FDA-approved
Heart & blood
Desmopressin
Also called DDAVP
Desmopressin is a synthetic vasopressin analog approved by the FDA since 1978. Learn how it concentrates urine, its approved uses, and its main safety risk.
- Reviewed by
- William Maish, MD MBA MPH, Clinical Product Lead
- Published
- October 5, 2026
- Last updated
- October 5, 2026
Key takeaway
Desmopressin (desmopressin acetate; brands include DDAVP and Nocdurna) is a synthetic version of the antidiuretic hormone vasopressin, engineered to concentrate urine without raising blood pressure. It treats central diabetes insipidus, bedwetting, nighttime urination, and certain bleeding disorders. It has been FDA-approved in the U.S. since 1978 and comes as tablets, a sublingual form, nasal spray, and injection.
At a glance
| What it is | A synthetic vasopressin analog that selectively activates the V2 (antidiuretic) receptor |
| Approved for | Central diabetes insipidus, primary nocturnal enuresis, nocturia from nighttime overproduction of urine, and hemophilia A or type 1 von Willebrand disease |
| Key fact | It concentrates urine and raises clotting factor VIII without the blood-vessel effects of natural vasopressin |
| Route | Oral tablet, sublingual, nasal spray, or injection |
| Evidence strength | FDA approved |
What is desmopressin?
Desmopressin, known generically as desmopressin acetate and sold as DDAVP and Nocdurna, is a modified copy of vasopressin, the body's antidiuretic hormone. The modifications make it act longer and focus its activity on water balance while stripping away the blood-pressure-raising effect of the natural hormone. It was approved in the United States in 1978.
How does desmopressin work?
Desmopressin selectively activates the V2 vasopressin receptor in the kidney's collecting ducts, where it increases the number of water channels (aquaporin-2) that reabsorb water back into the body. The result is more concentrated urine and less urine volume. Because the chemical changes that give desmopressin this selectivity also remove its activity at the V1 receptors on blood vessels, it does not cause the vasoconstriction that vasopressin does.
This makes it useful across several conditions. Desmopressin also has a second action unrelated to the kidney: it prompts the release of clotting factor VIII and von Willebrand factor from storage sites in blood-vessel walls. The table shows which action each use draws on:
| Condition | What desmopressin does |
| Central diabetes insipidus, where the body lacks vasopressin | Restores normal water conservation |
| Bedwetting and nighttime urination | Reduces overnight urine production |
| Mild hemophilia A and type 1 von Willebrand disease | Releases stored clotting factor VIII and von Willebrand factor, which is why higher doses are used to manage bleeding |
The main hazard of over-concentrating urine is dilutional low blood sodium.
Is it FDA-approved?
Yes. Desmopressin was first approved by the FDA in 1978, with later products including the Noctiva nasal spray (2017) and the Nocdurna sublingual tablet (2018) for nocturia. Noctiva and the Stimate nasal spray have since been discontinued1 in the U.S. Nocdurna carries a boxed warning about the risk of low blood sodium (hyponatremia), as Noctiva did.
What is desmopressin prescribed for?
Desmopressin is prescribed for central (cranial) diabetes insipidus, primary nocturnal enuresis (bedwetting), nocturia caused by nighttime overproduction of urine, and bleeding control in mild hemophilia A and type 1 von Willebrand disease. Fluid intake is usually managed carefully during treatment to avoid low sodium.
What are the side effects?
Common side effects include:
- Headache
- Nausea
- Nasal discomfort with the spray
- Flushing
More serious considerations include:
- Low blood sodium (hyponatremia), which can cause seizures if severe, the reason fluid intake is restricted and the basis of the Nocdurna boxed warning
- Caution in people at risk of fluid overload or with heart or kidney disease
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Sources: FDA prescribing information for DDAVP, Nocdurna, and Noctiva. This document is educational and does not constitute medical advice.