Archive for the ‘Medications’ Category

Bed Wetting Medication

Wednesday, March 10th, 2010

My son is 8 and wets every night. My doctor mentioned that he can prescribe a medication to help. I’m a little nervous about giving my son medicine for this. Can you tell me more?
The most frequently prescribed medication for bedwetting is DDAVP (desmopressin). This synthetic form of the natural hormone vasopressin decreases the quantity of urine produced for the next eight to 12 hours. It begins to work quickly, usually within one hour of taking it. This medication is designed to curb bedwetting by making the urine more concentrated and decreasing the total amount of urine produced that night.

Medication often has immediate results, but when you stop it, the relapse rate is high-about 80 percent. DDAVP allows about half the children who use it to sleep dry that night, which makes it particularly useful for sleepovers and camps. DDAVP is available in two forms: a nasal spray and tablet. The tablet is now preferred because it delivers a more consistent and convenient dose. The nasal spray has a Black Box Warning because of some reported cases of seizures and death because of water intoxication. Also, children with allergic congestion can get erratic results with the nasal spray.

Dosage of DDAVP must be individualized, with one to three tablets (0.2 mg.) each night before bed as the recommended dose. The greatest number of dry nights is achieved by 0.4 to 0.6 mg. nightly. If your child is taking the medication for a situation outside of his home, such as sleepover camp, start it ahead of time to establish the appropriate dose. Your child’s doctor or nurse practitioner is responsible for determining your child’s dosage, but the general recommendation is as follows:
• If your child wets when taking one tablet, increase it to two.
• If wetting occurs with two tablets, his dosage should be three tablets.
• Three tablets is the maximum amount recommended for any age group.

DDAVP is generally safe with few side effects. Reported side effects include headache, stomach ache or water intoxication if a large amount of water is ingested after taking it. The manufacturer provides fluid guidelines, recommending no more than four ounces of water before bedtime. This medication can be safely used for three- to six-month intervals with a one week break. If wetting persists, it can be used for another interval. DDAVP is expensive, as much as $3-4 per tablet. The cost should be taken into account when considering long-term use.

DDAVP does not stop wetting in every child. Increasing the length of time taken will not make it work. The expected results should be seen in a week or two. Parents should realize that this medication does not provide long-lasting effects, but it does provide short-term dryness for many children. For long lasting results, getting to dryness by using a bedwetting alarm has a more permanent response.

Bed Wetting Problem

Tuesday, February 23rd, 2010

RA writes, I hope you can help with my son’s bedwetting problem. My almost 10 year old boy is a major bedwetter and I mean he wets 3-4 times per night. He has been seeing a urologist and the biofeedback determines he is not an efficient voider during the day- he does not empty his bladder completely. So all this urine builds up all day long and he wets at night. He is supposed to be doing kegel type exercises. We have tried the alarm for six months and it does not help. He was on medication for nighttime but it made no difference. He is a heavy sleeper and we end up getting up. He double voids before bed and we limit liquids. What else can we do? I am at my wits end! I feel he will be 16 before this ends!

Bedwetting can be so frustrating at times. It sounds like you have explored many avenues to get your son to dryness. Since it sounds like his daytime voiding is inefficient, working on that a little more may help. Did the urologist recommend a timed voiding program in the daytime? The kids wear a vibratory wristwatch that discreetly reminds them to go to the bathroom about every 2 hours, even if they don’t feel like it. If he hasn’t tried this yet, it may help to empty his bladder more efficiently during the day. I use the Vibrowatch for my patients because it can be set to precise times. I like to set times that do not require the kids to leave the middle of class, and allow them to start the bus ride home at the end of the day with an empty bladder. Taking a water bottle to school helps to assure that they are adequately hydrated during the day and not thirsty late in the day. Once he’s done this for a few months, he could restart the alarm at night.

Illness and Bedwetting

Monday, December 21st, 2009

My son is using his Malem alarm. We make sure he double voids before bedtime. He is on a 5 day course of Amoxicillin 3x a day. He was having longer stretches of dryness- a couple of days at a time. Since he has started the Amoxicillin, he is wetting every night- sometimes really small and sometimes a medium spot. Is this typical when a child is on antibiotics?

I do see this phenomenon regularly in the kids that I work with. I don’t know of a medical explanation, but I do see more wetting in children who have colds, ear infections, flu etc. and who are on medications such as antibiotics, cold medicine, and acetaminophen. It seems like the body is working hard to fight off the virus or bacteria, and cannot attend to the alarm or other bodily messages. Some parents discontinue the alarm for a few nights when the kids are most ill, then restart it when he feels better. That is perfectly fine.

The good news is that once the kids are off the medication and feeling better, dryness patterns do return. Working around challenges that face families is part of getting to dryness. Ultimately, your son will be able to stay dry, no matter what the challenges are.

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