Until recently, the reliability and predectibility of the intranasal route of administration of DDAVP has been too poor to recommend it in routine practice.With the development of a new delivery system in the form of a spray puip we have previously shown that absorption and biological effect of DDAVP in volunteers is enhanced(1).In this patient study we conpared intranasal administration of 300 pg DDAVP using a newly developed pre-corrpression spray pinp with intravenous administration of 0.3 -

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... 0.4 pg/kg. We studied 24 patients with mild haemophilia A, 23 with mild vWD Type IA and 8 with Type IB. We measured VIII:C (one-stage assay), vW:Ag (IRMA) and bleeding time (Simplate II) before and 30 - 60 min and 1 hour post treatment after i.v. and i.n. administration respectively.The spray resulted in a 2 to 4 times increase in basal levels of VIII:C and vW:Ag and was comparable in effect to intravenous administration. Moreover, bleeding time was significantly reduced to within the normal range in most patients. Several patients reported good clinical effects of the spray after tooth extraction, menorrhagia and epistaxis.We conclude that the DDAVP spray is a clear improvement over previous atterpts at intranasal administration. The spray deposits well controlled and reproducible doses in the nasal cavity resulting in a clear enhancement in absorption with a magnitude and reliability of its biological effect which is corparable to the intravenous delivery. Furthermore, the spray offers a convenient and practical means of self-treatment to haemophilia patients without delay.1. Harris A.S., Nilsson I.M., Wagier Z.-G., Alkner U. Intranasal Administration of Peptides: Nasal Deposition, Biological Response, and Absorption of Desmopressin. J Pharm Sci (in press, December 1986).