938-001AP16a471c1ec25d…
2025-03-22 03:13 UTC · 3 captures of this ZIP2025-03N018938-001AP1fd3edfee7708…
2025-02-26 10:13 UTC · 3 captures of this ZIP2025-02N018938-001AP1b8a1b40f171c…
2025-01-19 17:59 UTC · 7 captures of this ZIP2025-01N018938-001AP103ed91905a0d…
2024-12-13 21:23 UTC · 2 captures of this ZIP2024-12N018938-001AP12680178bc6a6…
2024-09-14 05:58 UTC · 2 captures of this ZIP2024-09N018938-001AP15bbf6a4d5a75…
2024-11-08 22:44 UTC · 3 captures of this ZIP2024-11N018938-001AP1d8e5a09893c0…
2024-10-29 15:01 UTC2024-10N018938-001AP1d06236e962d9…
2024-08-13 05:28 UTC · 3 captures of this ZIP2024-08N018938-001AP179d66fd596c7…
2024-07-13 05:37 UTC · 2 captures of this ZIP2024-07N018938-001AP1301d65b070ca…
2024-06-18 03:08 UTC · 5 captures of this ZIP2024-06N018938-001AP11e350fbaab3a…
2024-05-31 18:47 UTC2024-05N018938-001AP18072bd15b7f6…
2022-06-29 02:47 UTC · 2 captures of this ZIP2022-06N018938-001AP15c6f7cd8ea54…
2022-04-08 23:34 UTC2022-04N018938-001AP15d02ea3f76ae…
2022-04-04 05:41 UTC2022-04N018938-001AP14b0b4de00fa7…
2019-12-13 00:20 UTC2019-12N018938-001AP174a2ff9319b5…
2022-03-09 01:35 UTC2022-03N018938-001AP1bb7c543d1eb4…
2021-12-28 21:50 UTC2021-12N018938-001AP1782e0a99824c…
2021-05-05 16:15 UTC · 3 captures of this ZIP2021-05N018938-001AP187673890dc5c…
2021-03-12 10:30 UTC2021-03N018938-001AP15aa47cf7b7d7…
2020-12-22 03:56 UTC2020-12N018938-001AP18869cabd3fbd…
2020-11-12 02:37 UTC2020-11N018938-001AP1c0c555d07b60…
2019-12-14 00:12 UTC2019-12N018938-001AP13f01610625f2…
2019-09-15 20:21 UTC2019-09N018938-001AP1b00525d2431f…
2019-07-19 19:46 UTC2019-07N018938-001AP1ea99ee380514…
2024-03-16 18:09 UTC · 4 captures of this ZIP2024-03N018938-001AP16a51e52b5d6a…
2024-02-18 07:12 UTC2024-02N018938-001AP11c564ffb4f44…
2023-12-20 04:57 UTC2023-12N018938-001AP1ea1830bbd6c7…
2023-11-28 05:40 UTC · 2 captures of this ZIP2023-11N018938-001AP1a72a2bbeb626…
2023-10-25 00:34 UTC · 2 captures of this ZIP2023-10N018938-001AP19b2671bbb829…
2023-07-15 15:27 UTC · 2 captures of this ZIP2023-07N018938-001AP1a67488948f0b…
2023-06-13 01:57 UTC · 3 captures of this ZIP2023-06N018938-001AP13f0d92c62455…
2023-05-13 08:27 UTC2023-05N018938-001AP1053a50430f4f…
2023-01-26 05:58 UTC2023-01N018938-001AP13bdfa0b2c4d7…
2022-11-12 20:34 UTC · 5 captures of this ZIP2022-11N018938-001AP13a93d1ddd44b…

openFDA label cross-check#

OpenFDA label data provides additional search and identifier links. DailyMed’s Structured Product Label is the canonical label on FDA.report. Matching records are deduplicated before they are shown below.

Matched openFDA labels page 1 of 1 · 1 matching rows.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
DDAVPDESMOPRESSIN ACETATEFerring Pharmaceuticals Inc.651f6fee-a2c7-431b-8d5d-58b156c722442022-09-28Boxed warning, Warnings, Adverse reactionsExact identifier
ndc (package): 55566-2200-0
ndc (package): 55566-2300-0
ndc (product): 55566-2200
ndc (product): 55566-2300
ndc11 (package): 55566230000
ndc11 (package): 55566220000
spl id: 8837d5af-4cd2-4274-a30d-db28acc86364
spl set id: 651f6fee-a2c7-431b-8d5d-58b156c72244

Reported adverse events (FAERS/openFDA)#

Adverse event summaries are temporarily unavailable. Other product information remains available.