Central diabetes insipidus in children. V. Oral treatment with a vasopressin hormone analogue (DDAVP).

1-deamino-8-D-arginine-vasopressin, or DDAVP, a potent long acting antidiuretic analogue of AVP, is the treatment of choice in central diabetes insipidus (DI). We have studied the clinical and biological effect in 10 children with DI treated with peroral administration of DDAVP. During a dose ranging study in hospital, followed by 6 months of treatment at home, this peroral DDAVP tablet proved to be as effective as the intranasal administration of DDAVP and was preferred by the patients. Even doses as small as 12.5 micrograms, have an effect on diuresis and urinary osmolality. Therapeutic effects start at above 100 micrograms. During the dose ranging study 200 micrograms peroral DDAVP produced antidiuresis varying from 8 to 12.5 hours, in different patients. The recommended dose is 100-300 micrograms 2-3 times a day. This treatment offers an important alternative to that traditionally used and constitutes one of the first examples of a peptide conserving its biological activity after gastrointestinal transport.