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Desmopressin in haemophilia A and von Willebrand's disease

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Increases the levels of factor VIII and von Willebrand factor - can be used for nontransfusional treatment of patients with mild or moderate haemophilia and von Willebrand's disease.

DDAVP promotes the release of all available normal vWF into the circulation and should be considered for most mild to moderately affected patients, with or without tranexamic acid. However, repeated treatment is not effective because of exhaustion of stored vWF.

DDAVP is contraindicated in type IIb von Willebrand's patients because of interaction between the abnormal vWF and circulating platelets which results in platelet aggregation and thrombocytopenia as the aggregates are removed by splenic sequestration.


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