مقايسه اثر بخشي دسموپرسين خوراكي با شكل اسپري آن در درمان ديابت بي مزه مركزي

Comparison of the Effect of Desmopressin (DDAVP) Tablet and Intranasa (Spray on theTreatment of Central Diabetes Insipidus

Desmopressin(intranasal spray or drop, IV injection or tablet) is a drug choice for the treatment of central diabetes insipidus and the intranasal spray is a more common treatment. In the present study, the efficacy and side effect of oral desmopressin was compared with the intranasal spray. This before-after clinical trial study was performed on 14 outpatients(9F, 5M, age 14-50Y) with central diabetes insipidus treated with intranasal spray of desmopressin. Weight, pulse rate(PR), blood pressure(BP)(sitting-standing), biochemical profile, serum electrolytes, 24h urine volume, specific gravity of urine and LFT were measured before and after the study. No clinically significant change was noted with regard to weight, PR, BP, blood chemistry, electrolyte and urinalysis. Reported single adverse effects were headache(43%)in tablet group and dyspnea(7%) in spray group. Both of the drug modes were able to control polyuria and nocturia. The antiduretic dose-equivalence ratio for intranasal to oral desmopressin was 1:18. Spray was reported superior in terms of rapid onset of action and duration of antiduretic action in 100% and 75% of cases, respectively. Tablets were more available and much more easily consumed as reported by patients (86%). In conclusion, treatment with tablets offers a good alternative to the intranasal route, especially in patients with chronic rhinitis or common cold and similar conditions.