DDAVP is the synthetic version of a naturally occurring hormone in our bodies known as anti-diuretic hormone. DDAVP can be useful in patients with von Willebrand disease and mild to moderate haemophilia. It raises levels of factor eight clotting activity, which helps blood clot and stops bleeding.
If a trial proves useful, DDAVP can be used either prior to surgery or for treatment of an injury or trauma.
Suitability of DDAVP
DDAVP may work in children with:
- mild haemophilia A
- von Willebrand disease
- platelet function or storage disorders.
DDAVP should not be used in patients:
- with type 2B von Willebrand disease (it may cause platelet aggregation and thrombocytopenia)
- with type 3 (severe) von Willebrand’s disease
- with severe haemophilia
- who are under 18 months of age (due to the risk of water retention and hyponatraemia).
Note: Some children do not respond to DDAVP, so a trial will evaluate its effectiveness in your child.
There are two formulations available to administer DDAVP:
- DDAVP for intravenous injection (Minirin™) through a drip into a vein
- DDAVP for subcutaneous injection (Octostim™) under the skin (like a vaccination)
The current policy at the Queensland Children’s Hospital is to use the subcutaneous formulation of DDAVP as this minimises the distress caused to children and is better tolerated.
Blood tests are taken before the test dose of DDAVP and then 60 to 90 minutes after it is given. Peak levels of factor eight and von Willebrand factor occur about 90 minutes after subcutaneous administration.
Possible side effects
The most common side effect of DDAVP is facial flushing. This is harmless and not an allergic reaction. Subcutaneous DDAVP is generally well tolerated however some side effects may occur:
- mild headache
- fast heart rate
- blood pressure changes
- water retention (restrict fluid for 24 hours after DDAVP is given)
- mild stomach cramps
- nausea and vomiting
- lethargy and confusion.
Please report any of these to the nurse who will be monitoring your child for 30 minutes after the injection.
Important: limiting fluids
DDAVP stops your child from passing urine. If they drink too much fluid it may dilute your child’s normal electrolyte balance in their body. This can be a dangerous side effect of DDAVP. Your doctor or nurse will tell you how much fluid your child can drink during the 24 hours after the injection of DDAVP.
Haematology and Haemophilia Service
Queensland Children’s Hospital
Level 5, 501 Stanley Street, South Brisbane
t: 07 3068 3480
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.