In a nutshell
This study investigated the safety and effectiveness of timed furosemide (Lasix) and desmopressin (Ddavp) in treating nocturia in older patients. The study concluded that this combined treatment improved nocturia symptoms and was well tolerated.
Desmopressin has recently been investigated in the treatment on nocturia. Desmopressin reduces urine production, and if taken before bedtime can decrease nocturia episodes.
Furosemide is a commonly used drug among patients with fluid retention, used to increase urination. Well timed furosemide use can increase urination before bedtime, thus reducing the amount of urine in the bladder during the night.
The combination of timed furosemide with desmopressin may be useful in managing nocturia symptoms in older patients.
Methods & findings
The study included 82 nocturia patients (reported waking at least twice per night) over the age of 60. Patients were randomly assigned to receive a placebo (substance with no active effect), or combined treatment with furosemide 6 hours prior to bedtime and desmopressin before bedtime. The number of nocturnal voids (nighttime urinations) was recorded at the beginning and end of the study. Nighttime urine volume was also measured.
46% of patients treated with furosemide and desmopressin reported a decrease in the number of nighttime voids, compared to 10% in the placebo group. The average number of nocturnal voids in the treatment group reduced from 3.5 to 2 (compared to 3.3 to 3 voids in placebo group). Nighttime urine volume decreased by 37% in the treatment group (from 919.6 ml to 584.2 ml). This was significantly more than the 5% decrease seen in the placebo group (from 871.6 ml to 828 ml).
26% of patients in the treatment group and 20% in the placebo group reported adverse effects including headaches, nausea, dizziness and dry mouth.
Hyponatremia (dangerously low blood sodium levels) associated with desmopressin treatment, was noted in 2 patients (5%) receiving combination treatment.
The bottom line
This study concluded that timed furosemide and desmopressin treatment improved nocturia symptoms and was well tolerated.
The fine print
This study screened patients’ response to desmopressin prior to the trial, and patients who did not respond to or experienced significant side-effects were excluded from the trial.
Hyponatremia can pose a significant risk and is known to be associated particularly with older forms of desmopressin treatment.
Published By :
Neurourology and urodynamics
Mar 01, 2011