Minirin - a structural analogue of the hormone arginine-vasopressin; antidiuretic.
Release form and composition
- Oral intake tablets: oval or round, biconvex, white, labeled ("0.1" or "0.2") on one side and risky on the other (30 pieces each in plastic bottles with a screw cap, child protection and a drying capsule inside the lid, in a carton bundle (1 bottle);
- Sublingual tablets: round, white, on one side marking in the form of a drop (10 pieces in blisters of aluminum foil, in a cardboard bundle 1, 3 or 10 blisters).
The active ingredient Mininin - desmopressin, its content:
- 1 tablet - 100 or 200 mcg;
- 1 tablet sublingual - 60, 120 or 240 micrograms.
- Tablets: povidone, potato starch, lactose monohydrate, magnesium stearate;
- Sublingual tablets: mannitol, gelatin, citric acid.
Indications for use
Minirin is used in the following cases:
- Primary nocturnal enuresis in children over 5 years old;
- Diabetes insipidus of central origin;
- Nighttime polyuria in adults (symptomatic treatment).
- Hyponatremia, incl. in the anamnesis;
- Medium and severe renal failure (creatinine clearance less than 50 ml / minute);
- Syndrome inadequate production of antidiuretic hormone;
- Heart failure and other diseases / conditions that require the use of diuretic drugs;
- Habitual or psychogenic polydipsia;
- Lactose intolerance, lactase deficiency, glucose-galactose malabsorption (for tablets of 100 and 200 μg);
- Children under 4 years old - in the treatment of diabetes insipidus, 5 years - for the treatment of primary nocturnal enuresis;
- Hypersensitivity to the drug.
- Fibrosis of the bladder;
- Chronic renal failure (creatinine clearance more than 50 ml / minute);
- The risk of increased intracranial pressure;
- Violations of water and electrolyte balance;
- Age over 65 years.
During pregnancy and lactation, the drug may be prescribed after assessing the ratio of benefits and risks.
Dosing and Administration
Minirin tablets should be taken orally some time after meals, because food can affect the absorption and effectiveness of the drug.
Optimum doses are selected individually. As a rule, depending on the evidence prescribed:
- Diabetes insipidus of central origin: children over 4 years old and adults - 100 µg 1-3 times a day. Depending on the reaction, the dose is increased if necessary. The average daily dose varies from 200 to 1200 mcg, the optimal for most patients is 100-200 mcg 1-3 times a day;
- Nighttime polyuria in adults: the initial dose is 100 micrograms per night. If there is no effect during the week, it is first increased to 200 μg, then to 400 μg with a frequency of not more than 1 time per week. If there is no clinical effect after 4 weeks of therapy, the further use of Minirin is not appropriate;
- Primary nocturnal enuresis: initial dose - 200 mg per night. If necessary, increase the dose to 400 μg. A prerequisite is to limit fluid intake in the evening. The recommended course of therapy is 3 months. The decision to extend treatment is made on the basis of clinical data, which are observed within 1 week after discontinuation of the drug.
Minirin sublingual tablets should be taken sublingually (holding under the tongue) until completely dissolved after some time after meals. Do not drink!
The optimal dose is adjusted individually. As a rule, depending on the evidence prescribed:
- Non-sugar diabetes of central genesis: the initial dose is 60 μg 3 times a day, if necessary, it is increased. The average daily dose varies from 120 to 720 mcg, the best supporting is 60-120 mcg 3 times a day;
- Nocturia: the initial dose is 60 mcg at night. If there is no effect during the week, it is increased to 120 μg, then to 240 μg with a frequency of no more than 1 time per week. In the absence of efficacy after 4 weeks of treatment, the further use of the drug is impractical;
- Primary nocturnal enuresis: the initial dose is 120 mg per night. If necessary, it is increased to 240 micrograms. A prerequisite is to limit fluid intake in the evening. The recommended course of therapy is 3 months. The decision to extend treatment is made on the basis of clinical data, which are observed within 1 week after discontinuation of the drug.
The ratio of dosages between Mininin in two oral forms:
- Tablet 100 mcg = sublingual tablet 60 mcg;
- 200 μg tablet = sublingual tablet 120 μg;
- Tablets in a total dose of 400 micrograms = sublingual tablet 240 micrograms.
Possible side effects:
- Often: dizziness, headache, dry mouth, nausea, vomiting, weight gain, peripheral edema;
- Rarely: hot flashes, reddening of the eyes, convulsions, transient tachyarrhythmia.
In the case of taking the drug without complying with the restriction of fluid intake, fluid retention in the body is possible, which is accompanied by edema, weight gain, hyponatremia, and in severe cases - seizures.
With the simultaneous use of oxybutynin or imipramine there is a risk of developing hypoglycemic convulsions.
A prerequisite for successful treatment of primary nocturnal enuresis is to limit fluid intake 1 hour before taking the drug and within 8 hours after, because non-compliance with this rule is fraught with the development of side effects.
Older people with polyuria 2.8–3 l and initially low sodium concentration in plasma are likely to develop side effects.
Patients with the risk of increasing intracranial pressure, children and adolescents during the entire period of therapy should be under close medical supervision.
Minirin is contraindicated in cases where there are additional causes of fluid retention.
For nocturia and / or dysuria, urinary tract infections, acute urinary incontinence, decompensated diabetes mellitus, polydipsia, and if a prostate or bladder tumor is suspected, these conditions / diseases should be diagnosed and treated before Minirin is prescribed.
In the case of gastroenteritis, fever or systemic infections, if they are accompanied by an imbalance of electrolytes and fluids, the drug should be canceled.
For the purpose of prevention of hyponatremia during treatment to regularly determine sodium content in the blood plasma, especially while the use of nonsteroidal anti-inflammatory drugs and drugs that cause antidiuretic hormone syndrome of inappropriate secretion such as selective serotonin reuptake inhibitors, tricyclic antidepressants, narcotic analgesics, chlorpromazine, lamotrigine, carbamazepine.
Data on the effect of the drug on the reaction rate and concentration of attention are not available. However, drivers of vehicles and people employed in potentially hazardous industries should be aware that Minirin can cause side effects such as headache and dizziness. It is recommended to be careful.
Possible interaction reactions in the case of the use of Minirin with other drugs:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): the risk of side effects;
- Selective serotonin reuptake inhibitors, NSAIDs, narcotic analgesics, tricyclic antidepressants, carbamazepine, chlorpromazine, lamotrigine: increased antidiuretic effect of desmopressin, fluid retention, the development of hyponatremia;
- Hypertensive agents: enhancing their action;
- Tetracycline, norepinephrine, lithium preparations, buformin: weakening of the diuretic action of desmopressin;
- Indomethacin: increased action of desmopressin;
- Loperamide: a threefold increase in the concentration of desmopressin and, as a consequence, the risk of fluid retention and the development of hyponatremia. A similar reaction is possible with the simultaneous use of other drugs that slow down motility;
- Dimethicone: reduced absorption of desmopressin.
Terms and conditions of storage
Store at temperatures up to 25 ºС in a place inaccessible to children, protected from moisture and light. Do not remove the drying capsule from the cap of the bottle with pills.
Shelf life of tablets - 3 years, sublingual tablets - 4 years.