Desmopressin/indomethacin combination efficacy and safety in renal colic pain management: A randomized placebo controlled trial

Am J Emerg Med. 2019 Jun;37(6):1009-1012. doi: 10.1016/j.ajem.2018.08.033. Epub 2018 Aug 11.


Introduction: Renal colic is a prevalent cause of abdominal pain in the emergency department. Although non-steroidal anti-inflammatory drugs and opioids are used for the treatment of renal colic, some adverse effects have been reported. Therefore, desmopressin -a synthetic analogue of vasopressin- has been proposed as another treatment choice. In the present study, indomethacin in combination with nasal desmopressin was compared with indomethacin alone in the management of renal colic.

Methods: Included in the study were 124 patients with initial diagnosis of renal colic and randomized to receive indomethacin suppository (100 mg) with either desmopressin intranasal spray (4 puffs, total dose of 40 micrograms) and or placebo intranasal spray.

Results: All the included patients were finally diagnosed with renal colic. There was no difference between the two groups in pain at the baseline (p = 0.4) and both treatments reduced pain successfully (p < 0.001). There was no significant difference between the two groups in pain reduction (p = 0.35).

Conclusions: While there was significant pain reduction in both patients groups, pain reduction of NSAIDs (e.g. indomethacin) in renal colic, does not significantly improve when given in combination with desmopressin.

Keywords: Desmopressin; Indomethacin; Pain; Renal colic.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Deamino Arginine Vasopressin / standards*
  • Deamino Arginine Vasopressin / therapeutic use
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Humans
  • Indomethacin / standards*
  • Indomethacin / therapeutic use
  • Male
  • Middle Aged
  • Pain / drug therapy
  • Pain Management / methods
  • Pain Management / standards*
  • Pain Management / statistics & numerical data
  • Pain Measurement / methods
  • Patient Safety / standards*
  • Patient Safety / statistics & numerical data
  • Placebos
  • Prospective Studies
  • Renal Colic / complications
  • Renal Colic / drug therapy
  • Renal Colic / psychology


  • Drug Combinations
  • Placebos
  • Deamino Arginine Vasopressin
  • Indomethacin