Short answer: Desmopressin has a half-life of about 1.5 to 2.5 hours (tablets). Levels peak about 0.9 hours (tablets) after a dose. People vary, so treat these as estimates.
Desmopressin is a man-made version of vasopressin, the hormone that tells the kidneys to hold on to water. It is sold as DDAVP tablets, a nasal spray and an injection, approved for central diabetes insipidus and for bedwetting, and, as an injection, to help blood clot in some people with hemophilia A or von Willebrand disease.
Also known as: DDAVP, Stimate.
DDAVP tablets come as 0.1 mg and 0.2 mg. DDAVP injection is 4 mcg/mL, in single-dose ampules and a 10 mL multiple-dose vial. Desmopressin is also sold as a nasal spray.
The DDAVP tablet label approves it for central diabetes insipidus (and the short-term excess urine and thirst after head injury or pituitary surgery) and for bedwetting (primary nocturnal enuresis). For diabetes insipidus it starts at 0.05 mg (half a 0.1 mg tablet) twice a day; most people in trials needed 0.1 mg to 0.8 mg a day in divided doses. For bedwetting in children 6 and older it starts at 0.2 mg at bedtime and can go up to 0.6 mg, with fluids kept to a minimum from 1 hour before the dose until the next morning (at least 8 hours). The injection is also approved for hemophilia A and mild to moderate type I von Willebrand disease with factor VIII levels above 5%.
The main risk is low blood sodium (hyponatremia) from holding too much water, which can cause seizures, coma or death. The injection label puts this in a boxed warning: it is not used with excessive fluid intake, with loop diuretics or with systemic or inhaled steroids, and sodium should be checked within 7 days and about 1 month after starting. The tablet label says it is not used with moderate to severe kidney impairment (creatinine clearance below 50 mL/min) or a history of low sodium.
WADA lists desmopressin among masking agents (S5), banned at all times.
The DDAVP tablet label gives a plasma half-life of 1.5 to 2.5 hours, regardless of dose, and peak levels 0.9 hours after a tablet (1.5 hours after the nasal form). Tablets deliver about 5% as much as the nasal form and 0.16% as much as an IV dose. Doses of 0.1 to 0.2 mg kept urine concentrated for up to 8 hours. After an injection, the half-life rose from 3 hours with normal kidneys to 9 hours with severe kidney impairment.
Numbers shown are taken from the source above. Half-life varies from person to person.
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