conivaptan

Generic Name: conivaptan (koe NYE vap tan)
Brand Name: Vaprisol

What is conivaptan?

Conivaptan reduces the level of a hormone that regulates the balance of water and salt (sodium) in the body. High levels of this hormone can cause an imbalance that results in low sodium levels and fluid retention.

Conivaptan is used to treat hyponatremia (low sodium levels). Conivaptan improves urine flow without causing the body to lose too much sodium as you urinate.

Conivaptan may also be used for purposes than those listed in this medication guide.

What is the most important information I should know about conivaptan?

You should not receive this medication if you are allergic to conivaptan or corn products, or if you are unable to urinate.

Before you receive conivaptan, tell your doctor if you have congestive heart failure, liver disease, kidney disease, alcoholism, or if you are malnourished.

To be sure this medicine is helping your condition, your blood will need to be tested often.

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Tell your caregivers at once if you have a serious side effect such as confusion, extreme thirst, muscle weakness or limp feeling, trouble speaking or swallowing, mood changes, or swelling or discomfort where the IV needle is placed.

There are many other drugs that should not be used together with conivaptan, including certain antibiotics or antifungal medicines, heart or blood pressure medication, and HIV/AIDS medicine.

Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

What should I discuss with my health care provider before receiving conivaptan?

You should not receive this medication if you are allergic to conivaptan or corn products, or if you are unable to urinate.

You should not use conivaptan if you are using any of the following drugs:

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), or telithromycin (Ketek);

  • an antidepressant such as nefazodone;

  • antifungal medication such as clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Nizoral), or voriconazole (Vfend);

  • heart or blood pressure medication such as diltiazem (Cartia, Cardizem), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others; or

  • HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra).

To make sure you can safely receive conivaptan, tell your doctor if you have any of these other conditions:

  • congestive heart failure;

  • liver disease;

  • kidney disease;

  • alcoholism; or

  • if you are malnourished.

FDA pregnancy category C. It is not known whether conivaptan will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether conivaptan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are receiving conivaptan.

How is conivaptan given?

Conivaptan is injected into a vein through an IV. You will receive this injection in a hospital setting. Conivaptan is given through an IV line and a needle placed into one of your large veins (such as in your upper chest).

Conivaptan is infused around-the-clock for up to 4 days. This medication is usually given only in a hospital.

Because conivaptan can irritate the skin or vein when the medicine enters the body, your IV needle will be moved to a different vein every 24 hours.

To be sure this medicine is helping your condition, your blood will need to be tested often.

What happens if I miss a dose?

Since conivaptan is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while receiving conivaptan?

Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Conivaptan side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers at once if you have a serious side effect such as:

  • feeling like you might pass out;

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);

  • trouble speaking, trouble swallowing, weakness, mood changes, muscle spasm or weakness in your arms and legs, seizure;

  • pain, redness, or swelling where the IV needle is placed;

  • swelling, rapid weight gain; or

  • pain or burning when you urinate.

Less serious side effects may include:

  • mild fever;

  • headache;

  • diarrhea; or

  • vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Conivaptan Dosing Information

Usual Adult Dose for SIADH:

For hospitalized patients:
loading dose: 20 mg in 100 mL of 5% dextrose intravenously over 30 minutes. The loading dose should be followed by 20 mg in 250 mL of 5% dextrose administered in a continuous intravenous infusion over 24 hours. Following the initial day of treatment, conivaptan is to be administered for an additional 1 to 3 days in a continuous infusion of 20 mg per day. If serum sodium is not rising at the desired rate, conivaptan may be titrated upward to a dose of 40 mg daily administered in a continuous intravenous infusion. The total duration of infusion of conivaptan (after the loading dose) should not exceed four days. .

Usual Adult Dose for Hyponatremia, euvolemic:

For hospitalized patients:
loading dose: 20 mg in 100 mL of 5% dextrose intravenously over 30 minutes. The loading dose should be followed by 20 mg in 250 mL of 5% dextrose administered in a continuous intravenous infusion over 24 hours. Following the initial day of treatment, conivaptan is to be administered for an additional 1 to 3 days in a continuous infusion of 20 mg per day. If serum sodium is not rising at the desired rate, conivaptan may be titrated upward to a dose of 40 mg daily administered in a continuous intravenous infusion. The total duration of infusion of conivaptan (after the loading dose) should not exceed four days. .

What other drugs will affect conivaptan?

Many drugs can interact with conivaptan. Below is just a partial list. Tell your doctor if you are using:

  • digoxin (Lanoxin);

  • an antibiotic such as doxycycline (Doryx, Oracea, Periostat, Vibramycin), rifampin (Rifater, Rifadin, Rifamate), rifabutin (Mycobutin), tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap), or trimethoprim (Proloprim, Bactrim, Septra, SMX-TMP);

  • anti-malaria medication;

  • an antidepressant;

  • anti-psychotic medication;

  • asthma or allergy medication such as albuterol (Proventil, Ventolin), budesonide (Pulmicort, Rhinocort), fluticasone (Flonase, Flovent), montelukast (Singulair), theophylline (Elixophyllin, Theo-24, Uniphyl);

  • a beta-blocker such as bisoprolol (Zebeta, Ziac);

  • cancer medicine such as bortezomib (Velcade), busulfan, docetaxel (Taxotere), doxorubicin (Adriamycin), exemestane (Aromasin), etoposide (VePesid, Toposar), flutamide (Eulexin), ifosfamide (Ifex), irinotecan (Camptosar), letrozole (Femara), paclitaxel (Taxol), tamoxifen (Soltamox), teniposide (Vumon), vinorelbine (Navelbine), vincristine (Oncovin, Vincasar), vinblastine (Velban);

  • cholesterol-lowering drugs such as atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev, Advicor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Simcor, Vytorin);

  • diabetes medication such as nateglinide (Starlix), pioglitazone (Actos), repaglinide (Prandin);

  • erectile dysfunction medicine;

  • ergot medicines such as D.H.E. 45, Ergomar, Cafergot, Ergotrate, Methergine, Migergot, or Migranal;

  • heart or blood pressure medications such as amiodarone (Cordarone, Pacerone), amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), disopyramide (Norpace), enalapril (Vasotec), isradipine (Dynacirc), losartan (Cozaar, Hyzaar), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), quinidine (Quin-G);

  • HIV medicines such as efavirenz (Sustiva, Atripla), nevirapine (Viramune), or tipranavir (Aptivus);

  • medicines used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf);

  • narcotic medications;

  • a sedative such as clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), and others;

  • seizure medication; or

  • stomach acid reducers such as lansoprazole (Prevacid), ondansetron (Zofran), rabeprazole (AcipHex).

This list is not complete and there are many other drugs that can interact with conivaptan. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about conivaptan.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2011-11-10, 3:21:24 PM.

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