Herbal Spotlight
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 Taking tolvaptan (Samsca)
Dear Patient,
Your health care provider has prescribed tolvaptan to treat your low sodium levels. This drug helps raise sodium levels by removing extra water in your body as urine. The brand name of this drug is Samsca.
How you'll take tolvaptan
Take this drug about the same time each day. You may take it with or without food.
What to do if you miss a dose
If you miss a dose, take it as soon as you remember. If it's almost time to take the next dose, just skip the missed dose. Don't try to "make up" doses. Don't take more than one dose per day.
What to do about side effects
Notify your health care provider if you experience side effects to this medication.
Common: thirst, dry mouth, weakness, constipation, frequent urination (possibly in large amounts), increased blood sugar levels.
Less common: nausea, loss of appetite, fever, irregular heart beat.
What you must know about other medications
There are drugs that could cause problems if you combine them with tolvaptan. For example, antifungal drugs (fluconazole, ketoconazole, itraconazole), antibiotics (rifampin, rifabutin, rifapentine, clarithromycin, telithromycin, erythromycin), antivirals (saquinavir, nelfinavir, ritonavir), barbiturates, phenytoin, carbamazepine, cyclosporine, and nefazodone may affect drug levels. Taking this drug with digoxin may increase digoxin levels, causing heart problems. St. John's wort may alter levels of this drug. Tell any health care provider who takes care of you that you're taking this drug.
Special directions
- Don't stop or restart this drug; the drug must be restarted in the hospital so sodium levels can be monitored closely.
- Tell your health care provider if you have kidney problems or if you can't feel whether you're thirsty.
- Tell your health care provider if you experience vomiting and diarrhea and can't drink normally or if you feel dizzy or faint.
- Notify your health care provider promptly if you develop bleeding from your gastrointestinal tract or if you experience adverse effects such as elevated blood sugar levels, thirst, dry mouth, weakness, constipation, or frequent urination (possibly in large amounts).
- Don't drink grapefruit juice while taking this drug; doing so could increase drug levels.
- Don't use St. John's wort while taking this drug because it can alter drug levels.
Keep in mind
- It isn't known how this drug could affect an unborn baby. You should use contraceptive measures while taking this drug. If you become pregnant while taking this drug, consult with your health care provider.
- It isn't known if this drug appears in breast milk. Because of the potential for adverse effects, another method of feeding the baby should be used.
- Notify your health care provider if you experience trouble speaking or swallowing, drowsiness, confusion, mood swings, trouble controlling body movement, or seizures, which may signal a serious condition known as osmotic demyelination syndrome.
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