Wet pajamas must be back in style???

Implications: The FDA has made the nasal spray formulation of DDAVP be withdrawn due to potential significant side effects of life threatening hyponatremia (low blood sodium) as well as potential seizures. I an unable to identify the data from this announcement as to why this occured. DDAVP nasal spray has been used for over 10 years for the treatment of primary noctural eneuresis (bedwetting) with good success.

Analysis:  

With this recent withdrawl of nasal DDAVP for the treatment of primary noctural enuresis, it will make it very difficult to offer treatment to young children that are unable to swallow the tablets. I am not sure how I will be able to treat these patients. Althought 90% of children will attain dryness at nite by age 7, many youngsters will be fraught with anxiety if they are invited to sleep outside of these homes given they will not be able to use the nasal spray. In my clinical practice, I have been fortunate not to see these side effects, of hyponatremia and seizures. I will continue to use the oral formulation for now.