Tolvaptan
Uses of Tolvaptan
The primary use of Tolvaptan is to manage hyponatremia (low blood sodium levels) associated with conditions such as heart failure, liver cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH). It belongs to the group of vasopressin receptor 2 antagonists.
Additionally, it is used in slowing down kidney function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD).
Side effects of Tolvaptan
Thirst
Dry mouth
Weakness (asthenia)
Constipation
Frequent urination (pollakiuria or polyuria)
How Tolvaptan works
Tolvaptan is a vasopressin receptor 2 antagonist.
It works by selectively preventing vasopressin, which is an antidiuretic hormone, from binding to V2 receptors in the kidneys. This prevents the formation of aquaporin-2 water channels and reduces water reabsorption in the collecting ducts of the kidneys.
Certified content
Written By
Doctor of Medicine
Reviewed By
BMS, FMC, MD Resident
Expert Advice
Dosage Forms Available
Tolvaptan can be taken orally (tablet).
Age and Dose Restrictions
This medicine is meant for adults aged 18 and above.
Contraindications
Tolvaptan should not be taken by individuals who have an urgent need to raise serum sodium levels acutely. It is also contraindicated in patients who have a lack of ability to sense or respond to thirst. The concomitant use of Tolvaptan with strong CYP 3A inhibitors is contraindicated.
Other Medications to Avoid
Tolvaptan can interact with strong CYP 3A inhibitors (such as ketoconazole and ritonavir), strong CYP3A inducers (such as rifampin and phenytoin) and V2 agonists (such as desmopressin).
Overdose and Missed Dose
Overdose of Tolvaptan may lead to an excessively rapid correction of hyponatremia, resulting in serious complications such as osmotic demyelination syndrome. If you suspect an overdose, seek medical attention immediately.
If you miss a dose of Tolvaptan, take it as soon as you remember. However, if it's nearly time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for the missed one.
Management of Side Effects
Most side effects of Tolvaptan are temporary and generally harmless, resolving when the medicine is discontinued. However, if you experience any severe side effects or worsening of symptoms, please consult your doctor.
For common side effects like dry mouth or thirst, try drinking small amounts of water throughout the day.
Regular rest and relaxation techniques may help manage feelings of weakness or fatigue.
Use in Driving and Operating Machinery
Tolvaptan may cause dizziness or weakness in some individuals. If you feel affected, avoid driving or operating heavy machinery.
Use in Pregnancy and Lactation
Tolvaptan is not recommended for use during pregnancy or while breastfeeding. Consult your doctor before using this medicine if you are pregnant or nursing.
Caution in Other Conditions
Patients with liver diseases, including cirrhosis, should exercise caution when taking Tolvaptan, as it can cause serious liver injury.
Special Dietary and Lifestyle Recommendations
It is important to listen to your body's signals for thirst while taking Tolvaptan. Consuming sufficient amounts of fluid is advised to prevent dehydration.
Frequently asked questions
Is Tolvaptan a steroid?
No, Tolvaptan is not a steroid. It belongs to the class of medicines known as vasopressin receptor 2 antagonists.
Does Tolvaptan have any effect on sleep?
Tolvaptan is not directly associated with affecting sleep. However, it increases urine production which might lead to frequent urination, potentially disturbing your sleep.
Will Tolvaptan affect fertility?
Tolvaptan is not directly associated with affecting fertility. However, always consult your doctor if you have concerns regarding this.
Is it safe to take Tolvaptan daily?
Yes, it is safe to take Tolvaptan daily as prescribed by your doctor.
How much time does Tolvaptan take to work?
The time it takes Tolvaptan to show its effect may vary depending on the condition being managed and the individual patient's response.
Is Tolvaptan available over the counter, or do I need a prescription?
Tolvaptan is a prescription medicine and is not available over the counter.
What is the best time to take Tolvaptan?
Tolvaptan can be taken at any time of the day, but it should be taken at the same time every day for consistent results and effectiveness.
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