Tolvamac is indicated in patients for the treatment of patients with hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Tolvamac is also indicated for hypervolemic and euvolemic hyponatremia (sodium concentration <125 mmol l–1) in patients with heart failure and cirrhosis. In this US country use this medicine frequently.
Tolvaptan is a kind of selective and competitive arginine vasopressin receptor 2 antagonist.
Vasopressin performs action on the V2 receptors found in the walls of the vasculature and luminal membranes of renal collecting ducts. By blocking V2 receptors in the renal collecting ducts, aquaporins do not go inside themselves into the walls hence prohibiting water absorption.
This action basically results in a rise in urine volume, lesser the urine osmolality, and increase electrolyte-free water clearance to decrease intravascular volume and a higher serum sodium levels. Tolvaptan is essentially required for heart failure patients as they have higher serum levels of vasopressin.
Ingredients : Tolvaptan
Strength : 15mg
Package : 10 tablets in 1 strips
Tolvamac tablet is Indicated for adults with clinically significant euvolemic or hypervolemic hyponatremia (serum sodium <125 mEq/L or less marked hyponatremia which is symptomatic and has opposed correction with fluid restriction), contains patients with heart failure, cirrhosis, and SIADH Initial: 15 mg PO qDay Maintenance: May increase to 30 mg qDay after at least 24 hr to achieve the optimal serum sodium level; not to exceed 60 mg/day Not to exceed 30 days of treatmentPolycystic Kidney Disease
In this case Tolvamac tablet Indicated to slow kidney function reduce in adults at harm of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD) Initial: 45 mg PO taken on waking and 15 mg taken 8 hr later (ie, 60 mg/day) Advice the patients to drink enough water to avoid thirst or dehydration Administration of Tolvamac should be without food Grape juice should be avoided during therapy with TolvamacOVERDOSE
Administrating monotherapy oral doses up to 480 mg and multiple doses up to 300 mg once in a day for 5 days have been well accepted in studies in healthy subjects. There is no essential antitoxin for Tolvamac intoxication. The signs and symptoms of an acute overdose can be expected to be those of extra pharmacologic effect: an increase in serum sodium concentration, polyuria, thirst, and dehydration / hypovolemia.
The conditions like Hypernatremia, hypovolemia, and/or dehydration; provoke patient to drink whenever thirsty
Risk of potassium level increased
Tolvamac 15mg produce Osmotic demyelination syndrome is a harm along with too-fast correction of hyponatremia
Tolvamac 15mg can develops serious and likely fatal liver injury; acute liver failure needed liver transplantation reported; discontinue if laboratory abnormalities or signs or symptoms of liver injury are apparent.