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Drug Interactions between conivaptan and Jynarque

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

conivaptan tolvaptan

Applies to: conivaptan and Jynarque (tolvaptan)

GENERALLY AVOID: Coadministration with conivaptan may significantly increase the plasma concentrations of drugs that are primarily metabolized by CYP450 3A4. Conivaptan is a mechanism-based inhibitor of CYP450 3A4. In pharmacokinetic studies with drugs that primarily undergo metabolism by CYP450 3A4 such as midazolam, simvastatin and amlodipine, conivaptan 30 to 40 mg/day has increased systemic exposure (AUC) by 2- to 3-fold.

MANAGEMENT: Concomitant use of conivaptan with sensitive CYP450 3A4 substrates or those that demonstrate a narrow therapeutic index should generally be avoided. Subsequent treatment with CYP450 3A4 substrates may be initiated no sooner than 1 week after completion of conivaptan treatment.

References (1)
  1. (2006) "Product Information. Vaprisol (conivaptan)." Cumberland Pharmaceuticals Inc

Drug and food interactions

Moderate

tolvaptan food

Applies to: Jynarque (tolvaptan)

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of tolvaptan. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. According to the product labeling, administration of tolvaptan with grapefruit juice resulted in a 1.8-fold increase in tolvaptan systemic exposure. The clinical significance is unknown, although increased pharmacologic effects may be expected. Too rapid correction of hyponatremia increases the risk of osmotic demyelination syndrome, which is associated with dysarthria, mutism, dysphagia, lethargy, affective changes, spastic quadriparesis, seizures, coma, and death.

MANAGEMENT: Patients treated with tolvaptan should avoid consumption of grapefruits and grapefruit juice.

References (1)
  1. (2009) "Product Information. Samsca (tolvaptan)." Otsuka American Pharmaceuticals Inc

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Vasopressin antagonists

Therapeutic duplication

The recommended maximum number of medicines in the 'vasopressin antagonists' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'vasopressin antagonists' category:

  • conivaptan
  • Jynarque (tolvaptan)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer