Indications for NOCDURNA:
Nocturia due to nocturnal polyuria in adults who awaken ≥2 times per night to void.
Empty bladder immediately before bedtime. Limit fluid intake to a minimum from 1hr before until 8hrs after dose. Dissolve under tongue. Females: 27.7mcg once daily 1hr before bedtime. Males: 55.3mcg once daily 1hr before bedtime.
Hyponatremia, or history of. Polydipsia. Concomitant loop diuretics, systemic or inhaled glucocorticoids. Renal impairment (eGFR <50mL/min/1.73m2). Known or suspected SIADH secretion. During illnesses that can cause fluid/electrolyte imbalance (eg, gastroenteritis, salt-wasting nephropathies, or systemic infection). Heart failure. Uncontrolled hypertension.
Evaluate and confirm diagnosis with 24-hr urine collection prior to initiation. Risk of hyponatremia (may be severe). Monitor serum sodium levels prior to initiating or resuming dose, within 7 days and approx. 1 month after starting therapy, and periodically thereafter. Monitor more frequently for elderly (≥65yrs) or those on concomitant drugs that can increase the risk of hyponatremia. Interrupt or permanently discontinue if hyponatremia occurs; treat appropriately. Risk of increased intracranial pressure, history of urinary retention: not recommended. Pregnancy: not recommended. Nursing mothers.
See Contraindications. Avoid caffeine or alcohol before bedtime. May start or resume Nocdurna 3 days or 5 half-lives after glucocorticoid is discontinued (whichever is longer). Concomitant medications that may cause water retention or increase hyponatremia risk (eg, tricyclics, SSRIs, NSAIDs, opioids, chlorpromazine, carbamazepine, lamotrigine, thiazides, chlorpropamide): monitor serum sodium more frequently.
Dry mouth, hyponatremia, dizziness, headache.