Dosing

Dosing of UreaAide™ Urea is based on the European Best Practice Guidelines (see below):
Urea is dosed at 0.25-0.5 grams per kilogram per day usually in divided doses either BID or TID.
Example: 60 KG person would get 30 grams per day in divided doses,1 packet or 1 scoop twice daily.

European renal best practice guidelines for the treatment of SIADH

7.4.3. Patients with SAIDH

7.4.3.1. In moderate or profound hyponatremia, we suggest restricting fluid intake as a first-line-treatment (2D).

7.4.3.2 In moderate or profound hyponatremia, we suggest the following can be considered equal second-line treatments: a) Increasing solute intake with 0.25–0.50g/kg per day if urea or a combination of low dose loop diuretics and oral sodium chloride (2D).

7.4.3.3 In moderate or profound hyponatremia, we recommend against lithium or demeclocycline (1D).

7.4.3.4 In moderate hyponatremia, we do not recommend vasopressin receptor antagonists (1C).

7.4.3.5 In profound hyponatremia, we recommend against vasopressin receptor antagonists (1C).

http://www.ncbi.nlm.nih.gov/pubmed/24569125

Insurance Coverage for UreaAide™

UreaAide™ is a qualified medical expense and is thus tax deductible through an HSA, FSA, or HRA. 
Insurance carriers will undoubtedly ask for a prior authorization from the physician or medical provider. 
The patient should contact their insurance carrier and let them know their provider has recommended UreaAide™.

UreaAide™, if covered, will be covered under Medical Benefit not pharmaceutical benefits or under DME.  HCPCS codes B-4155 or the DME code A-9999 are utilized when the PA form is submitted. In practice unfortunately, insurance carriers often will not cover the cost. This is why we offer our Unflavored UreaAide™ urea at modest prices. 

Urea Safety in Long Term Use

Urea has been effetively used for Hyponatremia since 1980.  

Here a 2012 study compared 12 patients with SIADH given 1 year of treatment with an oral V2 receptor antagonist, then given an 8 day drug holiday and started on Urea for another year of therapy. 

The mean age was 73 years. 

Mean baseline serum sodium level was 125 meq/L. 

After 1 year of Urea therapy the mean serum Sodium was 135 meq/L. 

1 patient stopped the Vaptan due to excessive thirst, whereas all patients were able to continue Urea without any significant adverse effects.  

DOI: https://doi.org/10.2215/CJN.06990711