Intranasal desmopressin (DDAVP, DDVP, Minirin, Stimate Nasal Spray) is no longer indicated for primary nocturnal enuresis and is associated with an increased risk of severe hyponatremia (possibly resulting in seizures and death) in certain patients (including children), according to an FDA MedWatch notice (FDA MedWatch 2007 December 4; full-text available online at: www.fda.gov/medwatch/safety/2007/safety07; accessed March 11, 2008). Intranasal desmopressin should not be used in patients with hyponatremia or history of hyponatremia. Desmopressin tablets should be discontinued during acute illnesses that may lead to fluid and/or electrolyte imbalance. All formulations should be used with caution in patients at risk for water intoxication with hyponatremia.
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