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Molecule Description

Tolvaptan is a medicine used to treat hyponatremia (low blood sodium/ salt level).

Uses of Tolvaptan

  • Treat hyponatremia in people with heart failure and vasopressin hormonal imbalance
  • Polycystic kidney disease

Contraindications of Tolvaptan

When should one not use Tolvaptan

  • You are allergic to Tolvaptan
  • You have conditions such as kidney problems, being unable to urinate, severe dehydration and being unable to tell whether or not you are thirsty, you must not take this medicine
  • You have too high or too low blood sodium
  • You have diabetes

Side effects of Tolvaptan

Common side effects of this drug are:

  • Diarrhea or constipation
  • Dry mouth
  • Increased thirst
  • Increased urination
  • Nausea
  • Weakness
  • Dizziness
  • Dry skin
  • Decreased appetite
  • Acute liver failure
  • Neurologic: Osmotic demyelination syndrome

Precautions and Warnings of Tolvaptan


Can I take Tolvaptan during pregnancy?
Use of this medicine has to be avoided if you are pregnant or planning a pregnancy.

Breast Feeding

Can I take Tolvaptan while breastfeeding?
Use of this medicine has to be avoided if you are breastfeeding.


Can I drive if I have consumed Tolvaptan?
Dizziness, tiredness has been reported with the use of Tolvaptan. If this happens to you, please do not drive until you feel well.


Can I consume alcohol with Tolvaptan?
Alcohol should be avoided while taking Tolvaptan, as both may increase dizziness.

Other General Warnings

Talk to your doctor if
  • You suffer from liver disease
  • You cannot drink enough water or you have to restrict your fluid intake
  • Taking this medicine causes water loss because it increases your urine production. It is necessary to drink sufficient amount of water whenever you feel thirsty
  • You have difficulties urinating or have an enlarged prostate
  • You suffer from too high or too low blood sodium
  • You have diabetes
  • You have high levels of a chemical called uric acid in your blood (which may have caused attacks of gout)

Mode of Action of Tolvaptan

How Does It Work?

Tolvaptan acts by blocking the vasopressin receptor-2, which is found in the walls of the blood vessels and collecting ducts of kidneys. Vasopressin is the hormone that acts on these receptors by blocking V2 receptors; Tolvaptan prevents the water absorption from kidneys. This action ultimately increases urine output, reduce water volume in blood vessels and thereby increase the serum sodium levels.
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Interactions of Tolvaptan

Interactions with other medicines

  • ACE inhibitors (such as Lisinopril), angiotensin receptor blocker (such as Losartan) as these medicines may increase the blood potassium levels
  • Carbamazepine, Hydantoins (such as Phenytoin), Phenobarbital, Primidone, Rifamycins (such as Rifabutin, Rifampin, Rifapentine) or St. John's wort as these medications may decrease Tolvaptan's desirable effect
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Interactions with food items

  • Do not eat grapefruit or drink grapefruit juice while taking the medication of Tolvaptan
  • This food may cause too much concentration of Tolvaptan in blood that results in side effects such as difficulty in swallowing, trouble to speaking, weakness to muscle, trouble for controlling body movements, confusion, mood changes, seizures and sometimes coma
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Dietary Restrictions of Tolvaptan

No information is available on dietary restrictions while you are taking Tolvaptan. Consult your doctor or pharmacist for further information.

Dosage of Tolvaptan


The overdose of tolvaptan may present with severe symptoms such as fainting, trouble in breathing, excessive urination, very low blood pressure and dehydration. Contact your doctor immediately if you suspect overdose.
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Missed a Dose

Take the missed dose as early as you remember. If it is almost time for the next dose, then skip the missed dose and continue with next regular dose. Do not take a dose twice to compensate for a missed one.
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Content Details


Dr. Abhishek B L

MBBS, MD (Pharmacology)


Dr. Ritu Budania

MBBS, MD (Pharmacology)

Frequently Asked Questions (FAQs)


Q: What should I tell my healthcare expert before starting the medication of Tolvaptan?

A: Give a detailed account of your medical and surgical history. Also, mention to your doctor all the prescription and non-prescription medicines, herbal preparations and nutritional supplements that you may be taking before starting this medication.

Q: What special precautions should be taken while on this medication?

A: Take this drug with caution, if you are a diabetic patient as it may raise the blood sugar level. It must be used with caution in children.

Q: When and how to consume the medicine?

A: Take medicine orally with or without food as directed by your doctor. Take this medicine with a full glass (about 230ml.) of water.
Last Updated on: 05 Oct 2020 | 10:47 PM (IST)

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The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts. Please click here for detailed T&C.
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