Desmopressin for nocturia can be combined with BPH medication

This study investigated the safety and effectiveness of desmopressin for the treatment nocturia among benign prostatic hyperplasia (BPH) patients. The study concluded that low dose desmopressin is a safe and effective treatment for nocturia in combination with the BPH medication tamsulosin (Flomax). 

Patients with benign prostate hyperplasia (BPH, or an enlarged prostate) often develop urinary symptoms such as frequent nighttime urinations which interrupt sleep (nocturia). While patients with BPH are often treated with prostate relaxing medications (such as tamsulosin), these drugs do not always relieve symptoms such as nocturia.

Desmopressin, a drug that reduces urine production, has been the focus of recent investigation as a novel way to treat nocturia. Desmopressin tablets or nasal spray taken before bed-time have been shown to reduce nightly trips to the toilet and sleep interruptions. However, little is known on the effects of desmopressin on BPH patients treated with medications such as tamsulosin.

This study included 248 men with urinary symptoms associated with BPH, including nocturia. Patients were randomly assigned to two groups. One group received tamsulosin plus 60 mcg desmopressin once daily before bedtime. The second group received tamsulosin alone. Follow-up assessments were performed monthly for 3 months.

Patients in both treatment groups reported an improvement of urinary symptoms. Patients taking both desmopressin and tamsulosin had a greater reduction in the number of nightly trips to the toilet (64% less), compared to patients treated with tamsulosin alone (45% less).

The first sleep period (until the first nightly void) was also increased from 82 to 160 minutes with combination treatment including desmopressin. Among patients treated with BPH medication alone the first sleep period increased from 83 to 124 minutes.

Quality of life, as reported by patient questionnaires, was improved in both treatment groups with little statistical difference. No serious side-effects were noted in either treatment group.

This study concluded that low dose desmopressin is safe and effective in combination with tamsulosin to treat nocturia.

Desmopressin is known to be associated with an increased risk for hyponatremia (dangerously low blood sodium levels).