What is Tolvaptan?

Tolvaptan is a medication a doctor may choose to prescribe to a patient with low sodium levels. The drug will increase the retention of sodium to keep levels stable and safe. Patients with heart or kidney damage along with a condition called syndrome of inappropriate antidiuretic hormone may need treatment with tolvaptan to address low sodium. One potentially serious complication of this medication is a rapid increase in sodium levels, leading to nerve damage. It is important for patients to take the medication carefully and to report any side effects to their doctors.

This medication works in the kidneys to encourage them to eliminate urine while retaining sodium. Over time, this will lead to an increase in sodium levels. Patients on tolvaptan need to avoid grapefruit and grapefruit juice because they can interact negatively with the medication. Other drugs, including herbal and over-the-counter remedies, could also potentially be dangerous. Patients should discuss their drug regimens with their doctors when they meet to discuss the prescription, in addition to taking notes about how and when the medication should be taken.

Tolvaptan side effects can include abdominal pain, fatigue, dilute urine, thirst, and internal bleeding. Patients need to drink water whenever they are thirsty, and to make sure that water is readily available while they are on the drug. It is also important to have access to a bathroom because the drug can cause frequent urination. A doctor will usually recommend regular blood tests to monitor the patient's hyponatremia or low calcium, with the goal of identifying the point when the patient's calcium levels are stable and high enough for safety.

High sodium levels can cause symptoms like difficulty speaking, tremors, and trouble swallowing. If patients notice these signs of nerve damage, they need to speak with a doctor. The doctor can run some tests and evaluate the patient to decide how to proceed with treatment. Sometimes, nerve damage onsets gradually and a patient may not notice; if friends and family spot tell-tale signs of nerve damage, it is important to bring it up so the patient can receive medical treatment as quickly as possible.

Doctors may start treatment with tolvaptan in a hospital so they can monitor their patients and adjust the dosage and timing as needed. Patients taking the medication at home must be consistent about dosing and should keep the drug in a cool, dry place out of reach of children and pets, as it can be dangerous. If it is ingested by accident, a doctor or veterinarian can provide advice on what to do.