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Tolvaptan
Tolvaptan is a medication used to treat low blood sodium levels in people with certain conditions such as heart failure and liver diseases like cirrhosis. It's known as a vasopressin receptor antagonist. Common side effects are thirst, dry mouth, and frequent urination, but your healthcare provider will make sure the benefits outweigh these implications.
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Frequently Asked Questions
Can I drink alcohol while taking Tolvaptan?
It?s not recommended as alcohol may increase some side effects such as dizziness from Tolvaptan.
Can I stop taking Tolvaptan if my sodium levels are back to normal?
Do not stop taking this medication without your healthcare provider?s advice. Abruptly stopping the medication can lead to sodium levels decreasing again.
Does Tolvaptan cause weight loss?
Tolvaptan may cause you to lose weight due to the increased urination and lowering of body fluid levels.
What happens if I overdose on Tolvaptan?
An overdose may result in increased side effects such as thirst or urination. In case of suspected overdose, seek immediate medical attention.
Comprehensive Drug Guide
How Does Tolvaptan Work?
Tolvaptan is a selective, competitive arginine vasopressin receptor 2 antagonist that works by promoting increased water excretion in the urine, therefore increasing sodium concentrations in the blood.
What is Tolvaptan Used For?
FDA indications: Tolvaptan is used to treat low sodium levels (hyponatremia) in people with congestive heart failure, cirrhosis, and Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Offlabel uses: It's also been used for the offlabel treatment of polycystic kidney disease.
Common Dosages
Tablets: 15mg, 30mg, 60mg
Typical Dosing
FDA Approved Indications
- Hyponatremia: Initiate with 15mg once daily, the dose may be titrated up to 60mg daily.
- Congestive Heart Failure and Cirrhosis: 15mg to 30mg once daily.
Off-Label Uses
- Polycystic kidney disease: 60mg to 120mg daily in two divided doses.
Who Shouldn't Take Tolvaptan?
- Have hypersensitivity to the drug or components of the formula.
- Have difficulty urinating or are completely unable to urinate.
- Are symptomatic hyponatremia, including encephalopathy.
- Require a medication that inhibits the enzyme CYP 3A.
- Currently taking other V2receptor antagonists.
Advice From The Pharmacist
- You may experience increased thirst and can combat this by drinking plenty of water; this medication is designed to help you urinate more.
- Take this medication with food to avoid an upset stomach.
- Tolvaptan can make you urinate more often, and in larger amounts. You may also wake up at night to urinate. This is normal and should not be a cause for worry.
- Do not stop taking Tolvaptan all of a sudden. Your healthcare provider will likely taper you off to avoid abrupt changes in your sodium levels.
- Tolvaptan can sometimes result in dry mouth; chewing gum, sucking hard candy, or melting ice in your mouth can help.
- Women who are pregnant or breastfeeding should consult their doctor before starting tolvaptan.
- Lastly, ensure regular visits to your healthcare provider. They may need to check your liver function or the sodium levels in your blood.
Side Effects of Tolvaptan
Common Side Effects
- You might feel thirsty often.
- You might have a dry mouth and urinate frequently.
- You might experience constipation and generalized weakness.
Uncommon/Severe Side Effects
- You might get low blood pressure or feel dizzy.
- Severe side effects:
- If you experience rapid weight loss, stomach pain, vomiting, fever, or jaundice, these are serious and you should contact your healthcare provider immediately.
- Your body might respond with an allergic reaction like rash, itching, swelling of the face/tongue/throat, severe dizziness, or trouble breathing, and seek immediate medical attention.
Risks and Warnings of Tolvaptan
- Tolvaptan is not for everyone and should not be used by those who are hypersensitive to it, have anuria (are unable to urinate), or have symptomatic hyponatremia.
- As Tolvaptan may cause significant increases in serum sodium concentrations, closely monitor serum sodium and neurologic status in all patients.
- Tolvaptan is contraindicated in patients with liver disease or potentially caused liver injury; liver function tests should be performed during therapy.
- If you have certain kidney conditions or are undergoing dialysis, consult your healthcare provider before starting Tolvaptan.
- Lastly, remember to stay hydrated while taking Tolvaptan as it works by causing you to urinate more.
Interactions with Tolvaptan
Common Drug Interactions
- CYP3A inhibitors (like ketoconazole, itraconazole, clarithromycin)
- CYP3A inducers (rifampin, phenytoin, St. John's Wort)
Alternatives to Tolvaptan
- Conivaptan
- Demeclocycline
- Lithium
- Vasopressin
