Desmopressin (Stimate)

How does this medicine work?

Stimate is a brand of desmopressin used to help stop bleeding in patients with von Willebrand's disease or mild hemophilia A. Stimate causes the release of von Willebrand's antigen from the platelets and the cells that line the blood vessels where it is stored. Von Willebrand's antigen is the protein that carries factor VIII. This increase in von Willebrand's antigen and factor VIII helps to stop bleeding.

The medicine begins to work about 30 minutes after it is given and has its peak effect in 2 or 3 hours. The effect may last 8 to 12 hours or longer.

How should I give it?

Stimate comes as a nose spray. Make sure that the pharmacy gives you Stimate, which has 1.5 mg of desmopressin in each ml of fluid and 150 mcg per spray. Other brands of desmopressin have different concentrations and are used for different purposes.

The dose of Stimate is one spray for patients who weigh 44 to 110 pounds and two puffs for patients who weigh more than 110 pounds. This medicine should not be used in children who weigh less than 44 pounds. For those patients, intravenous (IV) desmopressin is preferred.

Stimate is usually given 2 hours before surgery, or right away if bleeding occurs. It can be given as often as every 12 to 24 hours.

Follow these instructions:

1. If possible, children should blow their nose to clear out any mucus before receiving Stimate. (If your child is unable to do this, bulb-suction mucus out of the nose.)
2. Tilt the bottle so the tube inside the bottle is in the medicine. Before using the medicine for the first time, prime it by pumping it into the air 4 times. If it has not been used for a month or more, prime it again by spraying once.
3. Give the prescribed number of sprays. If your child's dose is more than one spray, then give one spray into each nostril.
4. Tell your child to sniff in (if able) as the medicine is sprayed into the nose.
5. Rinse the spray tip with hot water and dry with a clean cloth or tissue.

Are there any precautions for my child's diet?

Fluids need to be restricted for 18 to 24 hours after a dose of Stimate. Your doctor or nurse will give you more specific instructions on fluids. There are no restrictions for solid food.

What are the side effects?

Common

• fluid retention
• redness and warmth in face

Occasional

• runny or stuffy nose
• headache
• nausea (upset stomach)
• dizziness
• faster heart rate

Rare

• slight increase or decrease in blood pressure
• blood clots in undesired areas
• seizure

When should I call the doctor?

• headaches or other pain not relieved by acetaminophen (such as Tylenol®)
• irritation or bleeding in the nose
• faster heart rate
• rapid weight gain
• continued bleeding
• dizziness
• vision problems
• confusion
• seizures
• signs of an allergic reaction:
  
  • fever or chills
  • rash or hives
  • wheezing
  • trouble breathing - call 911

What else do I need to know?

If your child has a nosebleed, give the medicine into the nostril that is not bleeding. If both nostrils are bleeding, call the hematology/oncology clinic. In this case it is possible that Stimate may not be effective, and IV desmopressin may be needed to stop the bleeding.

Stimate may not be effective for all patients. Your health care provider may recommend a Stimate challenge test to see if it works.
This is done by giving a dose and then testing the blood at different times.

Stimate should not be used by anyone who has heart problems or who has ever had a blood clot.

Check the bottle for the number of sprays it contains. After that number of sprays, throw the bottle away (even if there is still some liquid in the bottle). The patient instruction sheet that comes with it tells you how to keep track of the number of sprays.

Not all pharmacies stock Stimate. You will need to call ahead if you are running low so that your prescription can be filled before you run out. Always make sure you have enough medicine on hand. Each time you refill your prescription, check to see how many refills are left. If no refills are left, the pharmacist will need 2 or 3 days to contact the doctor to renew the prescription.

Before giving the first dose, read the label. Be sure it is what was prescribed. After a refill, if the medicine looks different to you, ask your pharmacist about it before giving it.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program empty them into the trash.

Store this medicine in the refrigerator, as far from children's reach as possible.

If too much or the wrong kind of medicine is taken, call the hematology/oncology clinic.

Questions?

This sheet is not specific to your child but provides general information. If you have any questions, please call the pharmacist or the hematology/oncology clinic.

Children's Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
Last reviewed 8/2015 ©Copyright

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