The Food and Drug Administration (FDA) said the spray, called Noctiva, is not approved to treat all causes of frequent nighttime urination, so doctors must determine the cause and best treatment for each person. Noctiva is approved specifically for a common condition caused by such issues as chronic heart failure, poorly controlled diabetes, and bladder and prostate problems, as well as some medications.
The nasal spray is used daily about 30 minutes before bedtime. It works by making the kidneys absorb more water, which reduces the amount of urine.
Noctiva carries the FDA's strongest warning, a so-called black box, because the drug can cause dangerously low levels of sodium in the blood. Other side effects include colds, bronchitis, increased blood pressure, dizziness, back pain and nosebleeds. Before using the spray, patients must undergo testing to confirm they produce excess urine at night.
The treatment was tested for three months in about 1,000 people 50 and older with the condition, called nocturnal polyuria. The half who used Noctiva had more nights with one or no trips to the bathroom than the group who got a dummy nasal spray, according to the FDA.
The FDA said the nasal spray version is the first approved treatment for frequent nighttime urination.