Drug Interaction Report
1 drug interaction and 5 additional warnings found for the following 2 drugs:
- tolvaptan
- trofinetide
Drug interactions
Moderate drug interactions
Moderate:tolvaptan trofinetide
Applies to: tolvaptan, trofinetide
Trofinetide may increase the blood levels and effects of tolvaptan.
Talk to your doctor if you have any questions or concerns.
You may need more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:Food/Lifestyle tolvaptan
Applies to: tolvaptan
You should avoid drinking grapefruit juice during treatment with tolvaptan. Grapefruit juice can cause too much of the medication to be in the blood.
Serious nervous system side effects such as difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, and coma may occur.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
4 potential interactionsApplies to: 3 conditions, including Liver Disease, Alcoholism, and Renal Dysfunction.
Alcoholism
Moderate:tolvaptan
Tolvaptan has a moderate potential interaction with 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.
Liver Disease
Major:tolvaptan
Tolvaptan has a major potential interaction with 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.
Moderate:tolvaptan
Tolvaptan has a moderate potential interaction with Liver Disease.
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.
Renal Dysfunction
Major:tolvaptan
Tolvaptan has a major potential interaction with 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.
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Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.