US FDA approved a new medicine noctiva with active ingredient desmopressin acetate in nasal preparation for the treatment of frequent urination or overproduction of urine during sleep time (polyuria). This is first kind of drug approved by FDA to reduce symptoms of frequent urination at night time.
Urgency to urinate at night time is termed as nocturia while the underlying cause of nocturia is over production of urine at night time is termed polyuria. Polyuria is not the only cause of nocturia it might be due to number of reasons like congestive heart failure, daibetes insipidus, diabetes mellitus, hyper active bladder, benign prostate hyperplasia, drug induced nocturia etc. So, it is the responsibility of health care provider to rule out the underlying causes of nocturia before prescribing this medicine because the drug is effective only in case of nocturia induced by nocturnal polyuria.
Basic mechanism of action by which desmopressin reduces the urinary frequency is that it limits the amount of water in urine in renal collecting duct by binding with V2 receptors. According to pharmacokinetics, desmopressing has longer duration of action as compared to vasopression due to slow metabolic degradation. Moreover, it has better safety profile as compared to vasopressin.