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Tolvaptan is used to treat low levels of salt (sodium) in the blood, which can result from conditions such as heart failure and certain hormone imbalances.

How it works

Tolvaptan is a diuretic and belongs to a class of drugs known as vasopressin receptor antagonists. It works by increasing the amount of urine you make, causing your body to get rid of extra water. This helps to slowly increase the normal levels of salt (sodium) in the blood.

Common side effects

Nausea, Excessive thirst, Frequent urge to urinate, Abnormal urination, Abdominal pain, Constipation, Dark colored urine, Diarrhoea, Fainting, Dizziness, Dry mouth, Fatigue, Headache, Itching, Loss of appetite, Feeling of discomfort, Vomiting, Yellow discoloration of skin


Expert advice

  • Do not eat grapefruit or drink grapefruit juice while taking this medication. If you stop taking tolvaptan 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 with tolvaptan.
  • Consult your doctor immediately if you have any of these signs: problems with speech or muscle control, trouble swallowing, trouble moving your arms and legs, mood changes, and seizure (convulsions).
Do not start or continue tolvaptan:
  • if you are allergic to tolvaptan, or to any of the other ingredients of this medicine.
  • if your kidneys do not work (no urine production).
  • if you have a condition which increases the salt in your blood (“hypernatraemia”).
  • if you have a condition which is associated with a very low blood volume.
  • if you do not realise when you are thirsty.
  • if you are pregnant or breastfeeding.
Talk with your doctor before taking tolvaptan:
  • if you cannot drink enough water or if you are fluid restricted.
  • if you have difficulties in urination or have an enlarged prostate.
  • if you suffer from liver disease.
  • if you have diabetes.

Frequently asked questions


Q. Is tolvaptan / samsca a diuretic?
Samscais brand name of tolvaptan and it is a diuretic.
Q. Does tolvaptan work in pkd-Polycystic kidney disease?
Yes. Recently it is found that tolvaptan can slow the development and progression of polycystic kidney disease in animal models.

Content on this page was last updated on 18 October, 2016, by Dr. Varun Gupta (MD Pharmacology)