Tolvaptan

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Jynarque; Samsca

Brand Names: Canada

Jinarc; Samsca

Warning

For all uses of this drug:

  • Severe and sometimes deadly liver problems have happened with this drug. Sometimes, people using this drug to slow the progress of kidney problems have needed a liver transplant. If you have questions, talk with the doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

For treating low sodium levels:

  • Start and restart this drug in a hospital setting where your sodium levels will be closely watched. Very bad and sometimes deadly effects may happen from fixing low sodium levels too fast. The chance is raised in people with poor nutrition, very bad liver disease, or alcohol addiction. Call your doctor right away if you have signs like trouble speaking or swallowing, feeling sleepy, confusion, mood changes, trouble controlling body movements, muscle weakness, and seizures.
  • This form of this drug is not for use to slow the progress of kidney problems. If you have questions, talk with your doctor.

What is this drug used for?

  • It is used to treat low sodium levels.
  • It is used to slow the progress of kidney problems in some people.

What do I need to tell my doctor BEFORE I take this drug?

For all uses of this drug:

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you cannot tell when you are thirsty or you are not able to drink normally.
  • If you are dehydrated, talk with your doctor.
  • If you have ever had liver problems.
  • If you have trouble passing urine.
  • If you have been told that your body has problems with certain sugars (lactose, glucose, galactose).
  • If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for HIV, infections, or depression. There are many drugs that must not be taken with this drug. Your doctor or pharmacist can tell you if you are taking a drug that must not be taken with this drug.
  • If you are breast-feeding. Do not breast-feed while you take this drug.

For treating low sodium levels:

  • If you have kidney problems.
  • If you have a low sodium level that needs raised right away. Talk with your doctor.

For slowing the progress of kidney problems:

  • If you have a high or low sodium level.
  • If you have other types of kidney problems.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

For all uses of this drug:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Do not use more than what your doctor told you to use. Do not use more often or longer than what you were told. Doing any of these things may raise the chance of very bad side effects.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • Avoid grapefruit and grapefruit juice.
  • If diarrhea happens or you are throwing up, call your doctor. You will need to drink more fluids to keep from losing too much fluid.
  • It is not known if this drug may cause harm to an unborn baby. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks to you and the baby.

For treating low sodium levels:

  • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

For all uses of this drug:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of fluid and electrolyte problems like mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or passing out, increased thirst, seizures, feeling very tired or weak, decreased appetite, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or severe upset stomach or throwing up.
  • Dizziness.
  • Weight loss.
  • Trouble walking.
  • Fever.

For treating low sodium levels:

  • Signs of high blood sugar like confusion, feeling sleepy, unusual thirst or hunger, passing urine more often, flushing, fast breathing, or breath that smells like fruit.
  • Black, tarry, or bloody stools.
  • Throwing up blood or throw up that looks like coffee grounds.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

For all uses of this drug:

  • Unusual thirst.
  • Feeling tired or weak.
  • Dry mouth.
  • Passing urine more often.
  • Upset stomach.

For treating low sodium levels:

  • Constipation.

For slowing the progress of kidney problems:

  • Diarrhea.
  • Decreased appetite.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.
  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
  • You will need to avoid getting dehydrated while taking this drug. Drink lots of water to avoid getting thirsty. This includes drinking if you feel thirsty, drinking during the day, and drinking at night if you are awake unless your doctor says otherwise. If you are not sure how to avoid getting dehydrated, talk with your doctor.

What do I do if I miss a dose?

For treating low sodium levels:

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.
  • If you miss taking this drug for a few days in a row, call your doctor before you start taking it again.

For slowing the progress of kidney problems:

  • Skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2021-05-10

Copyright

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Last Updated

Monday, December 12, 2022