Drug General Information (ID: DDIK730RN6)
Drug Name			Desmopressin		Drug Info		Levacetylmethadol		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiuretic Hormones				Analgesics
Structure

Mechanism of Desmopressin-Levacetylmethadol Interaction (Severity Level: Moderate)
Increased risk of hyponatremia Click to Show/Hide Mechanism Graph
Drug Name		Desmopressin				Levacetylmethadol
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 Levacetylmethadol

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	Appel WC "Possible roles of normeperidine and hyponatremia in a postoperative death." Can Med Assoc J 137 (1987): 912-3. [PMID: 3676934]
2	Sarret D, Le Berre JP, Zemraoui N "Tramadol-induced hyponatremia." Am J Kidney Dis 52 (2008): 1026 author reply 1027. [PMID: 18971023]
3	Product Information. OxyContin (oxycodone). Purdue Frederick Company, Norwalk, CT.