BNF for Children 2011-2012

BNFC 2011–2012 6.5.2 Posterior pituitary hormones and antagonists 387. IntranasallyChild 1–18 years 4 micrograms/kg as a singledose, for pre-operative use give 2 hours beforeprocedureRenal function testing. IntranasallyChild 1 month–1 year 10 micrograms (emptybladder at time of administration and restrict fluidintake to 50% at next 2 feeds to avoid fluid overload)Child 1–15 years 20 micrograms (empty bladderat time of administration and restrict fluid intake to500 mL from 1 hour before until 8 hours afteradministration to avoid fluid overload)Child 15–18 years 40 micrograms (emptybladder at time of administration and restrict fluidintake to 500 mL from 1 hour before until 8 hoursafter administration to avoid fluid overload). By subcutaneous or intramuscular injectionChild 1 month–1 year 400 nanograms (emptybladder at time of administration and restrict fluidintake to 50% at next 2 feeds to avoid fluid overload)Child 1–18 years 2 micrograms (empty bladder attime of administration and restrict fluid intake to500 mL from 1 hour before until 8 hours afteradministration to avoid fluid overload)Desmotabs c (Ferring) ATablets, scored, desmopressin acetate 200 micrograms,net price 30-tab pack = £29.43. Counselling,fluid intake, see aboveNote tablets may be crushedDesmomelt c (Ferring) AOral lyophilisates, desmopressin (as acetate)120 micrograms, net price 30-tab pack = £30.34;240 micrograms, 30-tab pack = £60.68. Label: 26,counselling, fluid intake, see above. For sublingualadministrationDesmospray c (Ferring) ANasal spray, desmopressin acetate 10 micrograms/metered spray, net price 6-mL unit (60 meteredsprays) = £25.02. Counselling, fluid intake, see aboveNote Children requiring dose of less than 10 microgramsshould be given DDAVP c intranasal solutionLow dose Desmospray c ANasal spray, desmopressin acetate 2.5 micrograms/metered sprayAvailable from Ferring on a named-patient basisOctim c (Ferring) ANasal spray, desmopressin acetate 150 micrograms/metered spray, net price 2.5-mL unit (25 meteredsprays) = £576.60. Counselling, fluid intake, see aboveInjection, desmopressin acetate 15 micrograms/mL,net price 1-mL amp = £19.22Administration for intravenous infusion dilute with 50 mL ofSodium Chloride 0.9% and give over 20 minutesDesmopressin acetate (Non-proprietary) ATablets, desmopressin acetate 100 micrograms, netprice 90-tab pack = £50.57; 200 micrograms, 30-tabpack = £24.36, 90-tab pack = £69.82. Counselling,fluid intake, see aboveNasal spray, desmopressin acetate 10 micrograms/metered spray, net price 6-mL unit (60 meteredsprays) = £18.74. Counselling, fluid intake, see aboveBrands include Presinex cNote Children requiring dose of less than 10 microgramsshould be given DDAVP c intranasal solutionDDAVP c (Ferring) ATablets, both scored, desmopressin acetate100 micrograms, net price 90-tab pack = £44.12;200 micrograms, 90-tab pack = £88.23. Counselling,fluid intake, see aboveNote Tablets may be crushedOral lyophilisates, (DDAVP c Melt), desmopressin(as acetate) 60 micrograms, net price 100-tab pack =£50.53; 120 micrograms, 100-tab pack = £101.07;240 micrograms, 100-tab pack = £202.14. Label: 26,counselling, fluid intake, see notes above. Forsublingual administrationIntranasal solution, desmopressin acetate 100 micrograms/mL.Net price 2.5-mL dropper bottle andcatheter = £9.72. Counselling, fluid intake, see aboveAdministration May be diluted with Sodium Chloride 0.9% to aconcentration of 10 micrograms/mLInjection, desmopressin acetate 4 micrograms/mL.Net price 1-mL amp = £1.10Administration May be administered orally [unlicensed]; forintravenous infusion, higher doses used in mild to moderatehaemophilia and von Willebrand’s disease may be diluted with30–50 mL Sodium Chloride 0.9% intravenous infusionTERLIPRESSIN ACETATECautions see under VasopressinContra-indications see under VasopressinPregnancy avoidBreast-feeding no information availableSide-effects see under Vasopressin, but effects milderLicensed use unlicensed for use in childrenIndication and doseAdjunct in acute massive haemorrhage of gastro-intestinaltract or oesophageal varices(specialist use only). By intravenous injectionChild 12–18 years initially 2 mg then 1–2 mgevery 4–6 hours until bleeding is controlled; max.duration of treatment 72 hoursGlypressin c (Ferring) AInjection, powder for reconstitution, terlipressinacetate, net price 1-mg vial with 5 mL diluent = £18.47Injection, solution for injection, terlipressin acetate,0.12 mg/mL, net price 1-mg (8.5 mL) vial = £19.39Variquel c (IS Pharmaceuticals) AInjection, powder for reconstitution, terlipressinacetate, net price 1-mg vial with 5 mL diluent = £17.90VASOPRESSINCautions heart failure, hypertension, asthma, epilepsy,migraine or other conditions which might be aggravatedby water retention; avoid fluid overloadContra-indications vascular disease (especially diseaseof coronary arteries) unless extreme caution,6 Endocrine system