NDC 69918-901 Desmopressin Acetate

Desmopressin Acetate

NDC Product Code 69918-901

NDC CODE: 69918-901

Proprietary Name: Desmopressin Acetate What is the Proprietary Name?
The proprietary name also known as the trade name is the name of the product chosen by the medication labeler for marketing purposes.

Non-Proprietary Name: Desmopressin Acetate What is the Non-Proprietary Name?
The non-proprietary name is sometimes called the generic name. The generic name usually includes the active ingredient(s) of the product.

Drug Use Information

Drug Use Information
The drug use information is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate. This information is not individual medical advice and does not substitute for the advice of a health care professional. Always ask a health care professional for complete information about this product and your specific health needs.

  • Desmopressin is used to control the amount of urine your kidneys make. Normally, the amount of urine you make is controlled by a certain substance in the body called vasopressin. In people who have "water diabetes" (diabetes insipidus) or certain kinds of head injury or brain surgery, the body does not make enough vasopressin. Desmopressin is a man-made form of vasopressin and is used to replace a low level of vasopressin. This medication helps to control increased thirst and too much urination due to these conditions, and helps prevent dehydration. Desmopressin products applied in the nose are no longer indicated to control nighttime bedwetting in children because of the increased risk of developing a serious side effect (a low level of sodium in the blood).

Product Characteristics

WHITE (C48325)

NDC Code Structure

  • 69918 - Amring Pharmaceuticals Inc.

NDC 69918-901-10

Package Description: 1 VIAL, MULTI-DOSE in 1 CARTON > 10 mL in 1 VIAL, MULTI-DOSE

NDC Product Information

Desmopressin Acetate with NDC 69918-901 is a a human prescription drug product labeled by Amring Pharmaceuticals Inc.. The generic name of Desmopressin Acetate is desmopressin acetate. The product's dosage form is solution and is administered via intravenous form. The RxNorm Crosswalk for this NDC code indicates multiple RxCUI concepts are associated to this product: 1723232 and 849501.

Dosage Form: Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.

Product Type: Human Prescription Drug What kind of product is this?
Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.

Desmopressin Acetate Active Ingredient(s)

What is the Active Ingredient(s) List?
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.

Inactive Ingredient(s)

About the Inactive Ingredient(s)
The inactive ingredients are all the component of a medicinal product OTHER than the active ingredient(s). The acronym "UNII" stands for “Unique Ingredient Identifier” and is used to identify each inactive ingredient present in a product.


Administration Route(s)

What are the Administration Route(s)?
The translation of the route code submitted by the firm, indicating route of administration.

  • Intravenous - Administration within or into a vein or veins.

Pharmacological Class(es)

What is a Pharmacological Class?
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

  • Factor VIII Activator - [EPC] (Established Pharmacologic Class)
  • Increased Coagulation Factor VIII Activity - [PE] (Physiologic Effect)
  • Increased Coagulation Factor VIII Concentration - [PE] (Physiologic Effect)
  • Vasopressin Analog - [EPC] (Established Pharmacologic Class)
  • Vasopressins - [CS]

Product Labeler Information

What is the Labeler Name?
Name of Company corresponding to the labeler code segment of the Product NDC.

Labeler Name: Amring Pharmaceuticals Inc.
Labeler Code: 69918
FDA Application Number: NDA018938 What is the FDA Application Number?
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.

Marketing Category: NDA - A product marketed under an approved New Drug Application. What is the Marketing Category?
Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Start Marketing Date: 01-20-2016 What is the Start Marketing Date?
This is the date that the labeler indicates was the start of its marketing of the drug product.

Listing Expiration Date: 12-31-2021 What is the Listing Expiration Date?
This is the date when the listing record will expire if not updated or certified by the product labeler.

Exclude Flag: N - NO What is the NDC Exclude Flag?
This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA"s requests for correction to deficient or non-compliant submissions ("Y"), or because the listing certification is expired ("E"), or because the listing data was inactivated by FDA ("I"). Values = "Y", "N", "E", or "I".

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Information for Patients

Desmopressin Nasal

Desmopressin Nasal is pronounced as (des moe press' in)

Why is desmopressin nasal medication prescribed?
Nasal desmopressin is used to control the symptoms of a certain type of diabetes insipidus ('water diabetes'; condition in which the body produces an abnormally large amo...
[Read More]
Desmopressin Oral

Desmopressin Oral is pronounced as (des moe press' in)
Why is desmopressin oral medication prescribed?
Desmopressin is used to control the symptoms of a certain type of diabetes insipidus ('water diabetes'; condition in which the body produces an abnormally large amount of...
[Read More]

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Desmopressin Acetate Product Labeling Information

The product labeling information includes all published material associated to a drug. Product labeling documents include information like generic names, active ingredients, ingredient strength dosage, routes of administration, appearance, usage, warnings, inactive ingredients, etc.

Product Labeling Index


DESMOPRESSIN ACETATE Injection (desmopressin acetate) 4 mcg/mL is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. It is chemically defined as follows:Mol. Wt. 1183.34                         Empirical Formula: C46H64N14O12S2•C2H4O2•3H2O   1-(3-mercaptopropionic acid)-8-D-arginine vasopressin monoacetate (salt) trihydrate.DESMOPRESSIN ACEATE Injection 4 mcg/mL is provided as a sterile, aqueous solution for injection.Each mL provides:   Desmopressin acetate   4.0 mcg   Sodium chloride           9.0 mg    Hydrochloric acid to adjust pH to 4The 10 mL vial contains chlorobutanol as a preservative (5.0 mg/mL).

Clinical Pharmacology

  • DESMOPRESSIN ACETATE Injection 4 mcg/mL contains as active substance, desmopressin acetate, a synthetic analogue of the natural hormone arginine vasopressin. One mL (4 mcg) of DESMOPRESSIN ACETATE (desmopressin acetate) solution has an antidiuretic activity of about 16 IU; 1 mcg of DESMOPRESSIN ACETATE is equivalent to 4 IU.DESMOPRESSIN ACETATE has been shown to be more potent than arginine vasopressin in increasing plasma levels of factor VIII activity in patients with hemophilia and von Willebrand's disease Type I. Dose-response studies were performed in healthy persons, using doses of 0.1 to 0.4 mcg/kg body weight, infused over a 10-minute period. Maximal dose response occurred at 0.3 to 0.4 mcg/kg. The response to DESMOPRESSIN ACETATE of factor VIII activity and plasminogen activator is dose-related, with maximal plasma levels of 300 to 400 percent of initial concentrations obtained after infusion of 0.4 mcg/kg body weight. The increase is rapid and evident within 30 minutes, reaching a maximum at a point ranging from 90 minutes to two hours. The factor VIII related antigen and ristocetin cofactor activity were also increased to a smaller degree, but still are dose-dependent.The biphasic half-lives of DESMOPRESSIN ACETATE were 7.8 and 75.5 minutes for the fast and slow phases, respectively, compared with 2.5 and 14.5 minutes for lysine vasopressin, another form of the hormone. As a result, DESMOPRESSIN ACETATE provides a prompt onset of antidiuretic action with a long duration after each administration.The change in structure of arginine vasopressin to DESMOPRESSIN ACETATE has resulted in a decreased vasopressor action and decreased actions on visceral smooth muscle relative to the enhanced antidiuretic activity, so that clinically effective antidiuretic doses are usually below threshold levels for effects on vascular or visceral smooth muscle.When administered by injection, DESMOPRESSIN ACETATE has an antidiuretic effect about ten times that of an equivalent dose administered intranasally.The bioavailability of the subcutaneous route of administration was determined qualitatively using urine output data. The exact fraction of drug absorbed by that route of administration has not been quantitatively determined.The percentage increase of factor VIII levels in patients with mild hemophilia A and von Willebrand's disease was not significantly different from that observed in normal healthy individuals when treated with 0.3 mcg/kg of DESMOPRESSIN ACETATE infused over 10 minutes.Plasminogen activator activity increases rapidly after DESMOPRESSIN ACETATE infusion, but there has been no clinically significant fibrinolysis in patients treated with DESMOPRESSIN ACETATE.The effect of repeated DESMOPRESSIN ACETATE administration when doses were given every 12 to 24 hours has generally shown a gradual diminution of the factor VIII activity increase noted with a single dose. The initial response is reproducible in any particular patient if there are 2 or 3 days between administrations.Human Pharmacokinetics: DESMOPRESSIN ACETATE is mainly excreted in the urine. A pharmacokinetic study conducted in healthy volunteers and patients with mild, moderate, and severe renal impairment (n=24, 6 subjects in each group) receiving single dose desmopressin acetate (2mcg) injection demonstrated a difference in DESMOPRESSIN ACETATE terminal half-life. Terminal half-life significantly increased from 3 hours in normal healthy patients to 9 hours in patients with severe renal impairment. (See CONTRAINDICATIONS.)


DESMOPRESSIN ACETATE Injection 4 mcg/mL is contraindicated in individuals with known hypersensitivity to desmopressin acetate or to any of the components of DESMOPRESSIN ACETATE Injection 4 mcg/mL.DESMOPRESSIN ACETATE is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50ml/min). DESMOPRESSIN ACETATE is contraindicated in patients with hyponatremia or a history of hyponatremia.


1. Very rare cases of hyponatremia have been reported from world-wide postmarketing experience in patients treated with DESMOPRESSIN ACETATE (desmopressin acetate). DESMOPRESSIN ACETATE is a potent antidiuretic which, when administered, may lead to water intoxication and/or hyponatremia. Unless properly diagnosed and treated hyponatremia can be fatal. Therefore, fluid restriction is recommended and should be discussed with the patient and/or guardian. Careful medical supervision is required.2. When DESMOPRESSIN ACETATE Injection is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular in pediatric and geriatric patients, fluid intake should be adjusted downward to decrease the potential occurrence of water intoxication and hyponatremia. (See PRECAUTIONS,  Pediatric Use and Generic Use.) All patients receiving DESMOPRESSIN ACETATE therapy should be observed for the following signs or symptoms associated with hyponatremia: headache, nausea/vomiting, decreased serum sodium, weight gain, restlessness, fatigue, lethargy, disorientation, depressed reflexes, loss of appetite, irritability, muscle weakness, muscle spasms or cramps and abnormal mental status such as hallucinations, decreased consciousness and confusion. Severe symptoms may include one or a combination of the following: seizure, coma and/or respiratory arrest. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma.3. DESMOPRESSIN ACETATE should not be used to treat patients with Type IIB von Willebrand's disease since platelet aggregation may be induced.4. DESMOPRESSIN ACETATE should be used with caution in patients with habitual or psychogenic polydipsia who may be more likely to drink excessive amounts of water, putting them at greater risk of hyponatremia.


General: For injection use only.DESMOPRESSIN ACETATE Injection (desmopressin acetate) 4 mcg/mL has infrequently produced changes in blood pressure causing either a slight elevation in blood pressure or a transient fall in blood pressure and a compensatory increase in heart rate. The drug should be used with caution in patients with coronary artery insufficiency and/or hypertensive cardiovascular disease.DESMOPRESSIN ACETATE (desmopressin acetate) should be used with caution in patients with conditions associated with fluid and electrolyte imbalance, such as cystic fibrosis, heart failure and renal disorders, because these patients are prone to hyponatremia.There have been rare reports of thrombotic events following DESMOPRESSIN ACETATE Injection 4 mcg/mL in patients predisposed to thrombus formation. No causality has been determined, however, the drug should be used with caution in these patients.Severe allergic reactions have been reported rarely. Anaphylaxis has been reported rarely with intravenous and intranasal DESMOPRESSIN ACETATE, including isolated cases of fatal anaphylaxis with intravenous DESMOPRESSIN ACETATE. It is not known whether antibodies to DESMOPRESSIN ACETATE Injection 4 mcg/mL are produced after repeated injections.Hemophilia A: Laboratory tests for assessing patient status include levels of factor VIII coagulant, factor VIII antigen and factor VIII ristocetin cofactor (von Willebrand factor) as well as activated partial thromboplastin time. Factor VIII coagulant activity should be determined before giving DESMOPRESSIN ACETATE for hemostasis. If factor VIII coagulant activity is present at less than 5% of normal, DESMOPRESSIN ACETATE should not be relied on.von WIllebrand's Disease: Laboratory tests for assessing patient status include levels of factor VIII coagulant activity, factor VIII ristocetin cofactor activity, and factor VIII von Willebrand factor antigen. The skin bleeding time may be helpful in following these patients.Diabetes Insipidus: Laboratory tests for monitoring the patient include urine volume and osmolality. In some cases, plasma osmolality may be required.Drug Interactions: Although the pressor activity of DESMOPRESSIN ACETATE is very low compared with the antidiuretic activity, use of doses as large as 0.3 mcg/kg of DESMOPRESSIN ACETATE with other pressor agents should be done only with careful patient monitoring. The concomitant administration of drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, NSAIDs, lamotrigine and carbamazepine) should be performed with caution.DESMOPRESSIN ACETATE has been used with epsilon aminocaproic acid without adverse effects.Carcinogenicity, Mutagenicity, Impairment of Fertility: Studies with DESMOPRESSIN ACETATE have not been performed to evaluate carcinogenic potential, mutagenic potential or effects on fertility.Pregnancy Category B: Fertility studies have not been done. Teratology studies in rats and rabbits at doses from 0.05 to 10 mcg/kg/day (approximately 0.1 times the maximum systemic human exposure in rats and up to 38 times the maximum systemic human exposure in rabbits based on surface area, mg/m2) revealed no harm to the fetus due to DESMOPRESSIN ACETATE. There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.Several publications of desmopressin acetate's use in the management of diabetes insipidus during pregnancy are available; these include a few anecdotal reports of congenital anomalies and low birth weight babies. However, no causal connection between these events and desmopressin acetate has been established. A fifteen year, Swedish epidemiologic study of the use of desmopressin acetate in pregnant women with diabetes insipidus found the rate of birth defects to be no greater than that in the general population; however, the statistical power of this study is low. As opposed to preparations containing natural hormones, desmopressin acetate in antidiuretic doses has no uterotonic action and the physician will have to weigh the therapeutic advantages against the possible risks in each case.Nursing Mothers: There have been no controlled studies in nursing mothers. A single study in postpartum women demonstrated a marked change in plasma, but little if any change in assayable DESMOPRESSIN ACETATE in breast milk following an intranasal dose of 10 mcg. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when DESMOPRESSIN ACETATE is administered to a nursing woman.Pediatric Use: Use in infants and pediatric patients will require careful fluid intake restriction to prevent possible hyponatremia and water intoxication. Fluid restriction should be discussed with the patient and/or guardian. (See WARNINGS .) DESMOPRESSIN ACETATE Injection 4 mcg/mL should not be used in infants less than three months of age in the treatment of hemophilia A or von Willebrand's disease; safety and effectiveness in pediatric patients under 12 years of age with diabetes insipidus have not been established.Geriatric Use: Clinical studies of DESMOPRESSIN ACETATE Injection did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. DESMOPRESSIN ACETATE is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50ml/min). (See CLINICAL PHARMACOLOGY, Human Pharmacokinetics, and CONTRAINDICATIONS.)Use of DESMOPRESSIN ACETATE injection in geriatric patients will require careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. Fluid restriction should be discussed with the patient. (See WARNINGS.)

Adverse Reactions

Infrequently, DESMOPRESSIN ACETATE has produced transient headache, nausea, mild abdominal cramps and vulval pain. These symptoms disappeared with reduction in dosage. Occasionally, injection of DESMOPRESSIN ACETATE has produced local erythema, swelling or burning pain. Occasional facial flushing has been reported with the administration of DESMOPRESSIN ACETATE. DESMOPRESSIN ACETATE Injection has infrequently produced changes in blood pressure causing either a slight elevation or a transient fall and a compensatory increase in heart rate. Severe allergic reactions including anaphylaxis have been reported rarely with DESMOPRESSIN ACETATE Injection.See WARNINGS for the possibility of water intoxication and hyponatremia.Post Marketing: There have been rare reports of thrombotic events (acute cerebrovascular thrombosis, acute myocardial infarction) following DESMOPRESSIN ACETATE Injection in patients predisposed to thrombus formation, and rare reports of hyponatremic convulsions associated with concomitant use with the following medications: oxybutinin and imipramine.


Signs of overdose may include confusion, drowsiness, continuing headache, problems with passing urine and rapid weight gain due to fluid retention. (See WARNINGS.) In case of overdosage, the dosage should be reduced, frequency of administration decreased, or the drug withdrawn according to the severity of the condition.There is no known specific antidote for desmopressin acetate or DESMOPRESSIN ACETATE Injection 4 mcg/mL.An oral LD50 has not been established. An intravenous dose of 2 mg/kg in mice demonstrated no effect.

Dosage And Administration

  • Hemophilia A and von Willebrand's Disease (Type I): DESMOPRESSIN ACETATE Injection 4 mcg/mL is administered as an intravenous infusion at a dose of 0.3 mcg DESMOPRESSIN ACETATE/kg body weight diluted in sterile physiological saline and infused slowly over 15 to 30 minutes. In adults and children weighing more than 10 kg, 50 mL of diluent is recommended; in children weighing 10 kg or less, 10 mL of diluent is recommended. Blood pressure and pulse should be monitored during infusion. If DESMOPRESSIN ACETATE Injection 4 mcg/mL is used preoperatively, it should be administered 30 minutes prior to the scheduled procedure.The necessity for repeat administration of DESMOPRESSIN ACETATE or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. The tendency toward tachyphylaxis (lessening of response) with repeated administration given more frequently than every 48 hours should be considered in treating each patient.Fluid restriction should be observed. (See   WARNINGS, PRECAUTIONS, Pediatric Use and Geriatric Use.)Diabetes Insipidus: This formulation is administered subcutaneously or by direct intravenous injection. DESMOPRESSIN ACETATE Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover.The usual dosage range in adults is 0.5 mL (2.0 mcg) to 1 mL (4.0 mcg) daily, administered intravenously or subcutaneously, usually in two divided doses. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. For patients who have been controlled on intranasal DESMOPRESSIN ACETATE and who must be switched to the injection form, either because of poor intranasal absorption or because of the need for surgery, the comparable antidiuretic dose of the injection is about one-tenth the intranasal dose.Fluid restriction should be observed. (See  WARNINGS,   PRECAUTIONS, Pediatric Use and Geriatric Use.)Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.Geriatric Use: This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. (See CLINICAL PHARMACOLOGY, Human Pharmcokinetics,  CONTRAINDICATIONS, and   PRECAUTIONS, Geriatric Use.)Directions for use of One Point Cut (OPC) Ampules for DESMOPRESSIN ACETATE Injection:Use aseptic technique to clean ampule. Gently tap the top of the ampule to assist the flow of the solution from the upper portion of the ampule to the lower portion.Locate the blue dot on the upper portion of the ampule. Below this dot is a small score on the neck of the ampule. Hold the ampule with the blue dot facing away from you.Cover the vial with an appropriate wipe. Apply pressure to the top and bottom portions of the ampule to snap the ampule open away from you.

How Supplied

DESMOPRESSIN ACETATE Injection 4 mcg/mL is available as a sterile solution in cartons of ten 1 mL single-dose ampules (NDC 69918-899-10) and in 10 mL multiple-dose vials (NDC 69918-901-10), each containing 4.0 mcg DESMOPRESSIN ACETATE per mL.Store refrigerated 2 to 8°C (36 to 46°F).Keep out of the reach of children.

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