Desmopressin is a nine-amino-acid peptide, a modified form of the hormone vasopressin that keeps the kidney's water-holding action and loses most of the blood-pressure effect. It is one of a small number of peptides approved in the United States in four ways — injection, nasal spray, tablet and, since 2026, an oral solution — and that is why the question "what is the dose?" has no single answer. This page reports the figures printed on the current labels, by route and condition, and the absorption numbers that explain why they differ so much. It recommends nothing; doses are set by a prescriber against urine output and blood sodium.
The labelled doses, by route
| Route and product | Condition | Labelled dose |
|---|---|---|
| Injection, 4 mcg/mL (subcutaneous or IV) | Central diabetes insipidus | 2–4 mcg a day, as one or two doses |
| Injection, 4 mcg/mL (IV infusion) | Haemophilia A, von Willebrand type 1 (factor VIII >5%) | 0.3 mcg/kg, maximum 20 mcg |
| Nasal spray, 10 mcg per spray | Central diabetes insipidus | Adults 10–40 mcg a day, single or 2–3 doses; children from 4 years 10–30 mcg |
| Nasal spray STIMATE, 150 mcg per spray | Haemophilia A, von Willebrand type 1 | 300 mcg (one spray each nostril) at 50 kg or more; 150 mcg below 50 kg |
| Tablets, 0.1 and 0.2 mg | Central diabetes insipidus | Start 0.05 mg twice daily; most trial patients 0.1–0.8 mg a day; range 0.1–1.2 mg in 2–3 doses |
| Tablets, 0.1 and 0.2 mg | Primary nocturnal enuresis, age 6+ | 0.2 mg at bedtime, up to 0.6 mg |
| Oral solution DESMODA, 0.05 mg/mL | Central diabetes insipidus, adults and children | Start 0.05 mg (1 mL) twice daily, empty stomach |
Every label says the dose is individual: for diabetes insipidus, adjusted to "adequate duration of sleep and adequate, not excessive, water turnover", in the tablet label's words.
Why the same drug spans 2 to 1,200 micrograms
The labels print the reason. The tablet label puts oral bioavailability at about 0.16% of an intravenous dose and about 5% of an intranasal one; the oral-solution label gives the same 0.16% and a 95% lower exposure than the nasal route. STIMATE's label puts nasal bioavailability at 3.3 to 4.1%.
Run those through the doses and the table lines up:
- Tablet vs injection. 100 mcg swallowed at 0.16% is roughly 0.16 mcg reaching the blood. The tablet's daily range (100–1,200 mcg) is 25 to 600 times the injection's (2–4 mcg); 1 ÷ 0.0016 is 625.
- Tablet vs spray. At 5%, 200 mcg of tablet corresponds to about 10 mcg sprayed, which is why the spray's 10–40 mcg sits where it does. Both labels require a gap when switching (12 hours for diabetes insipidus).
- High-strength spray vs infusion. 300 mcg sprayed at about 3.7% is roughly 11 mcg absorbed; a 70 kg patient's infusion is 0.3 × 70 = 21 mcg, capped at 20. STIMATE's label says the factor VIII rise after its 300 mcg dose was smaller than after the 0.3 mcg/kg infusion.
Food cuts the oral figure further: DESMODA's label reports peak level down 72% and exposure down 64% after a high-fat meal, which is why it is labelled for an empty stomach.
Two sprays, fifteen times apart
The generic diabetes-insipidus spray and STIMATE both deliver 0.1 mL per spray. One holds 10 mcg in it, the other 150 mcg. Each label states that its pump can only give multiples of its own spray and that a patient needing another dose should use a different product. A third spray, NOCTIVA, approved for night-time urination in adults, delivered 0.83 or 1.66 mcg per spray — about 180 times less than STIMATE — and is listed as discontinued.
What has been approved and withdrawn
Drugs@FDA, read 2 October 2026, lists the current desmopressin prescription products as DDAVP tablets (0.1 and 0.2 mg), DDAVP injection (4 mcg/mL) and DESMODA oral solution (Eton, NDA 219873), plus many generic tablets, injections and the 10 mcg spray. Listed as discontinued: the branded DDAVP sprays and nasal solution, Minirin spray, a 15 mcg/mL injection, NOCDURNA sublingual tablets (27.7 and 55.3 mcg), NOCTIVA, and both STIMATE product lines — although a Ferring STIMATE label revised on 2026-07-22 is on openFDA, so the product's status is worth checking against the pharmacy before relying on either listing.
The warning on every label: sodium
Every current label read for this page warns of hyponatraemia; on the injection label it is a boxed warning, and the DESMODA label contraindicates use in anyone with hyponatraemia or a history of it. The mechanism is the drug working as intended: the kidney keeps water, and if fluid intake continues, blood sodium falls. Severe cases can cause seizures, coma, respiratory arrest or death. The injection label contraindicates it with loop diuretics and systemic or inhaled glucocorticoids, requires normal sodium before starting, and calls for a sodium check within 7 days and about a month after starting, more often from age 65. The enuresis section of the tablet label limits fluids from 1 hour before a dose until the next morning, or at least 8 hours.
Kidney function changes the arithmetic. In the labels' 24-person study, a 2 mcg injection's half-life rose from 2.8 hours with normal kidneys to 8.7 hours with severe impairment, and exposure 3.6-fold.
Timing and duration
The tablet label reports antidiuretic effects starting at about 1 hour, peaking at 4 to 7 hours, and lasting up to 8 hours at 0.1–0.2 mg and up to 12 hours at 0.4 mg. Blood half-life is shorter than the effect: about 2.8 hours after injection, 1.5 to 2.5 hours (tablet label) or 3.6 hours (oral-solution label) by mouth, and 3.3 to 3.5 hours by STIMATE spray.
What is not covered by the labels
No US label covers desmopressin for any athletic, cosmetic or "research" use, and no label gives a dose for a powder vial reconstituted by the user. The absorption figures above come from approved formulations; a nasal or oral product of unknown concentration has none of them.
How desmopressin's nasal and oral figures compare with the other approved peptide sprays and tablets is on our peptide nasal spray page and comparison of peptide products approved for swallowing. How half-life figures are read across compounds is on our peptide half-life page, and the site's other label-based dose pages are indexed on the peptide dosage chart. What the molecule is and how it was developed is in Peptide Lexicon's desmopressin entry.
Sources and dates
- Desmopressin Acetate Tablets (Nordic Pharma, NDA 019955), label effective 2024-12-06: indications, dosage, clinical pharmacology, via openFDA, read 2026-10-02.
- Desmopressin Acetate Injection (Nordic Pharma, NDA 018938), label effective 2025-10-23: boxed warning, contraindications, dosage, pharmacokinetics, via openFDA, read 2026-10-02.
- Desmopressin Nasal Spray Solution 10 mcg/0.1 mL (Oceanside, ANDA 074830), label effective 2025-06-19, via openFDA, read 2026-10-02.
- STIMATE nasal spray 150 mcg/0.1 mL (Ferring, NDA 020355), label effective 2026-07-22, via openFDA, read 2026-10-02.
- DESMODA oral solution 0.05 mg/mL (Eton, NDA 219873), label effective 2026-03-02, via openFDA, read 2026-10-02.
- Drugs@FDA via openFDA, all NDA products with active ingredient desmopressin and their marketing status, read 2026-10-02.
Corrections go to the contact page.