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Substances that are known to induce disturbed ADH-secretion, e.g. tricyclic antidepressants, SSRI, chlorpromazine and carbamazepine as well as some antidiabetics of the sulfonylurea group, especially chlorpropamide, may cause an additive antidiuretic effect with an increased risk of fluid retention (see Precautions).
NSAID preparations may induce water retention/hyponatraemia (see Precautions).
Concomitant treatment with loperamide may result in a three-fold increase in desmopressin plasma concentration, which may lead to an increased risk of water retention and/or hyponatraemia.
Other drugs slowing intestinal transport might have the same effect. However, this has not been investigated.
Concomitant treatment with dimethicone may result in a decreased absorption of desmopressin.
It is unlikely that desmopressin interacts with pharmaceuticals affecting hepatic metabolism, since desmopressin has not been shown to undergo any significant liver metabolism in in vitro studies with human microsomes. However, no formal interaction studies in vivo have been carried out.
Concomitant food intake has not been investigated with MINIRIN Oral Lyophilisate. A standardised meal with 27% fat taken together with or 1.5 h prior to MINIRIN tablet decreased the extent and rate of absorption of desmopressin by 40%. No significant effect was observed with respect to pharmacodynamics (urine production or osmolality). It cannot be excluded that some patients may have decreased antidiuretic effect at concomitant food intake.
