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Samsca (tolvaptan) Disease Interactions

There are 3 disease interactions with Samsca (tolvaptan):


Tolvaptan (Includes Samsca) ↔ Renal Impairment

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

There are no clinical trials of tolvaptan in patients with CrCl < 10 mL/min, and because drug effects on serum sodium levels are likely lost at very low levels of renal function, use in these patients is not recommended. Additionally, no benefit can be expected in anuric patients, so the use of tolvaptan is contraindicated in these patients.


Tolvaptan (Includes Samsca) ↔ Liver Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Tolvaptan can cause serious and potentially fatal liver injury. Patients with symptoms that indicate liver injury such as fatigue, anorexia, right upper abdominal pain, dark urine or jaundice should discontinue treatment right away. Therapy duration should be limited to 30 days. The use of tolvaptan should be avoided in patients with underlying liver disease, including cirrhosis, because the ability to recover from liver injury may be impaired.


Vasopressin Antagonists (Includes Samsca) ↔ Liver Disease/Alcoholism

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Alcoholism

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.

Samsca (tolvaptan) drug Interactions

There are 286 drug interactions with Samsca (tolvaptan)

Samsca (tolvaptan) alcohol/food Interactions

There is 1 alcohol/food interaction with Samsca (tolvaptan)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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