Generic Name and Formulations:
Tolvaptan 15mg, 30mg; tabs.
Otsuka America Pharmaceutical, Inc.
Indications for SAMSCA:
Clinically significant euvolemic and hypervolemic hyponatremia (serum sodium <125mEq/L or less marked hyponatremia that is symptomatic and has resisted correction with fluid restriction), including patients with heart failure and syndrome of inappropriate antidiuretic hormone (SIADH). Limitations of use: not for urgent serum sodium correction to prevent or treat serious neurological symptoms.
Initiate and re-initiate only in a hospital. Initially 15mg once daily, may increase dose after ≥24hrs to 30mg once daily, then to max 60mg once daily as needed to raise serum sodium. Max therapy: 30 days duration. Avoid fluid restriction during the first 24hrs of therapy; resume fluid restriction after drug discontinuation.
Urgent need to raise serum sodium acutely. Inability of patient to sense or appropriately respond to thirst. Hypovolemic hyponatremia. Concomitant strong CYP3A inhibitors (eg, clarithromycin, ketoconazole, itraconazole, ritonavir, indinavir, nelfinavir, saquinavir, nefazodone, telithromycin). Anuric patients.
Risk of osmotic demyelination syndrome; discontinue or interrupt therapy if too rapid a rise in serum sodium occurs (eg, >12mEq/L/24hrs). Severe malnutrition, alcoholism, or advanced liver disease: slower rates of correction advisable. Avoid in patients with underlying liver disease, including cirrhosis; discontinue if symptoms of liver injury develop. Severe renal impairment (CrCl<10mL/min): not recommended. Monitor frequently for changes in serum sodium, volume and neurologic status during initiation and titration. Monitor serum potassium in patients with K+ >5mEq/L or on drugs known to increase potassium. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. Potentiated by CYP3A inhibitors, grapefruit juice; avoid moderate CYP3A inhibitors (eg, erythromycin, fluconazole, aprepitant, diltiazem, verapamil). Antagonized by CYP3A inducers (eg, rifampin, rifabutin, rifapentin, barbiturates, phenytoin, carbamazepine, St. John's wort); avoid; if given, may need to increase tolvaptan dose. Concomitant P-gp inhibitors (eg, cyclosporine); consider reducing tolvaptan dose. May potentiate digoxin. Concomitant hypertonic saline or V2 agonist (desmopressin): not recommended. Concomitant diuretics increases the risk of too rapid correction of sodium; monitor serum sodium closely.
Selective vasopressin V2-receptor antagonist.
Thirst, dry mouth, asthenia, constipation, pollakiuria, polyuria, hyperglycemia; osmotic demyelination syndrome, liver injury (may be fatal), hypovolemia (discontinue or interrupt if significant), hyperkalemia.
- Neurotoxicity After CAR T-cell Therapy May Be Associated With Endothelial Activation
- Navigation Programs Most Effective in Increasing Follow-up Colonoscopy
- New Class of Clinical Trial Enhances Research on Cancer Care Delivery
- Specialized Interventions Reduce Aberrant Opioid Behaviors in Cancer Patients
- Nivolumab Provides Better Long-Term Efficacy Compared With Docetaxel in NSCLC
- Anticancer Properties of The Probiotic Kefir: A Review
- Navigating the Transition From Treatment to Breast Cancer Survivor
- Combining Radiation, Immunotherapy: An Emerging Challenge for Oncology Nursing
- Naldemedine Effective for Opioid-Induced Constipation in Cancer Pain
- Disruptions to Circadian Rhythm Linked to Prostate Cancer Surgery Regret
- Novel Predictive Model More Effectively Identifies Risk for Lung Cancer
- Long-Term Eltrombopag Increases Platelet Counts, Decreases Bleeding in ITP
- Overall Survival Increase for Melanoma Brain Metastases
- Prophylactic Prochloperazine Ineffective for Opioid-induced Nausea/Vomiting in Cancer
Sign Up for Free e-newsletters
Regimen and Drug Listings
GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION
|Head and Neck Cancer||Regimens||Drugs|