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In patients with urgency/urge incontinence, organic causes for increased micturition frequency or nocturia (e.g. benign prostate hyperplasia, urinary tract infection, bladder stone/tumor), polydipsia and poorly adjusted diabetes mellitus, the specific cause should be treated primarily.
At treatment of primary nocturnal enuresis and nocturia, fluid intake should be limited to the least possible during the period of 1 hour before evening dose until at least 8 hours after administration. Treatment without concomitant reduction in fluid intake may lead to water retention and/or hyponatraemia (headache, nausea/vomiting, weight gain and in serious cases convulsions).
All patients and, when applicable, their guardians should be carefully instructed to adhere to the fluid restrictions.
In clinical trials, higher occurrence of hyponatraemia was found in patients over 65 years. Therefore, treatment should not be initiated in the elderly, especially not in patients suffering from other conditions that may increase the likelihood of fluid or electrolyte imbalance.
Elderly patients, patients with low serum sodium levels and patients with a high 24-hour urine volumes (above 2.8 to 3 litres) have an increased risk for hyponatraemia.
Precautions to avoid hyponatraemia including careful attention to fluid restriction and more frequent monitoring of serum sodium must be taken at: concomitant treatment with drugs known to induce syndrome with disturbed ADH secretion (SIADH), e.g. tricyclic antidepressants, selective serotonine reuptake inhibitors (SSRI), chlorpromazine and carbamazepine; concomitant treatment with NSAIDs.
Precautions must be taken in patients at risk for increased intracranial pressure.
Treatment with desmopressin should be interrupted during acute illnesses characterised by fluid and/or electrolyte imbalance such as systemic infections, fever, gastroenteritis.
Effects on Ability to Drive and Use Machines: MINIRIN has no or negligible effect on the ability to drive vehicles and use machines.
