DesmoMelt (desmopressin), put simply, helps reduce excessive thirst and the need for urination. It is commonly used in central diabetes insipidus (it is not effective in nephrogenic diabetes insipidus) and bedwetting in children, though it does provide use in a range of similar conditions.

The medication may also be used in some unrelated conditions, such as mild to moderate blood clotting disorders, like von Willebrand disease or hemophilia A. It typically does not provide sufficient benefit in severe cases.

DesmoMelt can be used in children 5 years of age and up.

DesmoMelt Benefits

One advantage DesmoMelt offers compared to other administration formulations is its ease of administration. Each tablet is designed to rapidly melt when placed under the tongue; there's no need to swallow a tablet or utilize relatively conspicuous nasal sprays. While certainly convenient for adults, it is particularly beneficial in children, who are often very reluctant to swallow tablets and may have difficulty with nasal sprays.

In functional terms, DesmoMelt helps alleviate excessive thirst and excessive urination. Its active ingredient has been widely used since its introduction in the 1970s in patients with central diabetes insipidus, urimia, polyuria, polydipsia, and related conditions. It also helps alleviate nocturnal urination in children and adults.

The medication works by increasing water permeability in renal cellular tubes; when permeability is increased, excessive thirst and the need for excessive urination decreases. Fluid regulation, particularly with respect to bedtime, will further enhance results.

Patients prone to fluid or electrolyte imbalances may want to consider alternatives to DesmoMelt, or at least speak with a doctor prior to starting treatment.

Alleviating Excessive Thirst & Urination

The goal of treatment with DesmoMelt is to ensure adequate sleep (not needing to get up to urinate) and adequate (not excessive) turnover of fluids. The exact dosage to achieve this can vary widely between individuals depending on the underlying cause of the condition, and the duration of treatment will vary according to the treatment of the underlying cause.

Treatment for patients age 13 and up with central diabetes insipidus:

• Start with 0.05 mg twice per day (1/2 of the 0.1 mg or 120 mcg tablets; tablets can be split)
• Dosage may be increased according to patient response.
• The majority of patients find 0.1 to 0.8 mg per day to be sufficient.

Some improvement should be noticeable a few days after starting treatment, especially if fluid regulation is also incorporated. Dosage adjustments may be needed and may vary over time. Treatment may continue indefinitely, as long as it provides benefit.

Patients treating conditions other than central diabetes insipidus will need to follow doctors orders, or find an organization familiar with using DesmoMelt for a given condition.

Alleviating Nocturnal Urination

In this instance DesmoMelt is most often used in children. Depending on location, the majority of doctors do not consider bedwetting an issue until the child is at least 5 or 6 years old; children below these ages are rarely treated with medications. Prior to prescribing DesmoMelt a doctor will also want to rule out other causes, such as physical injuries.

It should be noted that DesmoMelt is not 100 percent effective in stopping nocturnal urination. It is estimated that between 25 and 60 percent of patients see significant improvement. On average both adults and children experience 2 to 3 fewer incidents per week, though in practice some patients will completely or nearly completely eliminate nocturnal urination while other patients notice little difference. It is virtually impossible to say if the medication will help or not until it is tried.

To treat nocturnal urination:

• Treatment typically starts with 0.2 mg (or 240 mcg) before bedtime.
• Dosage may be increased to 0.4 or 0.6 mg before bedtime if needed.
• Do not exceed 0.6 mg in children. If it doesn't produce results at this dosage, alternatives should be considered.

Fluid intake should be minimized one hour prior to administering DesmoMelt, and maintained for at least 8 hours after a dose has been administered, in both children and adults.

In children treatment should continue for three months, after which it should be stopped for at least one week to see if bedwetting continues. If relapse occurs after three months, treatment may continue for another three months.

The medication can also be used as-needed, for example to keep a child dry during a sleepover, once an effective dose has been determined but the patient relapsed after treatment ended. Daily use should not exceed one week for as-needed use.