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Tolvaptan

Also known as: Tolvaptan

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. For informational purposes only. Always consult your pharmacist or physician.