Desmopressin as an adjuvant to opioids or NSAIDs in treatment of renal colic: a nationwide register-based study.

Abstract

AIMS:

Desmopressin has been reported to be effective as an adjuvant to opioids or NSAIDs in management of pain in renal colic; however real-life data are lacking on the utilisation of desmopressin in this patient segment.

METHODS:

The Danish National Prescription Registry data-linked with Danish National Patient Registry during a 3-year period from 2009 to 2011 was used to study prescriptions for desmopressin in renal colic.

RESULTS:

We identified 888 desmopressin prescriptions for renal colic, dispensed to 95 patients. The mean treatment period was 159 days, with a large variation up to a maximum of 924 days. Approximately two thirds of patients received dosing instructions to administer the drug 4 times daily to provide 24-h antidiuretic coverage. Among concomitant opioids and NSAIDs, tramadol and ibuprofen were prescribed most frequently. Antidepressants and diuretics were also widely used. A clear sex difference was seen, with female renal colic patients having three times more prescriptions overall than males, and in particular receiving more antidepressants and psychotropic drugs. A total of 4 (4.2%) of the patients experienced hospital admissions because of hyponatraemia or polydipsia during the 3-year period. We confirmed a previous case report that nephrolithiasis could be at least an occasional complication of successful therapy of Central Diabetes Insipidus (CDI) with desmopressin, identifying 12 CDI patients in total, or 2.4% of all Danish CDI patients in that period, who were also treated for renal colic.

CONCLUSION:

In summary, these real-life prescription data provide exact epidemiological measures on desmopressin utilisation in renal colic.

• Authors: Kristian V Juul, Marie K Schroeder, Søren Rittig, Jens Peter Nørgaard
• Journal: Pharmacoepidemiology and drug safety (Pharmacoepidemiol Drug Saf) Vol. 24 Issue 11 Pg. 1155-60 (Nov 2015) ISSN: 1099-1557 [Electronic] England
• PMID: 26349846 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 John Wiley & Sons, Ltd.

Chemical References

• Analgesics, Opioid
• Anti-Inflammatory Agents, Non-Steroidal
• Antidiuretic Agents
• Deamino Arginine Vasopressin

Topics

• Adult
• Aged
• Aged, 80 and over
• Analgesics, Opioid (administration & dosage)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
• Antidiuretic Agents (administration & dosage)
• Deamino Arginine Vasopressin (administration & dosage)
• Denmark
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Practice Patterns, Physicians' (statistics & numerical data)
• Registries
• Renal Colic (drug therapy)
• Sex Factors
• Time Factors