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Use of desmopressin and concomitant use of potentially interacting drugs in elderly patients in Sweden

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Objective

The aims of this study were to analyze the prescription pattern of desmopressin before and after the new indication was approved for treatment of nocturia in the elderly in Sweden in 2002 and to analyze to what extent other drugs potentially inducing hyponatremia were prescribed in combination with desmopressin.

Methods

We conducted epidemiological analyzes of the Swedish Prescribed Drug Register from 2000 to March 2007. All patients older than 60 years who were prescribed desmopressin in Sweden during the study period were included.

Results

A marked increase in filled prescriptions of desmopressin in elderly patients was noticed after the new approval in 2002. The therapeutic intensity peaked in 2005 and has thereafter markedly decreased. The magnitude of concurrent treatment with any of the following drugs was assessed: diuretics, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRI), chlorpromazine, carbamazepine, loperamide, and nonsteroid anti-inflammatory drugs. More than half of the patients on desmopressin during July 2005 and March 2007 filled a prescription of any of the potentially harmful drugs within 30 days of a filled prescription of desmopressin.

Conclusions

The use of desmopressin in the elderly after the new approval in 2002 showed a similar prescription pattern to any newly introduced drug or after a changed indication. A large part of the elderly on desmopressin also receives other drugs that are potentially harmful in combination with desmopressin. Increased awareness of potentially interacting concomitant medication can improve medication safety in this fragile group.

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References

  1. Asplund R (2005) Nocturia in relation to sleep, health, and medical treatment in the elderly. BJU Int 96(Suppl 1):15–21

    Article  PubMed  Google Scholar 

  2. Weatherall M, Arnold T (2006) Nocturia in adults: draft New Zealand guidelines for its assessment and management in primary care. N Z Med J 119(1234):U1976

    PubMed  Google Scholar 

  3. Del Gado R, Del Gaizo D, Cennamo M, Auriemma R, Del Gado G, Verni M (2005) Desmopressin is a safe drug for the treatment of enuresis. Scand J Urol Nephrol 39(4):308–312

    Article  PubMed  Google Scholar 

  4. Robson WL, Leung AK, Norgaard JP (2007) The comparative safety of oral versus intranasal desmopressin for the treatment of children with nocturnal enuresis. J Urol 178(1):24–30

    Article  PubMed  CAS  Google Scholar 

  5. Wolfish NM, Barkin J, Gorodzinsky F, Schwarz R (2003) The Canadian Enuresis Study and Evaluation—short- and long-term safety and efficacy of an oral desmopressin preparation. Scand J Urol Nephrol 37(1):22–27

    Article  PubMed  CAS  Google Scholar 

  6. Callreus T, Ekman E, Andersen M (2005) Hyponatremia in elderly patients treated with desmopressin for nocturia: a review of a case series. Eur J Clin Pharmacol 61(4):281–284

    Article  PubMed  CAS  Google Scholar 

  7. Rembratt A, Riis A, Norgaard JP (2006) Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia. Neurourol Urodyn 25(2):105–109

    Article  PubMed  CAS  Google Scholar 

  8. Weatherall M (2004) The risk of hyponatremia in older adults using desmopressin for nocturia: a systematic review and meta-analysis. Neurourol Urodyn 23(4):302–305

    Article  PubMed  Google Scholar 

  9. Hvistendahl GM, Riis A, Norgaard JP, Djurhuus JC (2005) The pharmacokinetics of 400 microg of oral desmopressin in elderly patients with nocturia, and the correlation between the absorption of desmopressin and clinical effect. BJU Int 95(6):804–809

    Article  PubMed  CAS  Google Scholar 

  10. Ho DR, Lin WY, Wu CF, Shee JJ, Huang YC, Chen CS (2005) Clinical observations of the effect of antidiuretic hormone on nocturia in elderly men. BJU Int 96(9):1310–1313

    Article  PubMed  Google Scholar 

  11. Kuo HC (2002) Efficacy of desmopressin in treatment of refractory nocturia in patients older than 65 years. Urology 59(4):485–489

    Article  PubMed  Google Scholar 

  12. Lose G, Mattiasson A, Walter S, Lalos O, van Kerrebroeck P, Abrams P, Freeman R (2004) Clinical experiences with desmopressin for long-term treatment of nocturia. J Urol 172(3):1021–1025

    Article  PubMed  CAS  Google Scholar 

  13. Cannon A, Carter PG, McConnell AA, Abrams P (1999) Desmopressin in the treatment of nocturnal polyuria in the male. BJU Int 84(1):20–24

    Article  PubMed  CAS  Google Scholar 

  14. Rembratt A, Norgaard JP, Andersson KE (2003) Desmopressin in elderly patients with nocturia: short-term safety and effects on urine output, sleep and voiding patterns. BJU Int 91(7):642–646

    Article  PubMed  CAS  Google Scholar 

  15. Callreus T (2007) Use of desmopressin in elderly patients in Denmark. Pharmacoepidemiol Drug Saf

  16. Chan TY (1997) Drug-induced syndrome of inappropriate antidiuretic hormone secretion. Causes, diagnosis and management. Drugs Aging 11(1):27–44

    Article  PubMed  CAS  Google Scholar 

  17. Garcia EB, Ruitenberg A, Madretsma GS, Hintzen RQ (2003) Hyponatraemic coma induced by desmopressin and ibuprofen in a woman with von Willebrand’s disease. Haemophilia 9(2):232–234

    Article  PubMed  CAS  Google Scholar 

  18. Miller M (2006) Hyponatremia and arginine vasopressin dysregulation: mechanisms, clinical consequences, and management. J Am Geriatr Soc 54(2):345–353

    Article  PubMed  Google Scholar 

  19. Agerso H, Seiding Larsen L, Riis A, Lovgren U, Karlsson MO, Senderovitz T (2004) Pharmacokinetics and renal excretion of desmopressin after intravenous administration to healthy subjects and renally impaired patients. Br J Clin Pharmacol 58(4):352–358

    Article  PubMed  CAS  Google Scholar 

  20. Callreus T, Lundahl J, Hoglund P, Bengtsson P (1999) Changes in gastrointestinal motility influence the absorption of desmopressin. Eur J Clin Pharmacol 55(4):305–309

    Article  PubMed  CAS  Google Scholar 

  21. Wettermark B, Hammar N, Michaelfored C, Leimanis A, Otterblad Olausson P, Bergman U, Persson I, Sundström A, Westerholm B, Rośen M (2007) The new Swedish prescribed drug register-opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf 16(7):726–735

    Google Scholar 

  22. The Swedish Medical Products Agency (2007) http://www.lakemedelsverket.se. Accessed 12 Sept 2007

  23. Bleumink GS, Feenstra J, Sturkenboom MC, Stricker BH (2003) Nonsteroidal anti-inflammatory drugs and heart failure. Drugs 63(6):525–534

    Article  PubMed  CAS  Google Scholar 

  24. Mattiasson A, Abrams P, Van Kerrebroeck P, Walter S, Weiss J (2002) Efficacy of desmopressin in the treatment of nocturia: a double-blind placebo-controlled study in men. BJU Int 89(9):855–862

    Article  PubMed  CAS  Google Scholar 

  25. Astrand B, Astrand E, Antonov K, Petersson G (2006) Detection of potential drug interactions-a model for a national pharmacy register. Eur J Clin Pharmacol 62(9):749–756

    Article  PubMed  Google Scholar 

  26. Astrand E, Astrand B, Antonov K, Petersson G (2007) Potential drug interactions during a three-decade study period: a cross-sectional study of a prescription register. Eur J Clin Pharmacol 63(9):851–859

    Article  PubMed  Google Scholar 

  27. Straubhaar B, Krahenbuhl S, Schlienger RG (2006) The prevalence of potential drug-drug interactions in patients with heart failure at hospital discharge. Drug Saf 29(1):79–90

    Article  PubMed  Google Scholar 

  28. Lafata JE, Schultz L, Simpkins J, Chan KA, Horn JR, Kaatz S, Long C, Platt R, Raebel MA, Smith DH et al (2006) Potential drug-drug interactions in the outpatient setting. Med Care 44(6):534–541

    Article  PubMed  Google Scholar 

  29. The Danish Medicines Agency (2007) http://www.dkma.dk. Accessed 12 Sept 2007

  30. Medicines and Healthcare products Regulatory Agency (2007) http://www.mhra.gov.uk. Accessed 12 Sept 2007

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Authors and Affiliations

  1. Centre for Epidemiology, The National Board of Health and Welfare, SE-106 30, Stockholm, Sweden

    Rickard Ljung

  2. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

    Rickard Ljung

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  1. Rickard Ljung
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Correspondence to Rickard Ljung.

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Ljung, R. Use of desmopressin and concomitant use of potentially interacting drugs in elderly patients in Sweden. Eur J Clin Pharmacol 64, 439–444 (2008). https://doi.org/10.1007/s00228-007-0439-5

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  • DOI: https://doi.org/10.1007/s00228-007-0439-5

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