Drug General Information (ID: DDID6QNXRZ)
  Drug Name Desmopressin Drug Info Codeine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antidiuretic Hormones Analgesics
  Structure

 Mechanism of Desmopressin-Codeine Interaction (Severity Level: Moderate)
     Increased risk of hyponatremia Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Desmopressin Codeine
      Mechanism Hyponatremia Hyponatremia
      Key Mechanism Factor 1
Factor Name Hyponatremia
Factor Description Hyponatremia is a condition in which the amount of sodium in the blood is lower than normal. Symptoms of hyponatremia may include: nausea and vomiting, fatigue, headache or confusion, muscle cramps, weakness, irritability and restlessness.
      Mechanism Description
  • Increased risk of hyponatremia by the combination of Desmopressin and Codeine 

Recommended Action
      Management Caution is recommended if desmopressin is used in combination with opiates. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly. Patients should be advised to seek immediate medical attention if they develop early signs and symptoms of water intoxication or hyponatremia such as anorexia, nausea, vomiting, drowsiness, lethargy, weakness, listlessness, headache, confusion, difficulty concentrating, memory impairment, anuria, and weight gain. Early treatment may help prevent progression to seizure, coma, respiratory arrest, and death.

References
1 Sarret D, Le Berre JP, Zemraoui N "Tramadol-induced hyponatremia." Am J Kidney Dis 52 (2008): 1026 author reply 1027. [PMID: 18971023]
2 Product Information. DDAVP (desmopressin). Rhone-Poulenc Rorer, Collegeville, PA.
3 Appel WC "Possible roles of normeperidine and hyponatremia in a postoperative death." Can Med Assoc J 137 (1987): 912-3. [PMID: 3676934]
4 Product Information. OxyContin (oxycodone). Purdue Frederick Company, Norwalk, CT.
5 Canadian Pharmacists Association.
6 Kokko H, Hall PD, Afrin LB "Fentanyl-associated syndrome of inappropriate antidiuretic hormone secretion." Pharmacotherapy 22 (2002): 1188-92. [PMID: 12222557]
7 Product Information. Stimate (desmopressin). Forest Pharmaceuticals, St. Louis, MO.
8 Callreus T, Lundahl J, Hoglund P, Bengtsson P "Changes in gastrointestinal motility influence the absorption of desmopressin." Eur J Clin Pharmacol 55 (1999): 305-9. [PMID: 10424324]
9 Product Information. MS Contin (morphine). Purdue Frederick Company, Norwalk, CT.