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At a glance

Tolvaptan is indicated for hypervolemic or euvolemic hyponatremia and autosomal dominant polycystic kidney disease. It is a selective vasopressin V2-receptor antagonist.

Indications
  • Hypervolemic or euvolemic hyponatremia
  • Autosomal dominant polycystic kidney disease (ADPKD)
Pharmacology

Tolvaptan antagonizes vasopressin at V2-receptors, increasing free water clearance (aquaresis), decreasing urine osmolality, and increasing serum sodium concentrations. Urinary excretion of sodium and potassium and plasma potassium concentrations are not significantly changed.

Dosage

Adult Dose (Oral):

  • Hyponatremia: Initial 15 mg once daily; increase to 30 mg once daily, then 60 mg once daily as needed; do not use for more than 30 days
  • ADPKD: Initial 60 mg/day (45 mg upon wakening + 15 mg 8 hours later); titrate to 90 mg/day, then 120 mg/day
Side effects

Common Side Effects:

  • Thirst
  • Dry mouth
  • Weakness
  • Constipation
  • Making large amounts of urine and urinating often
  • Increased blood sugar levels
Use in pregnancy

Use in Pregnancy: Contraindicated; animal studies show reproductive toxicity; do not use during pregnancy.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Too rapid correction of serum sodium can cause serious neurologic sequelae
  • Risk of hepatotoxicity; do not use for more than 30 days
  • Maintain adequate hydration
  • Contraindicated in pregnancy
Overdose effects

Symptoms: Rise in serum sodium, polyuria, thirst, dehydration/hypovolemia.

Treatment: Assess vital signs, electrolytes, ECG, fluid status; replace water and electrolytes.

Storage conditions

Store below 25°C in a dry place, protected from light; keep out of reach of children.

Tolvaptan — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.