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Tolvaptan

Also known as: Jynarque, Samsca

Vasopressin V2 Receptor AntagonistVasopressin V2 Receptor Antagonists

Route: Oral

9 interactions on record⛔ Black Box Warning

Tolvaptan has 9 known drug interactions based on U.S. FDA drug labeling data. Of these, 3 are contraindicated combinations that should be avoided entirely. 2 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Desmopressin, Grapefruit Juice, Ketoconazole. Patients taking Tolvaptan should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.

Total: 9
Contraindicated: 3
Major: 2
Moderate: 4

Contraindicated (3)

Tolvaptan + Desmopressin— V2-agonist activity may be interfered with by tolvaptan's V2-receptor antagonism. Concomitant use should be avoided.
Tolvaptan + Grapefruit Juice— CYP3A inhibitor; patients should avoid grapefruit juice beverages while taking tolvaptan.
Tolvaptan + Ketoconazole— Coadministration of ketoconazole with tolvaptan is contraindicated.

Major (2)

Tolvaptan + Cyp3a Inducers— Reduces exposure to tolvaptan. Avoid concomitant use.
Tolvaptan + Mao Inhibitors— Substantial increase in tolvaptan exposure expected. Avoid co-administration.

Moderate (4)

Tolvaptan + Angiotensin Ii— Concomitant use increases hyperkalemia risk by approximately 1-2%. Serum potassium levels should be monitored.
Tolvaptan + Deferasirox— Deferasirox may induce CYP3A4 resulting in decreased tolvaptan concentration. Monitor for reduced effectiveness.
Tolvaptan + Digoxin— Increases digoxin serum concentration by 30% and AUC by 20%. Requires monitoring and dose adjustment.
Tolvaptan + Potassium Supplements— Concomitant use increases hyperkalemia risk by approximately 1-2%. Serum potassium levels should be monitored.

Tolvaptan + Desmopressin⛔Contraindicated

V2-agonist activity may be interfered with by tolvaptan's V2-receptor antagonism. Concomitant use should be avoided.

Tolvaptan + Grapefruit Juice⛔Contraindicated

CYP3A inhibitor; patients should avoid grapefruit juice beverages while taking tolvaptan.

Tolvaptan + Ketoconazole⛔Contraindicated

Coadministration of ketoconazole with tolvaptan is contraindicated.

Tolvaptan + Cyp3a Inducers⚠️Major

Reduces exposure to tolvaptan. Avoid concomitant use.

Tolvaptan + Mao Inhibitors⚠️Major

Substantial increase in tolvaptan exposure expected. Avoid co-administration.

Tolvaptan + Angiotensin Ii🟡Moderate

Concomitant use increases hyperkalemia risk by approximately 1-2%. Serum potassium levels should be monitored.

Tolvaptan + Deferasirox🟡Moderate

Deferasirox may induce CYP3A4 resulting in decreased tolvaptan concentration. Monitor for reduced effectiveness.

Tolvaptan + Digoxin🟡Moderate

Increases digoxin serum concentration by 30% and AUC by 20%. Requires monitoring and dose adjustment.

Tolvaptan + Potassium Supplements🟡Moderate

Concomitant use increases hyperkalemia risk by approximately 1-2%. Serum potassium levels should be monitored.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.