The US Food and Drug Administration (FDA) has approved Noctiva (desmopressin acetate) nasal spray for adults who awaken at least two times per night to urinate due to a condition known as nocturnal polyuria (overproduction of urine during the night). Noctiva is the first FDA-approved treatment for this condition.

‘Today’s approval provides adults who overproduce urine at night with the first FDA-approved therapeutic option to help reduce the number of times a night they wake up to urinate,’ explained Hylton V Joffe, MD, MMSc, Director of the Division of Bone, Reproductive, and Urologic Products in the FDA’s Centre for Drug Evaluation and Research.

‘It is important to know that Noctiva is not approved for all causes of night-time urination, so patients should discuss their symptoms with their health care provider who can determine the underlying cause of the night-time urination and whether Noctiva is right for them.’

Nocturia (wakening at night to urinate) is a symptom that can be caused by a wide variety of conditions, such as congestive heart failure, poorly controlled diabetes mellitus, medications, or diseases of the bladder or prostate. Before considering Noctiva, healthcare providers should evaluate each patient for possible causes for the nocturia, and optimise the treatment of underlying conditions that may be contributing to the night-time urination.

Because Noctiva is approved only for adults with nocturia caused by nocturnal polyuria, healthcare providers should confirm overproduction of urine at night with a 24-hour urine collection, if one has not been obtained previously. Health care providers should also be mindful of underlying conditions that can cause nocturia, but that make treatment with Noctiva unsafe, such as excessive drinking of fluids, or symptomatic congestive heart failure.

Noctiva is taken daily, approximately 30 minutes before going to bed. It works by increasing the absorption of water through the kidneys, which leads to less urine production.