Notably, non-use of routine potassium monitoring with spironolactone in young women would reduce costs associated with its use. Breast changes
Spironolactone frequently causes breast pain and breast enlargement in women. This is "probably because of estrogenic effects on target tissue." At low doses, breast tenderness has been reported in only 5% of women, but at high doses, it has been reported in up to 40% of women. Breast enlargement and tenderness may occur in 26% of women at high doses. Some women regard spironolactone-induced breast enlargement as a positive effect.Spironolactone also commonly and dose-dependently produces gynecomastia (breast development) as a side effect in men. At low doses, the rate is only 5 to 10%, but at high doses, up to or exceeding 50% of men may develop gynecomastia. In the RALES, 9.1% of men taking 25 mg/day spironolactone developed gynecomastia, compared to 1.3% of controls. Conversely, in studies of healthy men given high-dose spironolactone, gynecomastia occurred in 3 of 10 (30%) at 100 mg/day, in 5 of 8 (62.5%) at 200 mg/day, and in 6 of 9 (66.7%) at 400 mg/day, relative to none of 12 controls. The severity of gynecomastia with spironolactone varies considerably, but is usually mild. As with breast enlargement caused by spironolactone in women, gynecomastia due to spironolactone in men is often although inconsistently accompanied by breast tenderness.
It is not recommended in severe disease or in those with abnormal factor VIII. Usefulness in type 2A, 2M, or 2N von Willebrand disease is variable. Generally not recommended in 2B and type 3 von Willebrand disease.Desmopressin is only recommended in mild hemophilia A. It may be used both for bleeding due to trauma or to try to prevent bleeding due to surgery. It is not effective in the treatment of hemophilia B (factor IX deficiency) or severe hemophilia A. May also be used in uremia induced bleeding. Diabetes insipidus
Desmopressin is used in the treatment of central diabetes insipidus (DI) as a replacement for endogenous antidiuretic hormone (ADH) that is in insufficient quantity due to decreased or non-existent secretion or production of ADH by the posterior pituitary or hypothalamus, respectively. It is also used in the diagnostic workup for diabetes insipidus, in order to distinguish central from DI due to the kidneys. Desmopressin is not effective at treating nephrogenic DI, thus a positive response is generally indicative of central DI. Side effects
headaches
facial flushing
nausea
hyponatremia
seizuresUS drug regulators added warning to the nasal sprays after two people died and fifty-nine other people had seizures. This occurred due to hyponatremia, a deficit of the bodys sodium levels, and the nasal spray is no longer approved for use in children in the United States. However, US drug regulators have said that desmopressin tablets can still be considered safe for treatment of nocturnal enuresis in children as long as the person is otherwise healthy.