Fluid intake must be limited to a min from 1 hr before until 8 hr after administration. Increased risk of hyponatremia in elderly patients w/ serum Na levels in the lower range of normal; females at a 50 mcg dose level. Discontinue if the serum Na level falls below the LLN range (eg, 135 mmol/L). Do not use daily doses >25 mcg for females & >50 mcg for males. Caution in patients w/ conditions characterized by fluid &/or electrolyte imbalance. Interrupt & reassess treatment during acute intercurrent illnesses characterised by fluid &/or electrolyte imbalance (eg, systemic infections, fever & gastroenteritis). Concomitant treatment w/ drugs which are known to induce SIADH (eg, TCAs, SSRIs, chlorpromazine, diuretics & carbamazepine & some antidiabetics of the sulfonylurea group) particularly chlorpropamide & concomitant treatment w/ NSAIDs. Patients taking thiazide or loop diuretics for HTN or other medical conditions not associated w/ fluid overload. Severe bladder dysfunction & outlet obstruction should be considered before starting treatment. Caution is required in cases of cystic fibrosis, CHD, HTN, chronic renal disease & pre-eclampsia. Exercise caution in patients taking lithium in case of masking of early-stage lithium-induced nephrogenic diabetes insipidus. Not recommended in patients suspected of having lithium-induced nephrogenic diabetes insipidus. Pregnancy. Elderly ≥65 yr.
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