{
  "schema_version": 1,
  "kind": "condition",
  "id": "diabetes-insipidus-referral",
  "name": "Diabetes Insipidus (Central)",
  "category": "chronic",
  "sources": "Endocrine Society Clinical Practice Guidelines · Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, cranial diabetes insipidus (printed p. 242)",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, cranial diabetes insipidus (printed p. 242) · Arginine Vasopressin Disorder (Diabetes Insipidus) - disease-level clinical article (diabetes-insipidus-referral-clinical.txt)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 594,
      "generic": "Desmopressin acetate",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 0.1,
      "adult_dose": "Initially 0.1 mg three times daily; total daily oral dose normally lies in the range of 0.2 to 1.2 mg (usual maintenance 0.1 mg to 0.2 mg three times daily)",
      "adult_duration": "long-term",
      "dose_source": "Egyptian National Drug Formulary, endocrine 2024, desmopressin acetate monograph, cranial diabetes insipidus (printed p. 242)",
      "rationale": "Synthetic vasopressin analogue that replaces the antidiuretic hormone deficient in central diabetes insipidus, reducing excessive urine output by increasing water reabsorption in the kidney; ineffective in nephrogenic DI, where the kidney cannot respond to the hormone at all.",
      "cautions": [
        "There is a risk of severe hyponatremia and water intoxication; monitor fluid intake and serum sodium regularly.",
        "Instruct patient to drink only when thirsty.",
        "The formulary's maintenance is 0.1-0.2 mg three times daily, with a total daily range up to 1.2 mg - the dose here stops at 0.8 mg, which is the more cautious end, not the label's ceiling.",
        "Desmopressin is effective ONLY in central DI and is ineffective in nephrogenic DI."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Specialist pediatric endocrinology titration only",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "DESMODJUST 0.1 MG 30 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)",
          "price_egp": 210.0,
          "pack_count": 30,
          "unit_price": 7.0,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OMEGAPRESS 0.1 MG 30 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ATCO PHARMA > OMEGA PHARMA OPCI",
          "price_egp": 288.0,
          "pack_count": 30,
          "unit_price": 9.6,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "diabetes-insipidus-referral"
    },
    {
      "id": 595,
      "generic": "Referral & safety-netting (no drug therapy)",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": null,
      "adult_duration": null,
      "dose_source": "Arginine Vasopressin Disorder (Diabetes Insipidus) - disease-level clinical article (diabetes-insipidus-referral-clinical.txt)",
      "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.",
      "cautions": [
        "RED FLAG - Monitor for hyponatremia and educate on the warning signs of water intoxication and hyponatremia (nausea, vomiting, lethargy, headache, confusion, seizures, coma)."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": null,
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "diabetes-insipidus-referral"
    }
  ]
}