Minirin Melt

Generic Name: Desmopressin acetate
Product Name: Minirin Melt

Indication

Minirin Melt is a medication used to treat primary nocturnal enuresis (bed wetting) in adults and children over 6 years of age whose ability to concentrate urine is normal. Minirin Melt should only be used to treat bed wetting, if management with a bed wetting alarm fails or when a bed wetting alarm is contraindicated or inappropriate.

Minirin Melt may also be used to treat cranial diabetes insipidus, a type of pituitary disorder characterised by the production of large amounts of urine and constant thirst.

In Australia, the cost of Minirin Melt (120 µg and 240 µg doses) is subsidised under the Government’s Pharmaceutical Benefits Scheme.

Download the guide Bedwetting Can Be Treated.

Order a FREE information pack. This pack includes an information leaflet and a copy of the “Understanding Bedwetting” DVD.

Action

Desmopressin, the active ingredient in Minirin Melt, is a synthetic version of the naturally occurring substance called vasopressin which is produced in the pituitary gland.

Vasopressin has several actions in the body including reducing the amount of urine produced by the kidneys. Desmopressin works in the same way as vasopressin.

Dose advice

Dose information

How to take Minirin Melt

The correct dose will be determined by the doctor who prescribes Minirin Melt. Always take the medicine as prescribed by your doctor, even if the dose information on the medicine packet is different. Continue to take the medicine even if you start feeling well. Minirin Melt controls your condition but does not cure it. You must continue to take the medicine or you may become unwell again.

Minirin Melt is a wafer for sublingual administration, which means that when you take them they should be placed under the tongue. Minirin Melt (wafers) are available in Australia in 120 µg and 240 µg doses (a 60 µg dose is available in other countries). Do not give the medicine to anybody else or use it to treat any other health problem.

To remove a wafer from its packet, carefully peel back the foil from one of the blisters, starting in the corner with the arrow. Do not try to push the wafer through the foil backing. Once removed, the wafer should be placed under your tongue. It will dissolve in a few seconds, without water. More detailed instructions about how to take the medicine are provided in the medicine packet.

Bed wetting

Usually you will start by taking 120 µg of Minirin Melt each day at bedtime. The doctor may increase the dose to 240 µg if the starting dose does not effectively treat your condition. Take the medicine every day before going to bed. If you miss a dose, do not take extra medicine to make up for the missed dose. Take your normal dose the following day.

When used as a treatment for bed wetting, Minirin Melt is usually prescribed for up to 3 months. After taking the medicine for periods of 3 months, the doctor will ask you to spend 1 week without taking the medicine. If bed wetting occurs again when you are not taking the medicine, you may be prescribed Minirin Melt for another 3 months. Always attend your scheduled doctor appointments so that your response to the medicine and the need for continued treatment can be assessed.

Dosage for cranial diabetes insipidus

Doses up to 120 µg three times a day may be used. Your doctor will determine how much you need to take, depending on your response to the medicine.

If you forget to take a dose, take it as soon as you remember. Do not take a double dose. Talk to your doctor if you are unsure when to take the following dose.

Fluid restriction

When using Minirin Melt to treat bedwetting, it is important that you restrict your fluid intake. This means that you should limit your fluid intake to a minimum from 1 hour before until 8 hours after taking your daily dose. Over this period, drink no more than a few sips of water or other fluids if needed. In this period, only drink a few sips of water or other fluids if needed- do not drink more than this. At other times of the day, drink fluids normally to prevent dehydration.

When taking Minirin Melt to treat cranial diabetes insipidus, follow your doctor’s instruction on fluid intake. It is important to keep your body fluids in balance.

Overdose

Taking too much Minirin Melt increases the risk of water retention and/or hyponatraemia. If you develop symptoms of these conditions, which include headache, drowsiness, confusion, rapid weight gain, nausea and vomiting and convulsions, stop taking the medicine immediately and consult your doctor or call the Poisons Information Hotline (telephone number in Australia is 13 11 26).

If you have any queries about the correct way to use Minirin Melt, please ask your doctor.

Contraindications

Minirin Melt should not be used under certain conditions. Tell your doctor if you:

• Have an allergy to desmopressin (the active ingredient) or any excipients (inactive ingredients) in the product, or any other medicine or food;
• Drink large quantities of water: A higher fluid intake at bedtime when taking Minirin Melt can increase the chance of fluid overload. Restrict or limit fluid intake from 1 hour before until 8 hours after taking Minirin Melt. Drinking too much water can lead to complications including water retention and/or hyponatraemia (a condition characterised by lack of salts in the blood). These conditions may occur with or without accompanying warning signs and symptoms (such as headache, nausea and vomiting, weight gain and convulsions);
• Have heart problems characterised by shortness of breath and swelling of the lower legs and feet as a result of fluid accumulation;
• Have kidney problems that cause you to pass small amounts of urine or no urine;
• Have low levels of sodium in your blood, a condition known as hyponatraemia;
• Have a condition called syndrome of inappropriate anti-diuretic hormone secretion (SIADH), which causes you to secrete too much anti-diuretic hormone (ADH).

Precautions

Special care needs to be taken before you can start using Minirin Melt. Tell your doctor if you:

• Have an allergy to desmopressin (the active ingredient in Minirin Melt) or any other medicines, foods, preservatives or dyes;
• Have a fluid imbalance in your body, which means that you have too much or too little water your body;
• Develop water retention and/or hyponatraemia, which may or may not cause signs and symptoms including headache, nausea and vomiting, weight gain and convulsions. If you develop these signs and symptoms whilst taking Minirin Melt, stop taking the medicine immediately and see your doctor;
• Have a condition affecting your bladder;
• Have a condition affecting how much urine you produce, including multiple sclerosis and urge incontinence (a sudden urge to urinate);
• Have diabetes mellitus;
• Have a condition which affects your kidneys;
• Have a condition affecting your heart;
• Have low blood pressure;
• Have cystic fibrosis;
• Have low blood sodium levels (hyponatraemia);
• Have a disease which affects the way your blood clots;
• Have a fluid or electrolyte imbalance which may arise due to systemic infection, gastroenteritis, fever or syndrome of inappropriate anti-diuretic hormone secretion;
• Take a medicine called a diuretic;
• Take a medicine called loperamide, which is used to treat diarrhoea;
• Take medicines called non-steroidal anti-inflammatory drugs (NSAIDs), which are used to relieve pain and inflammation;
• Take tricyclic antidepressants;
• Take selective serotonin reuptake inhibitors;
• Take chlorpromazine or carbamazepine;

Other medications

If you are taking Minirin Melt, tell your doctor, pharmacist or other healthcare professional before starting any new medicines. Tell the surgeon or anaesthetist that you are taking Minirin Melt before you are sedated to have surgery.

Pregnancy

Minirin Melt is a Pregnancy Category B2 medication. You should not use Minirin Melt if you are pregnant unless your doctor has specifically told you that you should. Studies have not been conducted to determine whether the medicine is safe when used during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant whilst taking Minirin Melt so that they can discuss the risks and benefits of using the drug during pregnancy.

Breastfeeding

You should not use Minirin Melt if you are breastfeeding. The medicine is passed into your breastmilk. Studies have not been done to determine whether or not the medicine is safe when used during breastfeeding.

Children

Minirin Melt can be used by children 6 years of age and older for the treatment of bedwetting. Children should be closely observed when they are taking the medicine to ensure they take the correct dose. They should also be monitored to ensure that they restrict their fluid intake.

Minirin Melt can also be used by children to treat cranial diabetes insipidus.

Storage

Minirin Melt should be stored below 25°C, in the original packaging and protected from moisture and light. Do not take the medicine if it has passed its expiry date or if the packaging shows signs of tampering. Return damaged or expired medicines to your pharmacy.

Schedule

Minirin (Melt) is a Schedule S4 (prescription only) medication.¹

Common side effects

All medicines can have side effects. Most commonly the side effects are minor; however, some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before starting you on Minirin Melt.

Without concomitant reduction of fluid intake, there is a risk of water retention/hyponatraemia when taking Minirin Melt with or without accompanying warning signs and symptoms (headache, nausea/vomiting, decreased sodium, weight gain and, in severe cases, convulsions). Elderly people (older than 60 years) have an increased risk, as do those taking higher doses of the medicine.

In clinical studies, the following side effects have occurred at least once in individuals using Minirin Melt to treat cranial diabetes insipidus:

• Cold;
• Headache;
• Weight gain (due to increased fluid retention);
• Dizziness;
• Sore throat;
• Depressed mood.

The following side effects of Minirin Melt have been observed in patients treated for diabetes insipidus and/or primary nocturnal enuresis (bed wetting).

Very common side effects

Very common side effects are those that occur in more than 10% of people given Minirin Melt. These include:

• N/A

Common side effects

Common side effects are those that occur in 1–10% of people given Minirin Melt. These include:

• Headache;
• Abdominal pain;
• Nausea.

Uncommon side effects

Side effects that occur in less than 1% of people given Minirin Melt are considered uncommon. People do not necessarily experience any of these side effects, so do not become alarmed by this list:

• N/A

Rare side effects

Rare side effects are those that occur in 0.01–0.1% of people given Minirin Melt. These include:

• N/A 

Very rare side effects

Very rare side effects are those that occur in less than 0.01% of people given Minirin Melt. These include:

• Hyponatraemia (a condition characterised by lack of salts in the blood). See Precautions for more information).

After Minirin Tablets were made available, there have been isolated occurrences of allergic skin reactions and more severe general allergic reactions, visual abnormalities and very rare cases of emotional disturbances in children.

If you experience any of the listed side effects, or any other symptoms that appear abnormal or unusual, please tell your doctor.

Useful resources:

For more information about the causes of and treatment options for bedwetting, see Treat Bedwetting.

To help you understand why you or your child wets the bed, complete this checklist and take it to your doctor.

Where Minirin (desmopressin) is not appropriate, a bed wetting alarm may be used.

Related Documents

References

For further information talk to your doctor.