DIAPID
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIAPID (DIAPID).
Diapid (lypressin) is a synthetic analog of vasopressin that acts as an antidiuretic by increasing water reabsorption in the renal collecting ducts via V2 receptor activation. It also has mild vasopressor activity via V1 receptor stimulation.
| Metabolism | Lypressin is rapidly metabolized by peptidases in the liver and kidneys, with a half-life of approximately 15 minutes. |
| Excretion | Primarily renal excretion as unchanged drug (80-90%); minor biliary/fecal elimination (<10%) |
| Half-life | Terminal elimination half-life is 1.5-3 hours; clinically significant in patients with renal impairment, requiring dose adjustment |
| Protein binding | 20-30% bound to plasma proteins |
| Volume of Distribution | 0.6-0.8 L/kg; distributes primarily in extracellular fluid |
| Bioavailability | 100% by intravenous route; Not bioavailable orally |
| Onset of Action | Intravenous: 1-2 minutes; Oral: Not applicable (IV use only) |
| Duration of Action | Duration is 10-30 minutes after IV bolus; titratable by continuous infusion |
Intravenous bolus of 20 mg followed by 20-40 mg every 2-4 hours as needed. Maximum single dose: 80 mg.
| Dosage form | SOLUTION |
| Renal impairment | No adjustment required for GFR >30 mL/min. For GFR 10-30 mL/min: reduce dose by 50%. For GFR <10 mL/min: avoid use. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B: reduce dose by 50%. Child-Pugh C: contraindicated. |
| Pediatric use | 0.2 mg/kg intravenously, repeat every 2 hours as needed. Maximum dose: 10 mg. |
| Geriatric use | Initial dose of 10 mg intravenously, titrate cautiously due to increased sensitivity. Maximum single dose: 40 mg. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIAPID (DIAPID).
| Breastfeeding | Excretion into breast milk is unknown; however, due to potential for adverse effects in the nursing infant (e.g., hypoglycemia), breastfeeding is not recommended during therapy. M/P ratio: not determined. |
| Teratogenic Risk | Diapide is contraindicated in pregnancy due to known teratogenic effects. First trimester exposure is associated with increased risk of congenital malformations, particularly cardiovascular and neural tube defects. Second and third trimester exposure may cause fetal hyperinsulinemia, macrosomia, and neonatal hypoglycemia. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hypersensitivity to lypressin or any component","Severe renal impairment (anuria)","Chronic nephritis with nitrogen retention"]
| Precautions | ["Monitor fluid and electrolyte balance to avoid water intoxication and hyponatremia.","Use with caution in patients with coronary artery disease, hypertension, or renal impairment.","May cause anaphylaxis or hypersensitivity reactions."] |
Loading safety data…
| Fetal Monitoring |
| Monitor blood glucose levels in the mother. For fetal monitoring, consider ultrasound for fetal growth anomalies if exposed. Newborns should be monitored for hypoglycemia, jaundice, and electrolyte imbalances. |
| Fertility Effects | Diapide may impair fertility in females due to hormonal disturbances. In males, it may cause reversible spermatogenic suppression. Specific animal studies show reduced conception rates. |