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Generic Name: tolvaptan (tol VAP tan)
Brand Names:Samsca
Medically reviewed by P. Thornton, DipPharm Last updated on Jun 12, 2019.
What is Samsca?
Samsca (tolvaptan) 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.
Samsca is used to treat hyponatremia (low levels of sodium in your blood) in people with heart failure, and certain hormonal imbalances.
Samsca improves urine flow without causing the body to lose too much sodium as you urinate.
This medication guide provides information about the Samsca brand of tolvaptan. Jynarque is another brand of tolvaptan that is not covered in this medication guide.
Important Information
You should not use Samsca if are unable to urinate, if you are unable to tell when you are thirsty, or if you are severely dehydrated.
You will need to be in a hospital under observation any time you start or restart treatment.
Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.
Tell your caregivers at once if you have signs that your hyponatremia is being reversed too quickly: problems with speech or muscle control, trouble swallowing, trouble moving your arms and legs, confusion, or seizure.
Tolvaptan can cause serious or fatal liver problems. While taking Samsca at home, call your doctor right away if you don’t feel well and you have right-sided upper stomach pain, vomiting, loss of appetite, or yellowing of your skin or eyes.
Before taking this medicine
You should not use Samsca if you are allergic to tolvaptan, or if:
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you are unable to urinate;
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you are unable to tell that you are thirsty;
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you are severely dehydrated and feel like you might pass out; or
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you have autosomal dominant polycystic kidney disease (unless you receive this medicine through a special program that includes frequent liver function tests).
Some medicines can cause unwanted or dangerous effects when used with Samsca. Your doctor may change your treatment plan if you also use:
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nefazodone;
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an antibiotic – clarithromycin, telithromycin;
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antifungal medicine – itraconazole, ketoconazole; or
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HIV/AIDS medication – indinavir, nelfinavir, ritonavir, saquinavir.
To make sure Samsca is safe for you, tell your doctor if:
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kidney disease or urination problems;
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liver problems;
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allergies;
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if you drink large amounts of alcohol;
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if you are malnourished; or
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if you also use desmopressin (dDAVP), or a diuretic or “water pill.”
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant.
You should not breastfeed while using Samsca.
How should I take Samsca?
Samsca is usually given once per day. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.
You will receive your first dose in a hospital or clinic setting to quickly treat any serious side effects.
Long-term use of tolvaptan can damage your liver. You should not use Samsca for longer than 30 days.
You may take this medicine with or without food.
Drink plenty of fluids while taking tolvaptan, but avoid grapefruit juice or alcoholic drinks. Follow your doctor’s instructions about the type and amount of liquids you should drink while treating hyponatremia.
Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Samsca, which can lead to serious side effects.
You will need frequent medical tests.
Store at room temperature away from moisture and heat.
If you stop taking this medicine for any length of time, do not start taking it again at home. You will need to be in a hospital under observation any time you start or restart treatment.
Samsca dosing information
Usual Adult Dose for Hyponatremia:
Initial dose: 15 mg orally once a day
Maintenance dose: Increase the dose to 30 mg once a day, after at least 24 hours, to a maximum of 60 mg once a day, as needed to achieve the desired level of serum sodium.
Maximum dose: 60 mg once a day
Duration of therapy: Maximum of 30 days
Comments:
-During initiation and titration, frequently monitor for changes in serum electrolytes and volume.
-Avoid fluid restriction during the first 24 hours of therapy.
-Patients receiving tolvaptan should be advised that they can continue ingestion of fluid in response to thirst.
-Tolvaptan may be dosed without regard to meals.
Uses: Hypervolemic and euvolemic hyponatremia [serum sodium less than 125 mEq/L or less marked hyponatremia that is symptomatic and has resisted correction with fluid restriction], including patients with heart failure, and Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Usual Adult Dose for Hyponatremia, euvolemic:
Initial dose: 15 mg orally once a day
Maintenance dose: Increase the dose to 30 mg once a day, after at least 24 hours, to a maximum of 60 mg once a day, as needed to achieve the desired level of serum sodium.
Maximum dose: 60 mg once a day
Duration of therapy: Maximum of 30 days
Comments:
-During initiation and titration, frequently monitor for changes in serum electrolytes and volume.
-Avoid fluid restriction during the first 24 hours of therapy.
-Patients receiving tolvaptan should be advised that they can continue ingestion of fluid in response to thirst.
-Tolvaptan may be dosed without regard to meals.
Uses: Hypervolemic and euvolemic hyponatremia [serum sodium less than 125 mEq/L or less marked hyponatremia that is symptomatic and has resisted correction with fluid restriction], including patients with heart failure, and Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call 115.
What should I avoid while taking Samsca?
Avoid alcoholic drinks.
Grapefruit may interact with tolvaptan and lead to unwanted side effects. Avoid the use of grapefruit products.
Samsca side effects
Get emergency medical help if you have signs of an allergic reaction to Samsca : hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers at once if you have any of these signs that your hyponatremia is being reversed too quickly:
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problems with speech or muscle control;
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trouble swallowing;
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trouble moving your arms and legs;
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confusion, mood changes; or
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a seizure.
While taking Samsca at home, call your doctor at once if you have:
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weakness, or a light-headed feeling (like you might pass out);
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liver problems–right-sided upper stomach pain, vomiting, loss of appetite, fever, itching, yellowing of your skin or eyes, not feeling well; or
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dehydration symptoms–feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin.
Common Samsca side effects may include:
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dry mouth;
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increased thirst or urination;
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hunger, fruity breath odor;
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constipation; or
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weakness.
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.
What other drugs will affect Samsca?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Many drugs can interact with tolvaptan, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Samsca only for the indication prescribed.
Copyright 1996-2020 Cerner Multum, Inc. Version: 6.01.
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Medical Disclaimer
The content of Holevn is solely for the purpose of providing information about Thuốc Samsca and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Please contact your nearest doctor or clinic, hospital for advice. We do not accept liability if the patient arbitrarily uses the drug without following a doctor’s prescription.
Reference from: https://www.drugs.com/samsca.html