THE ADMINISTRATION OF DESMOPRESSIN BY NASAL SPRAY - A DOSE-DETERMINATION STUDY IN PATIENTS WITH MILD HEMOPHILIA-A OR VONWILLEBRANDS-DISEASE

Desmopressin is an important haemostatic agent in many types of bleedi ng disorders. The intranasal route for administration of desmopressin has attracted much interest because it is convenient and makes self-tr eatment possible. In the present study the effects of three doses (300 , 450 and 600 mu g) of desmopressin delivered by nasal spray and those of 0.3 mu g/kg injected intravenously were compared in five patients with haemophilia A and 11 with von Willebrand's disease. There was no statistically significant difference in peak VIII:C concentration in t he haemophilia patients and no difference in peak vWF concentration in von Willebrand patients between the four desmopressin dosages. Bleedi ng time response was comparable after all four dosages. We recommend a spray dosage of 300 mu g for home treatment. As cover for major surge ry or in connection with severe bleedings, however, intravenous admini stration is to be recommended.