This guidance does not cover the circumstances of a
pandemic, an impending pandemic, or a widespread
epidemic of a new strain of influenza to which there is
little or no immunity in the community.
www.nice.org.uk/guidance/ta158
▶ Oseltamivir, zanamivir, and amantadine for treatment of
influenza (February 2009) NICE TA168
Oseltamivir is not a substitute for vaccination, which
remains the most effective way of preventing illness from
. When influenza is circulating in the community,
oseltamivir is an option recommended (in accordance
the onset of symptoms. (National surveillance schemes,
including those run by Public Health England, should be
used to indicate when influenza is circulating in the
. During local outbreaks of influenza-like illness, when
there is a high level of certainty that influenza is
present, oseltamivir may be used for treatment in at-risk
patients living in long-term residential or nursing
At risk patients include those aged over 65 years or those
who have one or more of the following conditions:
. chronic respiratory disease (including asthma and
chronic obstructive pulmonary disease);
. chronic neurological disease;
The Department of Health in England has advised
(November 2010 and April 2011) that ‘at risk patients’ also
includes patients under 65 years of age who are at risk of
developing medical complications from influenza
(treatment only) or women who are pregnant.
This guidance does not cover the circumstances of a
pandemic, an impending pandemic, or a widespread
epidemic of a new strain of influenza to which there is
little or no immunity in the community.
www.nice.org.uk/guidance/ta168
NHS restrictions Tamiflu ® is not prescribable in NHS
primary care except for the treatment and prophylaxis of
influenza as indicated in the NICE guidance; endorse
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral suspension, oral
CAUTIONARY AND ADVISORY LABELS 9
EXCIPIENTS: May contain Sorbitol
▶ Tamiflu (Roche Products Ltd)
Oseltamivir (as Oseltamivir phosphate) 6 mg per 1 ml Tamiflu
6mg/ml oral suspension sugar-free | 65 ml P £10.27 DT = £10.27
CAUTIONARY AND ADVISORY LABELS 9
▶ Tamiflu (Roche Products Ltd)
Oseltamivir (as Oseltamivir phosphate) 30 mg Tamiflu 30mg
Oseltamivir (as Oseltamivir phosphate) 45 mg Tamiflu 45mg
capsules | 10 capsule P £15.41
Oseltamivir (as Oseltamivir phosphate) 75 mg Tamiflu 75mg
capsules | 10 capsule P £15.41
l DRUG ACTION Reduces replication of influenza A and B
viruses by inhibiting viral neuraminidase.
Post-exposure prophylaxis of influenza
▶ Child 5–17 years: 10 mg once daily for 10 days
▶ Adult: 10 mg once daily for 10 days
Prevention of influenza during an epidemic
▶ Child 5–17 years: 10 mg once daily for up to 28 days
▶ Adult: 10 mg once daily for up to 28 days
▶ Child 5–17 years: 10 mg twice daily for 5 days (for up to
10 days if resistance to oseltamivir suspected)
▶ Adult: 10 mg twice daily for 5 days (for up to 10 days if
resistance to oseltamivir suspected)
l UNLICENSED USE Use of zanamivir for up to 10 days if
resistance to oseltamivir suspected is an unlicensed
l CAUTIONS Asthma . chronic pulmonary disease . uncontrolled chronic illness
▶ Asthma and chronic pulmonary disease Risk of
bronchospasm—short-acting bronchodilator should be
Avoid in severe asthma unless close monitoring possible
and appropriate facilities available to treat bronchospasm.
▶ Common or very common Skin reactions
adverse reactions (SCARs).throat tightness
▶ Rare or very rare Face oedema
SIDE-EFFECTS, FURTHER INFORMATION Neurological and
psychiatric disorders occur more commonly in children
l PREGNANCY Although safety data are limited, zanamivir
can be used in women who are pregnant when the
potential benefit outweighs the risk (e.g. during a
pandemic). Use only if potential benefit outweighs risk
l BREAST FEEDING Although safety data are limited,
zanamivir can be used in women who are breast-feeding
when the potential benefit outweighs the risk (e.g. during
a pandemic). Amount probably too small to be harmful;
use only if potential benefit outweighs risk (e.g. during a
l DIRECTIONS FOR ADMINISTRATION Other inhaled drugs
should be administered before zanamivir.
l PRESCRIBING AND DISPENSING INFORMATION Except for
the treatment and prophylaxis of influenza as indicated in
the NICE guidance; endorse prescription ‘SLS’.
l NATIONAL FUNDING/ACCESS DECISIONS
▶ Oseltamivir, zanamivir, and amantadine for prophylaxis of
influenza (September 2008) NICE TA158
Zanamivir is not a substitute for vaccination, which
remains the most effective way of preventing illness from
. Zanamivir is not recommended for seasonal prophylaxis
. When influenza is circulating in the community,
zanamivir is an option recommended (in accordance
influenza vaccine, and who have been in close contact
with someone suffering from influenza-like illness in the
same household or residential setting. Zanamivir should
be given within 36 hours of exposure to influenza.
(National surveillance schemes, including those run by
Public Health England, should be used to indicate when
influenza is circulating in the community).
. During local outbreaks of influenza-like illness, when
there is a high level of certainty that influenza is
present, zanamivir may be used for post-exposure
prophylaxis in at-risk patients (regardless of influenza
vaccination) living in long-term residential or nursing
At risk patients include those aged over 65 years or those
who have one or more of the following conditions:
. chronic respiratory disease (including asthma and
chronic obstructive pulmonary disease);
. chronic neurological disease;
The Department of Health in England has advised
(November 2010 and April 2011) that ‘at risk patients’ also
includes patients under 65 years of age who are at risk of
developing medical complications from influenza
(treatment only) or women who are pregnant.
This guidance does not cover the circumstances of a
pandemic, an impending pandemic, or a widespread
epidemic of a new strain of influenza to which there is
little or no immunity in the community.
www.nice.org.uk/guidance/TA158
▶ Oseltamivir, zanamivir, and amantadine for treatment of
influenza (February 2009) NICE TA168
Zanamivir is not a substitute for vaccination, which
remains the most effective way of preventing illness from
. When influenza is circulating in the community,
zanamivir is an option recommended (in accordance
(within 36 hours for zanamivir in children) of the onset
of symptoms. (National surveillance schemes, including
those run by Public Health England, should be used to
indicate when influenza is circulating in the
. During local outbreaks of influenza-like illness, when
there is a high level of certainty that influenza is
present, zanamivir may be used for treatment in at-risk
patients living in long-term residential or nursing
At risk patients include those aged over 65 years or those
who have one or more of the following conditions:
. chronic respiratory disease (including asthma and
chronic obstructive pulmonary disease);
. chronic neurological disease;
The Department of Health in England has advised
(November 2010 and April 2011) that ‘at risk patients’ also
includes patients under 65 years of age who are at risk of
developing medical complications from influenza
(treatment only) or women who are pregnant.
This guidance does not cover the circumstances of a
pandemic, an impending pandemic, or a widespread
epidemic of a new strain of influenza to which there is
little or no immunity in the community.
www.nice.org.uk/guidance/TA168
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
▶ Relenza (GlaxoSmithKline UK Ltd)
Zanamivir 5 mg Relenza 5mg inhalation powder blisters with
Diskhaler | 20 blister P £16.36
6.6 Respiratory syncytial virus
Ribavirin p. 626 is licensed for administration by inhalation
for the treatment of severe bronchiolitis caused by the
respiratory syncytial virus (RSV) in infants, especially when
they have other serious diseases. However, there is no
evidence that ribavirin produces clinically relevant benefit in
Palivizumab below is a monoclonal antibody licensed for
preventing serious lower respiratory-tract disease caused by
respiratory syncytial virus in children at high risk of the
disease; it should be prescribed under specialist supervision
and on the basis of the likelihood of hospitalisation.
Palivizumab is recommended for:
. children under 9 months of age with chronic lung disease
(defined as requiring oxygen for at least 28 days from
birth) and who were born preterm;
. children under 6 months of age with haemodynamically
significant, acyanotic congenital heart disease who were
Palivizumab should be considered for:
. children under 2 years of age with severe combined
. children under 1 year of age who require long-term
. children 1–2 years of age who require long-term
ventilation and have an additional co-morbidity (including
cardiac disease or pulmonary hypertension).
For details of the preterm age groups included in the
recommendations, see Immunisation against Infectious
Disease (2006), available at www.gov.uk/dh.
DRUGS FOR RESPIRATORY DISEASES ›
Prevention of serious lower respiratory-tract disease
caused by respiratory syncytial virus in children at high
risk of the disease (under expert supervision)
▶ Child 1–23 months: 15 mg/kg once a month, preferably
injected in the anterolateral thigh, to be administered
during season of RSV risk, injection volume over 1 mL
should be divided between 2 or more sites
Prevention of serious lower respiratory-tract disease
caused by respiratory syncytial virus in children at high
risk of the disease and undergoing cardiac bypass
surgery (under expert supervision)
▶ Child 1–23 months: Initially 15 mg/kg, to be
administered as soon as stable after surgery, preferably
in the anterolateral thigh, then 15 mg/kg once a
month, preferably injected in the anterolateral thigh,
to be administered during season of RSV risk, injection
volume over 1 mL should be divided between 2 or more
l UNLICENSED USE Licensed for the prevention of serious
lower respiratory-tract disease caused by respiratory
syncytial virus (RSV) in children under 6 months of age (at
the start of the RSV season) and born at less than 35 weeks
corrected gestational age, or in children under 2 years of
age who have received treatment for bronchopulmonary
dysplasia in the last 6 months, or in children under 2 years
of age with haemodynamically significant congenital heart
l CAUTIONS Moderate to severe acute infection . moderate
to severe febrile illness . serum-palivizumab concentration
may be reduced after cardiac surgery .thrombocytopenia
▶ Common or very common Apnoea
▶ Uncommon Seizure .thrombocytopenia . urticaria
▶ Frequency not known Hypersensitivity
l ALLERGY AND CROSS-SENSITIVITY Hypersensitivity to
humanised monoclonal antibodies.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Palivizumab 100 mg per 1 ml Synagis 100mg/1ml solution for
injection vials | 1 vial P £563.64
Synagis 50mg/0.5ml solution for injection vials | 1 vial P £306.34
BNF 78 Respiratory syncytial virus 665
1 Antidiuretic hormone disorders page 666
1.2 Syndrome of inappropriate antidiuretic hormone
2 Corticosteroid responsive conditions 670
2.1 Cushing’s syndrome and disease 681
3 Diabetes mellitus and hypoglycaemia 682
3.1a Diabetes, diagnosis and monitoring 719
3.2a Chronic hypoglycaemia 725
4 Disorders of bone metabolism 725
5 Dopamine responsive conditions 736
6 Gonadotrophin responsive conditions 737
7 Hypothalamic and anterior pituitary
7.1 Adrenocortical function testing 744
7.2 Assessment of pituitary function 744
7.3 Gonadotrophin replacement therapy 745
7.4 Growth hormone disorders 747
8 Sex hormone responsive conditions 750
8.1 Female sex hormone responsive conditions 753
8.2 Male sex hormone responsive conditions 767
8.2a Male sex hormone antagonism 770
Posterior pituitary hormones and
Vasopressin p. 669 (antidiuretic hormone, ADH) is used in
the treatment of pituitary (‘cranial’) diabetes insipidus as is its
analogue desmopressin p. 667. Dosage is tailored to produce
a slight diuresis every 24 hours to avoid water intoxication.
Treatment may be required for a limited period only in
diabetes insipidus following trauma or pituitary surgery.
Desmopressin is more potent and has a longer duration of
action than vasopressin; unlike vasopressin it has no
vasoconstrictor effect. It is given by mouth or intranasally
for maintenance therapy, and by injection in the
postoperative period or in unconscious patients.
Desmopressin is also used in the differential diagnosis of
diabetes insipidus. Following a dose intramuscularly or
intranasally, restoration of the ability to concentrate urine
after water deprivation confirms a diagnosis of cranial
diabetes insipidus. Failure to respond occurs in nephrogenic
In nephrogenic and partial pituitary diabetes insipidus
benefit may be gained from the paradoxical antidiuretic
Carbamazepine p. 311 is sometimes useful in partial
pituitary diabetes insipidus [unlicensed]; it may act by
sensitising the renal tubules to the action of remaining
Desmopressin is also used to boost factor VIII concentration
in mild to moderate haemophilia and in von Willebrand’s
disease; it is also used to test fibrinolytic response.
Desmopressin may also have a role in nocturnal enuresis.
Vasopressin infusion is used to control variceal bleeding in
portal hypertension, prior to more definitive treatment and
with variable results. Terlipressin acetate, a derivative of
vasopressin with reportedly less pressor and antidiuretic
Oxytocin p. 823, another posterior pituitary hormone, is
Antidiuretic hormone antagonists
Demeclocycline hydrochloride p. 564 can be used in the
treatment of hyponatraemia resulting from inappropriate
secretion of antidiuretic hormone, if fluid restriction alone
does not restore sodium concentration or is not tolerable.
Demeclocycline hydrochloride is thought to act by directly
blocking the renal tubular effect of antidiuretic hormone.
Tolvaptan p. 669 is a vasopressin V2-receptor antagonist
licensed for the treatment of hyponatraemia secondary to
syndrome of inappropriate antidiuretic hormone secretion;
treatment duration with tolvaptan is determined by the
underlying disease and its treatment.
Rapid correction of hyponatraemia during tolvaptan
therapy can cause osmotic demyelination, leading to serious
neurological events; close monitoring of serum sodium
concentration and fluid balance is essential.
Other drugs used for Diabetes insipidus Chlortalidone,
PITUITARY AND HYPOTHALAMIC HORMONES
AND ANALOGUES › VASOPRESSIN AND
l DRUG ACTION Desmopressin is an analogue of
▶ Child 1–23 months: Initially 10 micrograms 2–3 times a
day, adjusted according to response; usual dose
▶ Child 2–11 years: Initially 50 micrograms 2–3 times a
day, adjusted according to response; usual dose
▶ Child 12–17 years: Initially 100 micrograms 2–3 times a
day, adjusted according to response; usual dose
▶ Adult: Initially 100 micrograms 3 times a day;
maintenance 100–200 micrograms 3 times a day; usual
▶ BY SUBLINGUAL ADMINISTRATION
▶ Child 2–17 years: Initially 60 micrograms 3 times a day,
adjusted according to response; usual dose
40–240 micrograms 3 times a day
▶ Adult: Initially 60 micrograms 3 times a day, adjusted
according to response; usual dose 40–240 micrograms
▶ BY INTRANASAL ADMINISTRATION
▶ Child 1–23 months: Initially 2.5–5 micrograms 1–2 times
a day, adjusted according to response
▶ Child 2–11 years: Initially 5–20 micrograms 1–2 times a
day, adjusted according to response
▶ Child 12–17 years: Initially 10–20 micrograms 1–2 times
a day, adjusted according to response
▶ Adult: 10–40 micrograms daily in 1–2 divided doses
▶ BY SUBCUTANEOUS INJECTION, OR BY INTRAVENOUS
INJECTION, OR BY INTRAMUSCULAR INJECTION
▶ Child 5–17 years: 200 micrograms once daily, only
increased to 400 micrograms if lower dose not
effective; withdraw for at least 1 week for reassessment
after 3 months, dose to be taken at bedtime, limit fluid
intake from 1 hour before to 8 hours after
▶ Adult 18–65 years: 200 micrograms once daily, only
increased to 400 micrograms if lower dose not
effective; withdraw for at least 1 week for reassessment
after 3 months, dose to be taken at bedtime, limit fluid
intake from 1 hour before to 8 hours after
▶ BY SUBLINGUAL ADMINISTRATION
▶ Child 5–17 years: 120 micrograms once daily, increased
if necessary to 240 micrograms once daily, dose to be
taken at bedtime, limit fluid intake from 1 hour before
to 8 hours after administration, dose to be increased
only if lower dose not effective, reassess after 3 months
by withdrawing treatment for at least 1 week
▶ Adult 18–65 years: 120 micrograms once daily, increased
if necessary to 240 micrograms once daily, dose to be
taken at bedtime, limit fluid intake from 1 hour before
to 8 hours after administration, dose to be increased
only if lower dose not effective, reassess after 3 months
by withdrawing treatment for at least 1 week
Postoperative polyuria or polydipsia
▶ Adult: Dose to be adjusted according to urine
Polyuria or polydipsia after hypophysectomy
▶ BY SUBLINGUAL ADMINISTRATION
▶ Adult: Dose to be adjusted according to urine
Idiopathic nocturnal polyuria in females
▶ BY SUBLINGUAL ADMINISTRATION
▶ Adult: 25 micrograms daily, to be taken 1 hour before
Idiopathic nocturnal polyuria in males
▶ BY SUBLINGUAL ADMINISTRATION
▶ Adult: 50 micrograms daily, to be taken 1 hour before
Diabetes insipidus, diagnosis (water deprivation test)
▶ BY INTRANASAL ADMINISTRATION
▶ Adult: 20 micrograms, limit fluid intake to 500 mL from
1 hour before to 8 hours after administration
▶ BY INTRAMUSCULAR INJECTION, OR BY SUBCUTANEOUS
▶ Adult: 2 micrograms for 1 dose, limit fluid intake to
500 mL from 1 hour before to 8 hours after
Nocturia associated with multiple sclerosis (when other
▶ BY INTRANASAL ADMINISTRATION
▶ Adult 18–65 years: 10–20 micrograms once daily, to be
taken at bedtime, dose not to be repeated within
24 hours, limit fluid intake from 1 hour before to
▶ BY INTRANASAL ADMINISTRATION
▶ Adult: 40 micrograms, empty bladder at time of
administration and limit fluid intake to 500 mL from
1 hour before until 8 hours after administration to
▶ BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR
▶ Adult: 2 micrograms, empty bladder at time of
administration and restrict fluid intake to 500 mL from
1 hour before until 8 hours after administration to
Mild to moderate haemophilia and von Willebrand’s
▶ BY INTRANASAL ADMINISTRATION
▶ Adult: 300 micrograms every 12 hours if required, one
150 microgram spray into each nostril, 30 minutes
before surgery or when bleeding, dose may
alternatively be repeated at intervals of at least 3 days,
▶ BY INTRAVENOUS INFUSION, OR BY SUBCUTANEOUS INJECTION
▶ Adult: 300 nanograms/kg for 1 dose, to be administered
immediately before surgery or after trauma; may be
repeated at intervals of 12 hours
▶ BY INTRANASAL ADMINISTRATION
▶ Adult: 300 micrograms, blood to be sampled after
1 hour for fibrinolytic activity, one 150 microgram
spray to be administered into each nostril
▶ BY SUBCUTANEOUS INJECTION, OR BY INTRAVENOUS INJECTION
▶ Adult: 300 nanograms/kg for 1 dose, blood to be
sampled after 20 minutes for fibrinolytic activity
Lumbar-puncture-associated headache
▶ BY INTRAMUSCULAR INJECTION, OR BY SUBCUTANEOUS
▶ Adult: (consult product literature)
l UNLICENSED USE Consult product literature for individual
preparations. Oral use of DDAVP intravenous injection is
l CONTRA-INDICATIONS Cardiac insufficiency . conditions
GENERAL CAUTIONS Asthma . avoid fluid overload . cardiovascular disease (not indicated for nocturnal
enuresis or nocturia). conditions which might be
aggravated by water retention . cystic fibrosis . elderly
(avoid for primary nocturnal enuresis and nocturia
nocturnal enuresis or nocturia). migraine . nocturia—limit
fluid intake to minimum from 1 hour before dose until
8 hours afterwards . nocturnal enuresis—limit fluid intake
to minimum from 1 hour before dose until 8 hours
▶ With intranasal use should not be given intranasally for
nocturnal enuresis due to an increased incidence of sideeffects
CAUTIONS, FURTHER INFORMATION Elderly patients are at
increased risk of hyponatraemia and renal impairment—
manufacturer advises measure baseline serum sodium
concentration, then monitor regularly during treatment;
discontinue treatment if levels fall below the normal
range. Review treatment if no therapeutic benefit after
l INTERACTIONS → Appendix 1: desmopressin
▶ Common or very common Hyponatraemia (on
administration without restricting fluid intake). nausea
▶ Frequency not known Abdominal pain . aggression (in
children). allergic dermatitis . emotional disorder. fluid
retention . headache . hyponatraemic seizure . vomiting . weight increased
▶ With intranasal use Epistaxis . nasal congestion .rhinitis
▶ With intravenous or subcutaneous use Vasodilation
▶ With sublingual use Epistaxis . nasal congestion
SIDE-EFFECTS, FURTHER INFORMATION Manufacturer
advises avoiding concomitant use of drugs which increase
secretion of vasopressin (e.g. tricyclic antidepressants)—
increases risk of hyponatraemia.
l PREGNANCY Small oxytocic effect in third trimester;
increased risk of pre-eclampsia.
l BREAST FEEDING Amount too small to be harmful.
l RENAL IMPAIRMENT Use with caution; antidiuretic effect
l MONITORING REQUIREMENTS In nocturia, periodic blood
pressure and weight checks are needed to monitor for fluid
l DIRECTIONS FOR ADMINISTRATION DDAVP ® and
Desmotabs ® tablets may be crushed.
DDAVP ® intranasal solution may be diluted with
Sodium Chloride 0.9% to a concentration of
DDAVP ® injection may be administered orally.
Desmopressin oral lyophilisates are for sublingual
▶ With intravenous use in adults For intravenous infusion
(DDAVP ®, Octim®), give intermittently in Sodium chloride
0.9%; dilute with 50 mL and give over 20 minutes.
l PRESCRIBING AND DISPENSING INFORMATION Oral,
intranasal, intravenous, subcutaneous and intramuscular
doses are expressed as desmopressin acetate; sublingual
doses are expressed as desmopressin base.
Children requiring an intranasal dose of less than
10 micrograms should be given DDAVP ® intranasal
Hyponatraemic convulsions Patients being treated for
primary nocturnal enuresis should be warned to avoid fluid
overload (including during swimming) and to stop taking
desmopressin during an episode of vomiting or diarrhoea
Medicines for Children leaflet: Desmopressin for bedwetting
www.medicinesforchildren.org.uk/desmopressin-bedwetting-0
l NATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (August
2017) that desmopressin oral lyophilisate (Noqdirna ®) is
accepted for restricted use within NHS Scotland for the
symptomatic treatment of nocturia due to idiopathic
nocturnal polyuria in patients aged 65 years and over.
All Wales Medicines Strategy Group (AWMSG) decisions
The All Wales Medicines Strategy Group has advised
(October 2017) that desmopressin acetate (Noqdirna ®) is
recommended for restricted use within NHS Wales for
idiopathic nocturnal polyuria in adults aged over 65 years,
for whom treatment options are currently limited.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: capsule, oral
suspension, oral solution, spray, nasal drops
▶ Desmopressin (Non-proprietary)
Desmopressin acetate 100 microgram Desmopressin
100microgram tablets | 90 tablet P £76.62 DT = £63.08
Desmopressin acetate 200 microgram Desmopressin
200microgram tablets | 30 tablet P £26.15 DT = £11.47
▶ DDAVP (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 100 microgram DDAVP 0.1mg tablets | 90 tablet P £44.12 DT = £63.08
Desmopressin acetate 200 microgram DDAVP 0.2mg tablets | 90 tablet P £88.23
▶ Desmotabs (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 200 microgram Desmotabs 0.2mg tablets | 30 tablet P £29.43 DT = £11.47
▶ DDAVP (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 4 microgram per 1 ml DDAVP
4micrograms/1ml solution for injection ampoules | 10 ampoule P £13.16
▶ Octim (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 15 microgram per 1 ml Octim
15micrograms/1ml solution for injection ampoules | 10 ampoule P £192.20
▶ Desmospray (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 2.5 microgram per 1 dose Desmospray
2.5micrograms/dose nasal spray | 50 dose s
Desmopressin acetate 10 microgram per 1 dose Desmospray
10micrograms/dose nasal spray | 60 dose P £25.02 DT = £23.35
▶ Octim (Ferring Pharmaceuticals Ltd)
Desmopressin acetate 150 microgram per 1 dose Octim
150micrograms/dose nasal spray | 25 dose P £576.60 DT =
CAUTIONARY AND ADVISORY LABELS 26
▶ DDAVP Melt (Ferring Pharmaceuticals Ltd)
Desmopressin (as Desmopressin acetate) 60 microgram DDAVP
Melt 60microgram oral lyophilisates sugar-free | 100 tablet P £50.53 DT = £50.53
Desmopressin (as Desmopressin acetate) 120 microgram DDAVP
Melt 120microgram oral lyophilisates sugar-free | 100 tablet P £101.07 DT = £101.07
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