Health Centres - Presinex nasal spray (desmopressin)
How does it work?
Presinex nasal spray contains the active ingredient desmopressin, which is a type of medicine called a vasopressin analogue. It is similar to a hormone produced naturally by the body, called vasopressin or antidiuretic hormone. (NB. Desmopressin nasal spray is also available without a brand name, ie as the generic medicine.)
Antidiuretic hormone (ADH) is produced by the pituitary gland in the brain. It is involved in controlling the natural balance of water levels in the body. It normally acts on receptors in the kidneys to prevent excessive amounts of water being filtered out of the blood and into the urine. This reduces the production of urine. Desmopressin is similar in structure to this hormone and works by mimicking its action.
In the condition diabetes insipidus, the kidneys produce excessive quantities of very dilute (but otherwise normal) urine. This causes excessive thirst and can lead to dehydration. Diabetes insipidus can be caused by a problem with the kidneys themselves (nephrogenic diabetes insipidus), or by a deficiency in the production of ADH by the pituitary gland (cranial diabetes insipidus). Desmopressin is used to diagnose and treat this latter rare form of diabetes (which should not be confused with diabetes mellitus, also known as sugar diabetes).
Desmopressin works by binding to the ADH receptors in the kidneys, which mimics the effect of natural ADH. This reduces the production of urine.
Desmopressin can also be used to prevent excessive urination at night (nocturia) in people with multiple sclerosis. It is used when other treatments for this have been unsuccessful.
Presinex nasal spray is administered into the nose. The desmopressin is absorbed into the bloodstream from the rich supply of blood vessels lining the nasal passages. Follow the instructions for use that are provided with the spray.
What is it used for?
- Diagnosing and treating a disease in which large amounts of dilute urine are produced, resulting in constant thirst (cranial diabetes insipidus).
- Preventing excessive need to urinate at night (nocturia) in people with multiple sclerosis, when other treatments for this have been unsuccessful.
- Testing to check if the kidneys are functioning properly in producing urine.
Warning!
- If you are taking this medicine to diagnose diabetes insipidus or to test your kidney function, you should not drink more than 500ml fluid in the period starting one hour before your dose to eight hours after your dose. After the test you should only drink as much fluid as you need to satisfy your thirst.
- If you are taking this medicine for nocturia associated with multiple sclerosis, you should limit your fluid intake to a minimum, starting from one hour before each dose until eight hours after each dose.
- If you are taking this medicine to treat nocturia associated with multiple sclerosis, your blood pressure and weight should be regularly monitored to check for the possibility of fluid overload. If you suffer from vomiting or diarrhoea you should stop using this medicine until you feel better.
- If you experience signs or symptoms of water retention and/or decreased concentration of sodium in the blood (an unusually bad or prolonged headache, confusion, nausea and vomiting, unexplained weight gain and in severe cases, convulsions) you should stop taking this medicine and consult your doctor immediately.
Use with caution in
- Elderly people.
- Decreased kidney function.
-
Disease involving the heart and blood vessels.
-
Cystic fibrosis.
- Imbalance of water and salt concentrations in the blood (fluid and electrolyte imbalance).
- People at risk of developing raised pressure inside the skull (intracranial pressure).
Not to be used in
- Syndrome of inappropriate ADH secretion (SIADH).
- Low levels of sodium in the blood (hyponatraemia).
- History of heart failure.
- Any other condition treated with medicines that increase urine production (diuretics).
- Moderate to severely decreased kidney function.
- Abnormal intense thirst caused by mental disorders (pyschogenic polydipsia).
- People who drink large amounts of alcohol.
- When used to treat nocturia in multiple sclerosis, this medicine should also not be used in people aged over 65 years, or people with high blood pressure or cardiovascular disease.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should be used with caution during pregnancy, and only if the expected benefit is greater than any possible risk to the developing baby. Seek medical advice from your doctor. If this medicine is used during pregnancy, blood pressure monitoring is recommended due to an increased risk of pre-eclampsia.
- This medicine may pass into breast milk. Seek medical advice from your doctor.
Side effects
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
- Headache.
- Stomach ache.
- Nausea and vomiting.
- Blocked nose (nasal congestion).
- Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose.
- Nosebleeds (epistaxis).
- Emotional disturbance in children (very rarely).
- If taken without restricting fluid intake (see warnings above): retention of water in the body tissues (fluid retention), low blood sodium level (hyponatraemia) or seizures (convulsions).
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
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