Oxytocin
An approved obstetric drug with a rigorous evidence base, and separately the subject of a large intranasal social-behaviour literature that has largely failed to replicate.
Sexual & Hormonal
Desmopressin
A modified vasopressin approved for diabetes insipidus, nocturia and bleeding disorders. Effective and cheap, with hyponatraemia as its serious risk.
Overview
Vasopressin does two things: it tells the kidney to hold onto water, and it constricts blood vessels. Desmopressin is vasopressin with two changes that keep the water-retaining effect and remove almost all of the blood-pressure effect. That makes it usable for conditions where the body cannot concentrate urine. Separately, it triggers release of stored von Willebrand factor from blood vessel walls, which is why it is also used before minor surgery in mild bleeding disorders.
A synthetic vasopressin analogue with deamination at position 1 and D-arginine substituted at position 8, conferring V2 selectivity over V1a and resistance to peptidase degradation. V2 activation in renal collecting duct principal cells raises cAMP and drives aquaporin-2 trafficking to the apical membrane, increasing water reabsorption. A separate V2-mediated effect on vascular endothelium triggers exocytosis of Weibel-Palade bodies, releasing von Willebrand factor and factor VIII — the basis of its haemostatic indication in type 1 von Willebrand disease and mild haemophilia A. Available as tablets, sublingual lyophilisate, nasal spray and injection.
Research areas
Diabetes insipidusNocturiaVon Willebrand diseaseNocturnal enuresis
Dosing reported in the literature
Every protocol below is reproduced from a published study or approved labelling, with its source named. These are records of what was studied — not recommendations, and not a suggestion that any of them is appropriate for any person.
| Protocol as reported | Source |
|---|---|
| 0.1–1.2 mg orally daily in divided doses for central diabetes insipidus, titrated to urine output | Approved product labelling |
| 0.3 mcg/kg intravenously over 30 minutes before a procedure in mild von Willebrand diseaseTachyphylaxis develops after repeated doses as endothelial stores are depleted. | Haemostasis protocol |
Trial status
Approved for decades with an extensive trial and real-world record across indications.
Reported safety signals
- Hyponatraemia is the serious risk and can cause seizures. Fluid intake must be restricted around dosing, and sodium monitored in older adults.
- Risk is highest in people over 65, which is why the nocturia formulations carry specific age-related warnings.
- Repeated haemostatic dosing loses effect as von Willebrand factor stores are depleted.
- Contraindicated in significant renal impairment and in existing hyponatraemia.
Common questions
Why does a kidney drug help with bleeding?
The same V2 receptor sits on the endothelial cells lining blood vessels, where activating it causes stored von Willebrand factor and factor VIII to be released into the circulation. It is a genuinely separate effect from the kidney one, using the same receptor in a different tissue.
Primary sources
Medical disclaimer
This page is for informational and research purposes only. Nothing here constitutes medical advice. The compounds discussed are research chemicals. Consult a qualified clinician before starting any protocol.
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