Minirin

Minirin – the drug with vazopressinopodobny action used at treatment of not diabetes mellitus.

Form of release and structure

Minirin release in the following dosage forms:

• Tablets: white, convex, oval; on one party – risk, on another – a text (depending on a dosage) "0,1" or "0,2" (on 30 pieces in plastic bottles, on 1 bottle in a cardboard pack);
• Tablets are hypoglossal: round, white; on one party – marking in the form of 1, 2 or 3 drops (depending on a dosage of active agent on 0,06/0,12/0,24 mg respectively) (on 10 pieces in blisters, on 1, 3 or 10 blisters in a cardboard pack).

Is a part of 1 tablet:

• Active ingredient: desmopressin – 0,1 or 0,2 mg (in the form of desmopressin acetate);
• Auxiliary components: lactose, povidone, potato starch, magnesium stearate.

Hypoglossal is a part of 1 tablet:

• Active ingredient: desmopressin – 0,06, 0,12 or 0,24 mg (in the form of desmopressin acetate – 0,067, 0,135 or 0,27 mg respectively);
• Auxiliary components: gelatin – 12,5 mg, Mannitolum – 10,25 mg, citric acid – to рН 4,8.

Indications to use

• Central not diabetes mellitus;
• Night polyuria (nokturiya) at adults (as a symptomatic treatment);
• Primary night enuresis at children of 5 years (for tablets) or 6 years (for hypoglossal tablets).

Contraindications

Absolute:

• Heart failure and other states which demand use of medicines with diuretic action;
• Hyponatremia;
• The renal failure proceeding in heavy and average degree (at clearance of creatinine <50 ml a minute);
• Syndrome of inadequate products of antidiuretic hormone (Parkhon's syndrome);
• Polydipsia (psychogenic or usual);
• Age up to 6 years (for tablets hypoglossal);
• Hypersensitivity to drug components.

Relative (Minirin's appointment demands care):

• Renal failure (at clearance of creatinine> 50 ml a minute);
• Bladder fibrosis;
• Disturbances of water and electrolytic balance;
• Potential probability of increase in intracranial pressure;
• Pregnancy;
• Age till 1 year (for tablets);
• Age of 65 years (because of high probability of development of side effects, including a liquid delay, a hyponatremia; at purpose of drug prior to therapy, in 3 days after the beginning of its reception and at each increase in a dose it is necessary to carry out control of a condition of the patient and to determine sodium level in a blood plasma).

Route of administration and dosage

The doctor defines the scheme of administration of drug individually.

Ratio of dosages between dosage forms of Minirin (a tablet – a tablet hypoglossal):

• 0,1 mg – 0,06 mg;
• 0,2 mg – 0,12 mg;
• 0,4 mg – 0,24 mg.

It is desirable to accept drug after food (to avoid influence of food on its absorption and efficiency).

Depending on a dosage form Minirin accept:

• Tablets: inside, washing down with liquid;
• Tablets are hypoglossal: sublingual (it is impossible to wash down tablets with liquid).

The recommended dosing mode (in doses for tablets):

• Central not diabetes mellitus (children and adults): an initial single dose – 0,1 mg, frequency rate of reception – 1-3 times a day. Further, depending on reaction to the carried-out treatment, carrying out dose adjustment is possible. In most cases the daily dose is in limits of 0,2-1,2 mg; the optimum supporting single dose makes 0,1-0,2 mg with frequency rate of reception 1-3 times a day;
• Primary night enuresis: the initial dose – 0,2 mg, drug is recommended to accept for the night. At insufficient efficiency increase in a dose is possible twice. It is necessary to limit liquid reception in the evening. The recommended duration of a course of continuous therapy – 3 months. On the basis of clinical data (after drug withdrawal within 1 week) the decision on treatment continuation can be made;
• Night polyuria (adults): the initial dose – 0,1 mg, drug is recommended to accept for the night. At insufficient efficiency within 1 week increase in a dose by 2-4 times is possible (it is possible to increase a dose not more often than once a week).

During Minirin's reception it is necessary to remember danger of a delay of liquid in an organism.

If after a month of therapy the adequate clinical effect is not observed, further use of drug is not recommended.

Side effects

Most often side effects are observed in cases when therapy is carried out without liquid reception restriction that leads to emergence of a delay of liquid and/or a hyponatremia. Disturbances can proceed asymptomatically or be followed by following signs:

• Alimentary system: vomiting, nausea, dryness in a mouth;
• Central and peripheral nervous system: dizziness, headache; in especially hard cases – spasms;
• Others: increase in body weight, peripheral hypostases.

Special instructions

To avoid development of side effects, at patients with primary night enuresis without fail it is necessary to limit to a minimum reception of liquid in 1 hour prior to and for 8 hours after Minirin's reception.

According to data of clinical trials, most often side effects arise at elderly patients (aged from 65 years).

In the presence of other additional reasons for a delay of liquid and electrolytic frustration Minirin's use is not recommended.

Prevention of development of a hyponatremia consists in increase in frequency of definition of sodium in a blood plasma, in particular at the combined use with medicines which lead to emergence of a syndrome of inadequate secretion of antidiuretic hormone (including the selection inhibitors of serotonin, tricyclic antidepressants, carbamazepine, Chlorpromazinum), and non-steroidal anti-inflammatory drugs.

At a nocturia and/or a dysuria, an acute incontience of urine, infections of urinary tract, suspicion of a tumor of a prostate or a bladder, existence of a dekompensirovanny diabetes mellitus and polydipsia diagnosis and therapy of these diseases / states need to be carried out prior to Minirin's use.

If during treatment system infections, fever, a gastroenteritis develop administration of drug should be cancelled.

Medicinal interaction

At the combined Minirin's use with some drugs the following effects can be observed:

• Loperamide (presumably – and other drugs which are slowing down a peristaltics): significant increase in level of desmopressin in plasma that leads to increase in risk of a delay of liquid and development of a hyponatremia;
• Indometacin: strengthening, but not increase in duration of action of Minirin;
• Non-steroidal anti-inflammatory drugs: increase in risk of development of side effects;
• Norepinephrinum, глибутид, lithium, tetracycline: weakening of antidiuretic action of Minirin;
• Hypertensive drugs: strengthening of their action;
• Carbamazepine, Chlorpromazinum, the selection inhibitors of serotonin, tricyclic antidepressants: development of a syndrome of Parkhon, strengthening of antidiuretic effect of Minirin, increase in risk of a hyponatremia and delay of liquid;
• Dimetikon: desmopressin absorption reduction.

Terms and storage conditions

To store in protected from light, the place, dry, unavailable to children, at a temperature up to 25 °C.

Period of validity:

• Tablets – 2 years;
• Tablets hypoglossal – 4 years.