As a parent or caregiver of a tween or teen, making sure their bleeding disorders treatment is keeping up with their activities and growing independence is top of mind. You may have questions about the different types of treatment options for your child. This section has answers to common questions about desmopressin. This section can help you develop your own set of questions to ask your child’s health care provider to find the best treatment option.

What is this treatment for?  
Desmopressin is a lab made version (synthetic) of a natural hormone, called vasopressin, that prevents the body from releasing too much fluid (antidiuretic). Desmopressin can be used for joint and muscle bleeds, nose, and mouth bleeds, and before and after surgery.   
How does this treatment work in the body?
When there is an injury in the body, a blood clot is formed using a complex process called the clotting cascade. As part of the clotting cascade, different proteins called factors are activated in a series of events with one factor often activating another factor. Without von Willebrand Factor (VWF) and Factor VIII (8), it will be much more difficult for your body to form a strong blood clot. Desmopressin stops bleeding by helping the body to release von Willebrand factor (VWF) from cells, which also increases the level of factor VIII (8) in the body.   
How is this treatment given?
Desmopressin comes in different forms. In one form, a person will get medication into their body using a needle that goes into a vein (infusion). For this medication, it can take about 30 minutes. It is usually done at a clinic or even at a hospital if done before a medical procedure. Another form of desmopressin is a nasal (into the nose) spray. The manufacturer of DDAVP nasal spray issued a recall of all US products and does not expect to begin resupplying until mid-2024.
How much of this treatment is normally given? 
The dosage of desmopressin given is based on body weight, the reason for treatment (an active bleed, using before an operation, or using daily to prevent bleeding (prophylactically), and the form of treatment used (nasal spray or injection into a vein). 
Who can use this treatment? 
Desmopressin can be used for people with Hemophilia A and people with Type 1 and Type 2A VWD. Some people don’t respond to the treatment. Your child’s health care provider may have your child do a trial to see if it works. Desmopressin should not be used for children under age 2.
What are the benefits? 

  • Helps stop bleeding in individuals with some bleeding disorders.   

  • Can be used before surgery to help prevent extra bleeding.   

  • Nasal spray (when available) can be an easier option.

What are the known limitations? 

Some of the risks of desmopressin include the following:   

  • This type of medication (antidiuretics) causes the body to retain water. Due to this, it is important to limit your child’s fluid intake so that the medication does not reduce levels of sodium in their bloodstream (a condition called hyponatremia).    

  • Administered using a needle, into a vein (infusion). This can pose risks such as infection, bleeding, or other complications, so it's important to follow your child’s health care provider's instructions carefully.   

  • May be given using an injection to put the medicine into the body through a vein (infusion). This can be scary for some children. Learn more about needle fear and phobia in this video.   

  • The manufacturer of Stimate® nasal spray issued a recall of all US products and does not expect to begin resupplying until mid-2024. You can get more information on latest news updates and medical advisories.  

  • Learn more about infusion basics.

What are the other names for this treatment?

  • Stimate®   

  • DDAVP®   

It is best to speak with your child's health care provider to determine if this treatment option will work for your child. 
References
NHF’s Medical and Scientific Advisory Council. (2022). MASAC Recommendations Concerning Products Licensed for the Treatment of Hemophilia and Other Bleeding Disorders (MASAC 272). National Hemophilia Foundation. https://www.hemophilia.org/healthcare-professionals/guidelines-on-care/masac-documents/masac-document-272-masac-recommendations-concerning-products-licensed-for-the-treatment-of-hemophilia-and-other-bleeding-disorders