Pharmacologic treatment of nocturia

BPH: benign prostatic hyperplasia; SIADH: syndrome of inappropriate antidiuretic hormone secretion; GFR: glomerular filtration rate; NSAID: nonsteroidal antiinflammatory drug; SSRI: selective serotonin reuptake inhibitor.
* Can be used alone or in combination therapy.
¶ Contraindications to desmopressin include baseline hyponatremia (<135 mEql/L); history of hyponatremia; SIADH; use of loop diuretics or systemic or inhaled glucocorticoids; polydipsia; illness that can cause fluid or electrolyte imbalances (gastroenteritis, salt-wasting nephropathies, systemic infection); GFR <49.9 mL/min/1.73 m². Use is also avoided in patients over the age of 65 and in those with congestive heart failure, uncontrolled hypertension, or increased intracranial pressure. The risks of potential severe hyponatremia with this therapy (boxed warning) include risk of seizures and death.
Δ The patient should understand the need for and be compliant with serum sodium monitoring. Risks of therapy should be discussed.
◊ More frequent monitoring of serum sodium (every 3 months) is needed with concomitant use of NSAIDs, SSRIs, tricyclic antidepressants, thiazide diuretics, opioids, carbamazepine, lamotrigine, or chlorpromazine.