Nocturnal Urination (Nocturia): Drug Therapy

Therapeutic target

  • Sleeping through the night without urinating.

Therapy recommendations

  • You prioritize under “Further Therapy”
  • If necessary, desmopressin (antidiuretic) for nocturnal polyuria (increased urination) in adults:
    • Nasal therapy in the U.S.
    • Oral 0.2 mg (max. 0.4 mg) before bedtime (Germany oral therapy only)

Active ingredients (main indication)

ADH (vasopressin)

Active ingredient Dosage Special features
Desmopressin
  • Intranasal 10-40 μg/d
  • Orally 0.2 mg (max. 0.4 mg) before bedtime (in Germany only oral therapy)
 Wg. Risk of hyponatremia, sodium levels must be monitored before treatment and regularly during the course of therapy,
  • Mode of action: Stimulation V1 and V2 receptors → vasoconstriction (vasoconstriction), water reabsorption from renal tubules (antidiuretic).
  • Indications:
    • Nocturnal polyuria in adults
    • Diabetes insipidus centralis
  • Contraindications: Heart failure, poorly controlled diabetes mellitus, diseases of the bladder and prostate, polyuria as a side effect of various drugs (this must be excluded before prescribing).
  • Dosage instructions: For long-term use, a treatment-free period of at least one week should be taken every 3 months to assess whether spontaneous improvement has occurred
  • Side effects: Blood flow in the splanchnic area decreased, blood pressure increase, angina pectoris (“chest tightness”; sudden pain in the heart area), factor VIII and von Willebrandt factor ↑; hyponatremia.
  • Wg. Risk of hyponatremia, sodium levels must be monitored before treatment and regularly during the course of therapy,
  • To quickly notice water retention, the patient should weigh himself daily at the beginning of therapy.