← All compounds · evidence tier first, by design
| Use | E1 | E2 | E3 | E4 | E5 | E6 | E7 | E8 |
|---|---|---|---|---|---|---|---|---|
| E1 Nocturia due to nocturnal polyuria in adults | E1 | |||||||
| E1 Primary nocturnal enuresis in children | E1 | |||||||
| E4 Central diabetes insipidus | E4 | |||||||
| E4 Haemophilia A and von Willebrand disease (bleeding prevention) | E4 |
Desmopressin
Synthetic analogue of arginine vasopressin: 3-mercaptopropionic acid (deaminated Cys1)-Tyr-Phe-Gln-Asn-Cys-Pro-D-Arg-Gly-NH2, disulfide-bridged; contains a D-arginine and a C-terminal amide, so no standard one-letter sequence is given.
Non-standard residues or modifications: no plain one-letter sequence
Also: Desmopressin acetate, 1-deamino-8-D-arginine vasopressin · Codes: DDAVP, SER120 · Brands: DDAVP, Nocdurna
A synthetic nine-residue analogue of the pituitary hormone vasopressin, modified to act mainly on kidney water reabsorption with little effect on blood pressure. It has been an approved prescription drug for decades in tablet, nasal, sublingual and injectable forms. Labelled uses include central diabetes insipidus, primary nocturnal enuresis, nocturia due to nocturnal polyuria, and, for the injectable form, certain bleeding disorders.
- US A approved
- EU ? not verified
- UK ? not verified
- CA A approved
- AU ? not verified
- JP ? not verified
- CN ? not verified
01Regulatory status, by jurisdiction
| Jurisdiction | Status | Detail and primary source |
|---|---|---|
| US | Approved | Drugs@FDA lists DDAVP tablets (NDA 019955, Ferring) with marketing status Prescription. Other desmopressin NDAs include DDAVP injection (NDA 018938, Prescription). The DDAVP nasal products under NDA 017922 and Nocdurna (NDA 022517) are listed as Discontinued.“09/06/1995 ORIG-1 Approval Type 3 - New Dosage Form STANDARD”Drugs@FDA: FDA-Approved Drugs - NDA 019955 (DDAVP) · retrieved 2026-10-10 |
| CA | Approved | Health Canada Drug Product Database lists the DDAVP injectable product (Ferring Inc) with current status Marketed. DDAVP Spray, DDAVP Rhinyle and DDAVP tablet entries checked were listed as Cancelled Post Market.“Current status: Marketed Current status date: 1993-12-31 Original market date: See footnote 1 1993-12-31”Drug Product Database: Product information - DDAVP injection · retrieved 2026-10-10 |
| EU UK AU JP CN | Not yet verified from a primary source. No status is shown rather than an unsourced one. | |
Sport (WADA): Prohibited · class S5. “mannitol; Desmopressin; Probenecid; and other substances with a similar chemical structure or similar biological effect(s).” WADA source
02What the human evidence shows
Nocturia due to nocturnal polyuria in adults
Several adequately sized randomised, double-blind, placebo-controlled phase 3 trials of low-strength sublingual and nasal formulations reported modest reductions in night-time voids compared with placebo. Effect sizes over placebo were small in absolute terms. Hyponatraemia was the principal safety concern and was more frequent in older participants.
- [1] Greater reduction in nocturnal voids than placebo in men with nocturia in a randomised placebo-controlled trial
- [2] Pooled analysis of two placebo-controlled phase 3 trials reported fewer nocturnal voids with the nasal formulation than with placebo
Registered-study counts: ClinicalTrials.gov intervention search “desmopressin nocturia”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Primary nocturnal enuresis in children
n/c: not counted here; see the cited review.
A Cochrane systematic review of randomised trials found that desmopressin reduced the number of wet nights compared with placebo while it was being taken, but the review found no evidence that the benefit persisted after treatment stopped. The exact number of included RCTs is not restated here.
- [3] Fewer wet nights than placebo during treatment in children with nocturnal enuresis; no sustained effect after stopping
Registered-study counts: ClinicalTrials.gov intervention search “desmopressin enuresis”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Central diabetes insipidus
n/c: not counted here; see the cited review.
Use in central diabetes insipidus rests on early uncontrolled clinical studies from the 1970s showing an antidiuretic response, and on long clinical use. No placebo-controlled trial is cited here; in a condition with a direct physiological replacement rationale, randomised placebo-controlled trials have not been the basis of approval.
- [4] Early clinical report of antidiuretic response to nasal desmopressin in patients with central diabetes insipidus
Registered-study counts: ClinicalTrials.gov intervention search “desmopressin diabetes insipidus”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Haemophilia A and von Willebrand disease (bleeding prevention)
n/c: not counted here; see the cited review.
The use of desmopressin to raise factor VIII and von Willebrand factor levels in mild haemophilia A and type 1 von Willebrand disease was established in uncontrolled clinical studies beginning in 1977. No randomised trial with bleeding outcomes is cited here.
- [5] Uncontrolled clinical study reporting rises in factor VIII and von Willebrand factor after desmopressin in patients with haemophilia and von Willebrand disease
Registered-study counts: ClinicalTrials.gov intervention search “desmopressin hemophilia”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Key registered trials
| NCT | Title (as registered) | Phase | Status |
|---|---|---|---|
| NCT01262456 | Investigation of the Superiority Effect of Orally Disintegrating Desmopressin Tablets to Placebo in Terms of Night Voids Reduction in Nocturia Adult Male Patients | 3 | Completed |
| NCT01223937 | Investigation of the Superiority Effect of Desmopressin to Placebo in Terms of Night Voids Reduction in Nocturia Adult Female Patients | 3 | Completed |
03Safety signals
- Hyponatraemia [6]
A systematic review and meta-analysis found hyponatraemia to be a recognised risk in older adults treated with desmopressin for nocturia. Severe hyponatraemia can cause seizures.
04What is unknown
- No randomised placebo-controlled trial with clinical outcomes underpins use in central diabetes insipidus; the evidence is historical and uncontrolled
- Whether the small average reduction in night-time voids in nocturia trials outweighs hyponatraemia risk in people over 65 is not settled by the cited trials
- Benefit in childhood enuresis after treatment stops was not demonstrated in the cited review
- Status in the EU (national authorisations), UK, Australia, Japan and China was not verified from regulator sources for this record
05Product quality
No independent purity results have been published for this compound yet. The purity programme will publish full methods and vendor-named results, passes and failures, once its protocol has had legal review.
06Citations
- Efficacy and Safety of Low Dose Desmopressin Orally Disintegrating Tablet in Men with Nocturia: Results of a Multicenter, Randomized, Double-Blind, Placebo Controlled, Parallel Group Study (2013). doi:10.1016/j.juro.2012.12.112
- Efficacy and Safety of SER120 Nasal Spray in Patients with Nocturia: Pooled Analysis of 2 Randomized, Double-Blind, Placebo Controlled, Phase 3 Trials (2018). doi:10.1016/j.juro.2018.04.050
- Desmopressin for nocturnal enuresis in children (2002). doi:10.1002/14651858.CD002112
- THERAPEUTIC RESPONSE OF CENTRAL DIABETES INSIPIDUS ON NASAL APPLICATION OF A NEW SYNTHETIC ANALOGUE OF VASOPRESSIN (1-DEAMINO-8-D-ARGININE-VASOPRESSIN (DDAVP)) (1972). doi:10.1530/acta.0.069s052
- 1-DEAMINO-8-D-ARGININE VASOPRESSIN: A NEW PHARMACOLOGICAL APPROACH TO THE MANAGEMENT OF HAEMOPHILIA AND VON WILLEBRAND'S DISEASE (1977). doi:10.1016/s0140-6736(77)91197-7
- The risk of hyponatremia in older adults using desmopressin for nocturia: A systematic review and meta‐analysis. doi:10.1002/nau.20038
Every DOI is resolved against Crossref and every NCT number against ClinicalTrials.gov, title for title, before publication. Regulatory sources are cited inline above with a verbatim quote and retrieval date.
07Mechanism
Desmopressin is a selective vasopressin V2 receptor agonist; in human studies it reduces urine output by increasing water reabsorption in the kidney collecting duct and raises circulating factor VIII and von Willebrand factor levels.
Mechanism is placed last on purpose: a plausible mechanism is not evidence that a compound works in people.
Reviewed by OSMF research team (AI-assisted, source-verified) on 2026-10-10. Found an error? It goes in the corrections log: report it.