Antidiuretic hormones: Uses, common brands, and safety info

Antidiuretic hormone (ADH) is used to regulate the body’s fluid balance. This hormone works with your kidneys to manage the amount of water released from your body and, in general, decreases the production of urine. ADH is often administered to treat certain medical conditions, including diabetes insipidus, bleeding disorders, and bedwetting problems. 

Continue reading to learn more about antidiuretic hormone, its uses, and its side effects.

Other antidiuretic hormones

• Noctivia (desmopressin)

• Pitressin (vasopressin)

• Vasostrict (vasopressin)

What are antidiuretic hormones?

ADH, otherwise known as vasopressin or arginine vasopressin (AVP), is a peptide hormone produced in the brain. Specifically, it is produced in the hypothalamus gland and stored in the pituitary gland. These glands are important parts of the body’s endocrine system, which produces and secretes hormones. ADH regulates how the kidneys concentrate urine or retain water. In turn, by regulating water retention in the body, ADH helps manage blood pressure and fluid volume. 

This hormone promotes the reabsorption of water in the kidneys and decreases the excretion of water in the urine. In other words, ADH helps conserve the fluid volume in the body and decreases water dilution of the urine caused by certain health conditions. This results in more water volume in the bloodstream, more concentrated urine, and less water loss. Higher levels of antidiuretic hormone can cause blood vessels to constrict, which increases blood pressure, and is especially useful for treating hypovolemic shock. 

In the case of diabetes insipidus, low ADH levels can result in excessive urination and thirst. Large amounts of water are then lost through urination and can lead to a depletion of body fluid (dehydration). Desmopressin, which is a synthetic and more potent version of vasopressin, is a first-line therapy for diabetes insipidus. 

How does antidiuretic hormone work?

The release of ADH from the pituitary gland is usually triggered by a decrease in blood volume or a decrease in blood pressure, which is often caused by dehydration or blood loss. The release of ADH is also sensitive to changes in osmolality, or the concentration of salt (sodium) and other electrolytes in the blood. Osmotic sensors and baroreceptors detect changes in the osmolality of the blood to regulate ADH release. 

An increase in salt concentrations in the blood can trigger the release of ADH, keeping more fluid volume in the bloodstream and combatting the effects of dehydration. Water is reabsorbed back into the blood circulation when ADH binds to receptors on the collecting ducts in the kidney. ADH stimulates the positioning of aquaporin 2 water channels into the membrane of the kidney tubules, which reabsorb water back into the blood. This action causes urine to become more concentrated.

What are antidiuretic hormones used for?

ADH medications may be prescribed to treat different conditions including:

• Diabetes insipidus

• Von Willebrand’s disease

• Hemophilia A

• Hemorrhage

• Abdominal distension before an x-ray of after surgery

• Enuresis (bedwetting)

• Nocturia (excessive nighttime urination)

Types of antidiuretic hormones

Vasopressin

Vasopressin is a hormone responsible for maintaining fluid balance through the reabsorption of water in the kidneys. Vasopressin is typically administered in a hospital setting as a subcutaneous (subQ) or intramuscular (IM) injection. It can also be administered as a continuous intravenous (IV) infusion. Vasostrict (vasopressin) may be used to treat diabetes insipidus or to treat low blood pressure in patients experiencing shock. 

Desmopressin

Desmopressin is a synthetic form of the antidiuretic hormone vasopressin. It is given to treat diabetes insipidus, primary nocturnal enuresis, spontaneous bleeding or hemorrhage, hemophilia A, von Willebrand’s disease, and nocturia. Desmopressin is available as an oral tablet, sublingual tablet, nasal spray, and injectable solution under different brand names. Stimate is supplied in a spray and used to stop bleeding that can occur from hemophilia A or von Willebrand’s disease. Nocdurna is provided as a tablet dissolved under the tongue and used for nocturia. DDAVP is supplied as an oral tablet, nasal spray, and injectable solution, and it can be used to manage thirst and too much urination caused by different conditions. 

Who can take antidiuretic hormones?

Adults

Antidiuretic hormone is given to adults to treat several conditions. Diabetes insipidus is treated with DDAVP nasal spray, oral tablets, or sublingual tablets. Therapy is continued until symptoms such as dehydration and increased urine production are resolved. 

In adults with mild hemophilia A or von Willebrand’s disease, Stimate, or desmopressin nasal spray, is used for short-term minor bleeding or before minor invasive procedures that could result in bleeding. 

Nocturia that remains uncontrolled despite other treatments can be managed with sublingual Nocdurna or oral DDAVP in adults.

Children

Children can safely take different forms of desmopressin. However, children tend to have more changes in fluid volume and may develop low sodium more quickly than adults. Fluid restrictions and monitoring of blood sodium levels are necessary when treating children with DDAVP. 

DDAVP can be administered as a nasal spray or oral tablet to treat bedwetting in children. Fluids should be restricted for an hour before the dose and eight hours following the dose. 

Seniors

Seniors can take desmopressin for appropriate conditions. For example, geriatric patients may be able to take desmopressin sublingual tablets for nocturia, or they may be prescribed intranasal desmopressin to treat diabetes insipidus. However, there may be an increased risk of hyponatremia, or low blood sodium levels, so blood sodium levels may need to be monitored throughout treatment. Fluid intake in seniors may also need to be decreased to avoid the possibility of water intoxication and hyponatremia. 

Are antidiuretic hormones safe?

Severe allergic reactions have occurred with desmopressin. Desmopressin administration may result in fluid retention. It should be used with caution in patients with heart failure. Some product formulations are contraindicated in patients with heart failure, uncontrolled hypertension, increased intracranial pressure, or urinary retention. 

Black Box Warnings

Desmopressin carries a Black Box Warning stating it can cause hyponatremia (low sodium levels). Patients with an increased risk of severe hyponatremia should not take desmopressin. Serum sodium concentrations should be measured before starting desmopressin and monitored during the treatment course.

Antidiuretic hormone recalls

The following list details medications that have been recalled.

• DDAVP nasal spray, 8/5/2020

Antidiuretic hormone restrictions

Antidiuretic hormones should not be taken in combination with certain medications. Certain medications may enhance the effect of antidiuretic hormones and increase the risk of water intoxication with hyponatremia. These medications include:

• Intranasal corticosteroids

• Oral corticosteroids

• Inhaled corticosteroids

• Loop diuretics

• Thiazide diuretics

• Selective serotonin reuptake inhibitors

• Tricyclic antidepressants

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Opioid analgesics

Specific medications that may interact with antidiuretic hormone medications include:

• Samsca (tolvaptan)

• Tegretol (carbamazepine)

• Thorazine (chlorpromazine)

• Declomycin (demeclocycline)

• Lamictal (lamotrigine)

• Lithobid (Lithium)

• Imodium (loperamide)

This may not be a complete list of possible drug interactions. Consult a healthcare provider for other possible drug interactions that can occur while taking antidiuretic hormones. 

Individuals with kidney impairment are usually recommended to avoid taking an antidiuretic hormone depending on the severity of the problem. Those with a known hypersensitivity to any ingredients in antidiuretic hormone medications should also avoid treatment with antidiuretic hormones. Signs and symptoms of an allergic reaction may include trouble breathing, rash, and swelling of the face or throat. Antidiuretic hormone medications are not recommended in those with hyponatremia or a history of hyponatremia because treatment with antidiuretic hormone can increase the risk of low blood sodium levels. 

Can you take antidiuretic hormone medications while pregnant or breastfeeding?

Antidiuretic hormone medications are generally considered safe while pregnant, and they are often the treatment of choice for diabetes insipidus in pregnant patients. These medications can also be given for bleeding conditions during pregnancy. However, they should only be used if the benefits outweigh the potential risks. 

Antidiuretic hormone may pass into breast milk in small amounts. However, it is unlikely that vasopressin or desmopressin will cause adverse effects in a breastfed infant. Consult a healthcare provider for medical advice before taking an antidiuretic hormone medication while pregnant or breastfeeding.

Are antidiuretic medications controlled substances?

No, antidiuretic medications are not controlled substances. 

Common antidiuretic hormones side effects

The most common side effects of antidiuretic hormones include:

• Nausea

• Vomiting

• Diarrhea

• Stomach pain

• Indigestion

• Weakness

• Headache

• Dizziness

• Flushing

• Loss of appetite

More severe but rare side effects of antidiuretic hormones include:

• Low sodium levels

• Mental and mood changes

• Allergic reactions

This list of side effects is not comprehensive. Speaking with a healthcare professional is the best way to get a complete list of side effects and determine whether taking antidiuretic hormone treatment is suitable for you.

Tell your healthcare provider if you have any of the following before taking an antidiuretic hormone medication:

• Any drug allergies

• Kidney disease

• History of low sodium levels

• Heart failure

• Hypertension

• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

• Type IIB von Willebrand disease

• Adrenal gland problems

• Diarrhea

• Eating disorders

• Consumption of more water than normal

• Nasal issues, including recent nasal surgery

How much do antidiuretic hormones cost?

Antidiuretic hormone medications are available in brand name and generic formulas.  Medicare plans and other insurance plans will usually cover antidiuretic hormone medications depending on the formulation and condition being treated. Costs will vary depending on your insurance plan. Without insurance, the price can vary widely depending on the medication and quantity of medication prescribed. However, using a prescription discount card from SingleCare may help reduce the cost of antidiuretic hormone medications.