Conivaptan Disease Interactions

The amount of safety data on the use of conivaptan in patients with hypervolemic hyponatremia associated with heart failure is limited. Conivaptan should only be used to raise sodium in such patients after consideration of other treatment options. Caution is advised if using in these patients.

The systemic exposure to unbound conivaptan doubled in subjects with moderate and severe hepatic impairment. Caution is advised in these patients.

The use of conivaptan is not recommended in patients with severe renal impairment (CrCl < 30 mL/min), as there is an unlikely benefit. There is also a high incidence of infusion site phlebitis, which can reduce vascular access sites.

Osmotic demyelination syndrome is a risk associated with overly rapid correction of hyponatremia (> 12 mEq/L/24 hours). This syndrome can result in dysarthria, mutism, dysphagia, lethargy, affective changes, spastic quadriparesis, seizure, coma or death. Patients with advanced liver disease, alcoholism or severe malnutrition are at increased risk and require slower rates of correction. Serum sodium concentration and neurological status should be monitored appropriately during treatment administration. Vasopressin antagonists should be initiated and re- initiated in patients only in hospital settings were sodium levels can be monitored closely.