Effectiveness, Specificity and Safety of Intranasal l-Deamino-8-D-Arginine Vasopressin Treatment of Normal Blood Donors

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Abstract
A study of the absorption of 300 µg of l-deamino-8-D-arginine vasopressin (DDAVP) given intranasally to normal blood donors was carried out to determine (a) the correlation between plasma levels of DDAVP and the percent rise of factor VIII procoagulant activity (VIIl:C) and (b) the efficacy, specificity and safety of this treatment in increasing the recovery of factor Vlll:C in donated blood. The maximum drug concentration was highly correlated to the maximum percent rise of Vlll:C (r = 0.858, p < 0.01). A differentiated effect of DDAVP on increases of Vlll:C, VIIl:Ag, vWF:Ag and vWF multimers was observed. A transient rise of fibrinopeptide A from 5 to 16 ng/ml, 30 min post-DDAVP, was not accompanied by changes in fibrinogen levels or generation of detectable factor Xa or thrombin. DDAVP had no effect on the factor XII-dependent pathway of plasminogen activation, or on the donor’s vital signs and hematological parameters. Side effects were minor and of short duration. Intranasal DDAVP treatment of blood donors is considered to be a practical means of improving the recovery of Vlll:C from normal donors.