Desmopressin is an established treatment for nocturia due to nocturnal polyuria. In Japan, low-dose formulations (25 and 50 μg) were approved only for men in 2019. However, age- and dose-specific prescribing patterns in real-world practice remain unclear. Using nationwide aggregated claims data, we analyzed age-stratified prescribing trends and dose selection patterns.
Publicly available NDB Open Data (fiscal years 2020-2023) were used. Outpatient prescriptions for desmopressin orally disintegrating tablets (25 and 50 μg) were extracted by sex and 5-year age categories. Population-adjusted prescription rates per 1000 persons and 95% confidence intervals (CIs) were calculated. Temporal trends were evaluated using Poisson regression models with log-population offset.
In men, the population-adjusted prescription rate increased from 21.5 per 1000 persons in 2020 to 84.6 in 2023 (p for trend < 0.001). More than 90% of prescriptions were issued to individuals aged ≥ 65 years. Overall, use of the 25 and 50 μg formulations was balanced; however, the proportion of the 25 μg formulation increased with advancing age, and the 25 μg/50 μg ratio reached 1.37 among those aged ≥ 90 years. Prescriptions in women also increased, with predominance of the 25 μg formulation.
Desmopressin prescribing has increased nationwide in Japan, particularly among older men. Increased selection of the lower-dose formulation in older patients may reflect safety considerations. Off-label use in women is increasing, indicating the need for further safety evaluation and appropriate prescribing guidelines.
International journal of urology : official journal of the Japanese Urological Association. 2026 May [Epub]
Kenichi Sasaki, Motofumi Suzuki, Masahiro Yamamoto, Takamasa Sakamoto, Yukiyasu Horikawa, Toshihiko Kii, Junji Kitamura, Yu Nakamura, Manami Kinjo, Mitsuhiro Tambo, Hiroshi Fukuhara
Department of Urology, Kyorin University School of Medicine, Tokyo, Japan., Department of Urology, Mishima General Hospital, Shizuoka, Japan.