The administration of desmopressin by nasal spray: a dose-determination study in patients with mild haemophilia A or von Willebrand's disease.

Desmopressin is an important haemostatic agent in many types of bleeding disorders. The intranasal route for administration of desmopressin has attracted much interest because it is convenient and makes self-treatment possible. In the present study the effects of three doses (300, 450 and 600 μg) of desmopressin delivered by nasal spray and those of 0.3 μg/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 the haemophilia patients and no difference in peak vWF concentration in von Willebrand patients between the four desmopressin dosages. Bleeding time response was comparable after all four dosages. We recommend a spray dosage of 300 μg for home treatment. As cover for major surgery or in connection with severe bleedings, however, intravenous administration is to be recommended.