tolvaptan

tolvaptan

Pronunciation: tol VAP tan

Brand: Samsca

What is the most important information I should know about tolvaptan?

Multum donot

You should not use this medication if you are allergic to tolvaptan, if you are unable to urinate, if you are unable to tell that you are thirsty, or if you are severely dehydrated and feel like you might pass out.

You may need to stop taking certain drugs while you are taking tolvaptan. Tell your doctor about all other medications you use. Your doctor will tell you if any of your medications need to be changed while taking tolvaptan.

Also tell your doctor if you have kidney disease, severe liver disease or cirrhosis, if you have been drinking large amounts of alcohol, or if you are malnourished.

Multum emt

You will receive your first few doses of tolvaptan in a hospital setting where your heart rhythm can be monitored, in case the medication causes serious side effects.

Multum emt

If you stop taking tolvaptan for any length of time, do not start taking it again at home. You will need to be in a hospital under observation any time you start or restart treatment with tolvaptan.

Tell your caregivers at once if you have any of these signs that your hyponatremia is being reversed too quickly: problems with speech or muscle control, trouble swallowing, trouble moving your arms and legs, mood changes, and seizure (convulsions).

What is tolvaptan?

Tolvaptan reduces the level of a hormone that regulates the balance of water and salt (sodium) in the body. High levels of this hormone can cause an imbalance that results in low sodium levels and fluid retention.

Tolvaptan is used to treat hyponatremia (low levels of sodium in your blood) in people with heart failure, liver disease, and certain hormonal imbalances. Tolvaptan improves urine flow without causing the body to lose too much sodium as you urinate.

Tolvaptan may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before taking tolvaptan?

Multum donot

You should not use this medication if you are allergic to tolvaptan, if you are unable to urinate, if you are unable to tell that you are thirsty, or if you are severely dehydrated and feel like you might pass out.

Many drugs can interact with tolvaptan and some should not be used at the same time. Tell your doctor about all other medications you use, especially:

  • conivaptan;
  • imatinib;
  • isoniazid (for treating tuberculosis);
  • nefazodone;
  • an antibiotic--clarithromycin, telithromycin;
  • antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;
  • heart or blood pressure medication--nicardipine or quinidine;
  • the hepatitis C medications boceprevir or telaprevir; or
  • HIV/AIDS medication--atazanavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir.

Your doctor will tell you if any of your medications need to be changed while taking tolvaptan.

To make sure tolvaptan is safe for you, tell your doctor about your other medical conditions, especially:

  • severe liver disease (especially cirrhosis);
  • kidney disease;
  • if you are malnourished; or
  • if you have been drinking large amounts of alcohol.
Multum nopreg

FDA pregnancy category C. It is not known whether tolvaptan will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Multum nobrfeed

It is not known whether tolvaptan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using tolvaptan.

How should I take tolvaptan?

Tolvaptan is usually given once per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Multum emt

You will receive your first few doses of tolvaptan in a hospital setting where your heart rhythm can be monitored, in case the medication causes serious side effects.

Your doctor may occasionally change your dose to make sure you get the best results.

You may take tolvaptan with or without food.

Multum water

Take this medicine with a full glass (8 ounces) of water. Drink plenty of fluids during the first 24 hours of treatment with tolvaptan. It is best to drink something as soon as you feel thirsty, but avoid alcoholic drinks. Follow your doctor's instructions about the type and amount of liquids you should drink while treating hyponatremia. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

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Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medication, which can lead to serious side effects.

To be sure this medication is helping your condition, you may need frequent blood tests. You may not notice any change in your symptoms, but your blood work will help your doctor determine how long to treat you with tolvaptan.

Multum donot

If you stop taking tolvaptan for any length of time, do not start taking it again at home. You will need to be in a hospital under observation any time you start or restart treatment with tolvaptan.

Multum rt

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Multum emt

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking tolvaptan?

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Avoid alcoholic drinks.

Grapefruit and grapefruit juice may interact with tolvaptan and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

What are the possible side effects of tolvaptan?

Multum emt

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Multum donot

Tell your caregivers at once if you have any of these signs that your hyponatremia is being reversed too quickly:

  • problems with speech or muscle control;
  • trouble swallowing;
  • trouble moving your arms and legs;
  • mood changes; and
  • seizure (convulsions).
Multum calldoc

Stop using tolvaptan and call your doctor at once if you have:

  • weakness or fainting;
  • black, bloody, or tarry stools;
  • coughing up blood or vomit that looks like coffee grounds;
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
  • dehydration (feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin).

Common side effects may include:

  • dry mouth;
  • increased thirst or urination;
  • constipation; or
  • loss of appetite, fruity breath odor, drowsiness, dry skin, nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect tolvaptan?

Many drugs can interact with tolvaptan. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with tolvaptan, especially:

  • aprepitant;
  • bosentan;
  • cimetidine;
  • cyclosporine;
  • desmopressin;
  • haloperidol;
  • rifabutin, rifapentine, rifampin;
  • St. John's wort;
  • an ACE inhibitor--benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril;
  • an antibiotic--azithromycin, ciprofloxacin, doxycycline, erythromycin, metronidazole, nafcillin, norfloxacin, tetracycline;
  • an antidepressant--desipramine, sertraline;
  • antifungal medication--clotrimazole, fluconazole;
  • a beta blocker--atenolol, carvedilol, labetalol, metoprolol, nadolol, nebivolol, propranolol, sotalol;
  • heart or blood pressure medication--amiodarone, azilsartan, candesartan, carvedilol, diltiazem, dronedarone, eprosartan, felodipine, irbesartan, lidocaine, losartan, olmesartan, quinidine, ranolazine, telmisartan, valsartan, verapamil;
  • HIV or AIDS medicine--atazanavir, fosamprenavir, efavirenz, darunavir when given with ritonavir, lopinavir, nevirapine, saquinavir; or
  • seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone.

This list is not complete and many other drugs can interact with tolvaptan. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about tolvaptan.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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