Common Use

Tolvaptan is primarily used to correct clinically significant hyponatremia (low sodium levels) in patients with normal blood volume or fluid overload, particularly when associated with heart failure or SIADH.

Dosage and Direction

Tolvaptan is usually prescribed starting at 15 mg once daily, with adjustments made based on the patient's response and sodium levels. It should be taken orally, with or without food, and under hospital supervision during initiation to monitor sodium correction.

Precautions

• Frequent monitoring of serum sodium is essential to avoid overly rapid correction.
• Tolvaptan should not be used for more than 30 days in patients with autosomal dominant polycystic kidney disease due to potential liver injury.
• Avoid dehydration and ensure adequate fluid intake.
• Not recommended for patients unable to sense or respond to thirst.

Contraindications

• Do not use Tolvaptan in patients with urgent need to raise sodium levels.
• Contraindicated for those unable to drink, with anuria, or with significant liver impairment.
• Should not be used with strong CYP3A inhibitors like ketoconazole or clarithromycin.

Possible Side Effects

• Common side effects: thirst, dry mouth, frequent urination, constipation, and weakness.
• Serious effects: rapid sodium correction (leading to neurologic symptoms), liver injury, or dehydration.

Drug Interaction

• Tolvaptan may interact with CYP3A inhibitors or inducers, increasing or decreasing drug levels.
• Use caution with digoxin and diuretics due to additive effects on electrolytes and fluid balance.

Missed Dose

If a dose is missed, take it as soon as remembered. If it's close to the time for the next dose, skip the missed dose. Do not double up to make up for a missed one.

Overdose

Symptoms of overdose may include excessive urination, dehydration, and electrolyte imbalance. Seek immediate medical attention if overdose is suspected.

Storage

Store Tolvaptan at room temperature (68-77°F or 20-25°C), away from moisture and heat. Keep the medication in its original packaging and out of reach of children.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.