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Tolvaptan Disease Interactions

There are 3 disease interactions with tolvaptan.

Major

Tolvaptan (applies to tolvaptan) liver impairment

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Tolvaptan can cause serious and potentially fatal liver injury. Patients with symptoms that indicate liver injury such as fatigue, anorexia, right upper abdominal pain, dark urine or jaundice should discontinue treatment right away. Therapy duration should be limited to 30 days. The use of tolvaptan should be avoided in patients with underlying liver disease, including cirrhosis, because the ability to recover from liver injury may be impaired.

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Major

Tolvaptan (applies to tolvaptan) renal impairment

Major Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

There are no clinical trials of tolvaptan in patients with CrCl < 10 mL/min, and because drug effects on serum sodium levels are likely lost at very low levels of renal function, use in these patients is not recommended. Additionally, no benefit can be expected in anuric patients, so the use of tolvaptan is contraindicated in these patients.

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Moderate

Vasopressin antagonists (applies to tolvaptan) liver disease/alcoholism

Moderate Potential Hazard, Moderate plausibility.

Osmotic demyelination syndrome is a risk associated with overly rapid correction of hyponatremia (> 12 mEq/L/24 hours). This syndrome can result in dysarthria, mutism, dysphagia, lethargy, affective changes, spastic quadriparesis, seizure, coma or death. Patients with advanced liver disease, alcoholism or severe malnutrition are at increased risk and require slower rates of correction. Serum sodium concentration and neurological status should be monitored appropriately during treatment administration. Vasopressin antagonists should be initiated and re- initiated in patients only in hospital settings were sodium levels can be monitored closely.

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Tolvaptan drug interactions

There are 338 drug interactions with tolvaptan.

Tolvaptan alcohol/food interactions

There is 1 alcohol/food interaction with tolvaptan.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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