You are using an unsupported browser. Please upgrade your browser to a newer version to get the best experience on DrugBank.
Identification
NameTolvaptan
Accession NumberDB06212
TypeSmall Molecule
GroupsApproved
DescriptionTolvaptan is used to treat low blood sodium levels (hyponatremia) associated with various conditions like congestive heart failure, cirrhosis, and syndrome of inappropriate antidiuretic hormones (SIADH). FDA approved on May 19, 2009.
Structure
Thumb
Synonyms
Samsca
External Identifiers
  • OPC-41061
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Samscatablet30 mgOral useOtsuka Pharmaceutical Europe Ltd.2009-08-03Not applicableEu
Samscatablet15 mg/1oralOtsuka America Pharmaceutical Inc.2009-05-19Not applicableUs
Samscatablet60 mgoralOtsuka Pharmaceutical Co LtdNot applicableNot applicableCanada
Samscatablet30 mgOral useOtsuka Pharmaceutical Europe Ltd.2009-08-03Not applicableEu
Samscatablet30 mg/1oralOtsuka America Pharmaceutical Inc.2009-05-19Not applicableUs
Samscatablet15 mgOral useOtsuka Pharmaceutical Europe Ltd.2009-08-03Not applicableEu
Samscatablet15 mgoralOtsuka Pharmaceutical Co Ltd2011-09-22Not applicableCanada
Samscatablet15 mgOral useOtsuka Pharmaceutical Europe Ltd.2009-08-03Not applicableEu
Samscatablet30 mgoralOtsuka Pharmaceutical Co Ltd2011-09-22Not applicableCanada
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixtures
NameLabellerIngredients
JinarcOtsuka Pharmaceutical Co Ltd
SaltsNot Available
Categories
UNII21G72T1950
CAS number150683-30-0
WeightAverage: 448.941
Monoisotopic: 448.155370383
Chemical FormulaC26H25ClN2O3
InChI KeyInChIKey=GYHCTFXIZSNGJT-XMMPIXPASA-N
InChI
InChI=1S/C26H25ClN2O3/c1-16-6-3-4-7-20(16)25(31)28-19-10-11-21(17(2)14-19)26(32)29-13-5-8-24(30)22-15-18(27)9-12-23(22)29/h3-4,6-7,9-12,14-15,24,30H,5,8,13H2,1-2H3,(H,28,31)/t24-/m1/s1
IUPAC Name
N-{4-[(5R)-7-chloro-5-hydroxy-2,3,4,5-tetrahydro-1H-1-benzazepine-1-carbonyl]-3-methylphenyl}-2-methylbenzamide
SMILES
CC1=CC=CC=C1C(=O)NC1=CC(C)=C(C=C1)C(=O)N1CCC[C@@H](O)C2=C1C=CC(Cl)=C2
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as n-phenylbenzamides. These are benzamides that are N-linked to a phenyl group via the carboxamide group.
KingdomOrganic compounds
Super ClassBenzenoids
ClassBenzene and substituted derivatives
Sub ClassBenzamides
Direct ParentN-phenylbenzamides
Alternative Parents
Substituents
  • N-phenylbenzamide
  • Benzazepine
  • N-arylamide
  • Aminobenzoic acid or derivatives
  • Benzoic acid or derivatives
  • Aminotoluene
  • Benzoyl
  • Toluene
  • Chlorobenzene
  • Azepine
  • Aryl halide
  • Aryl chloride
  • Tertiary amine
  • Secondary carboxylic acid amide
  • Secondary alcohol
  • Carboxamide group
  • Azacycle
  • Organoheterocyclic compound
  • Carboxylic acid derivative
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Organochloride
  • Organohalogen compound
  • Carbonyl group
  • Amine
  • Alcohol
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available
Pharmacology
IndicationTreatment of symptomatic and resistant to fluid restriction euvolemic or hypervolemic hyponatremia associated with congestive heart failure, SIADH, and cirrhosis.
PharmacodynamicsUrine volume and fluid intake increase in a dose dependent manner which results in overall negative fluid balance in patients taking tolvaptan. Increases in serum sodium and osmolality can be observed 4-8 hours post-administration and is maintained for 24 hours. The magnitude of serum sodium and osmolality change increases with escalating doses. Furthermore, a decrease in urine osmolality and increase in free water clearance can be observed 4 hours after post-administration of tolvaptan. The affinity for V2 receptors is 29x greater than that of V1a receptors and does not have any appreciable affinity for V2 receptors.
Mechanism of actionTolvaptan is a selective and competitive arginine vasopressin receptor 2 antagonist. Vasopressin acts 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 insert themselves into the walls thus preventing water absorption. This action ultimately results in an increase in urine volume, decrease urine osmolality, and increase electrolyte-free water clearance to reduce intravascular volume and an increase serum sodium levels. Tolvaptan is especially useful for heart failure patients as they have higher serum levels of vasopressin.
Related Articles
AbsorptionTmax, Healthy subjects: 2 - 4 hours; Cmax, Healthy subjects, 30 mg: 374 ng/mL; Cmax, Healthy subjects, 90 mg: 418 ng/mL; Cmax, heart failure patients, 30 mg: 460 ng/mL; Cmax, heart failure patients, 90 mg: 723 ng/mL; AUC(0-24 hours), 60 mg: 3.71 μg·h/mL; AUC(∞), 60 mg: 4.55 μg·h/mL; The pharmacokinetic properties of tolvaptan are stereospecific, with a steady-state ratio of the S-(-) to the R-(+) enantiomer of about 3. The absolute bioavailability of tolvaptan is unknown. At least 40% of the dose is absorbed as tolvaptan or metabolites. Food does not impact the bioavailability of tolvaptan.
Volume of distribution

Healthy subjects: 3L/kg; slightly higher in heart failure patients.

Protein binding99% bound
Metabolism

Metabolism exclusively by CYP3A4 enzyme in the liver. Metabolites are inactive.

Route of eliminationFecal- very little renal elimination (<1% is excreted unchanged in the urine)
Half lifeTerminal half life, oral dose = 12 hours.
Clearance

4 mL/min/kg (post-oral dosing).

ToxicityThe oral LD50 of tolvaptan in rats and dogs is >2000 mg/kg. Most common adverse reactions (≥5% placebo) are thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, and hyperglycemia.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.961
Blood Brain Barrier+0.8429
Caco-2 permeable-0.5116
P-glycoprotein substrateSubstrate0.6765
P-glycoprotein inhibitor IInhibitor0.5241
P-glycoprotein inhibitor IINon-inhibitor0.5525
Renal organic cation transporterNon-inhibitor0.767
CYP450 2C9 substrateNon-substrate0.7217
CYP450 2D6 substrateNon-substrate0.7662
CYP450 3A4 substrateSubstrate0.7372
CYP450 1A2 substrateNon-inhibitor0.7512
CYP450 2C9 inhibitorNon-inhibitor0.7214
CYP450 2D6 inhibitorNon-inhibitor0.7887
CYP450 2C19 inhibitorNon-inhibitor0.5308
CYP450 3A4 inhibitorInhibitor0.8545
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.5874
Ames testNon AMES toxic0.7247
CarcinogenicityNon-carcinogens0.8623
BiodegradationNot ready biodegradable0.9939
Rat acute toxicity2.2269 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9807
hERG inhibition (predictor II)Inhibitor0.682
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
Tabletoral
Tabletoral15 mg/1
Tabletoral15 mg
Tabletoral30 mg
Tabletoral30 mg/1
Tabletoral60 mg
TabletOral use15 mg
TabletOral use30 mg
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5258510 No1993-11-022010-11-02Us
US5753677 No2000-05-192020-05-19Us
US8501730 No2006-09-012026-09-01Us
Properties
StateSolid
Experimental PropertiesNot Available
Predicted Properties
PropertyValueSource
Water Solubility0.00124 mg/mLALOGPS
logP4.14ALOGPS
logP5.35ChemAxon
logS-5.6ALOGPS
pKa (Strongest Acidic)11.76ChemAxon
pKa (Strongest Basic)-2.1ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area69.64 Å2ChemAxon
Rotatable Bond Count3ChemAxon
Refractivity129.16 m3·mol-1ChemAxon
Polarizability48.16 Å3ChemAxon
Number of Rings4ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
References
Synthesis Reference

Bandi Parthasaradhi Reddy, “PROCESS FOR PREPARING TOLVAPTAN INTERMEDIATES.” U.S. Patent US20130190490, issued July 25, 2013.

US20130190490
General References
  1. Gheorghiade M, Teerlink JR, Mebazaa A: Pharmacology of new agents for acute heart failure syndromes. Am J Cardiol. 2005 Sep 19;96(6A):68G-73G. [PubMed:16181825 ]
  2. Ambrosy A, Goldsmith SR, Gheorghiade M: Tolvaptan for the treatment of heart failure: a review of the literature. Expert Opin Pharmacother. 2011 Apr;12(6):961-76. doi: 10.1517/14656566.2011.567267. Epub 2011 Mar 15. [PubMed:21401442 ]
  3. Yi S, Jeon H, Yoon SH, Cho JY, Shin SG, Jang IJ, Yu KS: Pharmacokinetics and pharmacodynamics of oral tolvaptan administered in 15- to 60-mg single doses to healthy Korean men. J Cardiovasc Pharmacol. 2012 Apr;59(4):315-22. doi: 10.1097/FJC.0b013e318241e89c. [PubMed:22130104 ]
  4. Nemerovski C, Hutchinson DJ: Treatment of hypervolemic or euvolemic hyponatremia associated with heart failure, cirrhosis, or the syndrome of inappropriate antidiuretic hormone with tolvaptan: a clinical review. Clin Ther. 2010 Jun;32(6):1015-32. doi: 10.1016/j.clinthera.2010.06.015. [PubMed:20637957 ]
External Links
ATC CodesC03XA01
AHFS Codes
  • 40:28.28
PDB EntriesNot Available
FDA labelDownload (468 KB)
MSDSDownload (103 KB)
Interactions
Drug Interactions
Drug
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Tolvaptan.
AcetaminophenThe serum concentration of Tolvaptan can be increased when it is combined with Acetaminophen.
Acetylsalicylic acidThe serum concentration of Acetylsalicylic acid can be increased when it is combined with Tolvaptan.
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Tolvaptan.
AlbendazoleThe serum concentration of Tolvaptan can be increased when it is combined with Albendazole.
AldosteroneThe serum concentration of Tolvaptan can be decreased when it is combined with Aldosterone.
AldosteroneThe serum concentration of Aldosterone can be increased when it is combined with Tolvaptan.
AlectinibThe serum concentration of Tolvaptan can be increased when it is combined with Alectinib.
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Tolvaptan.
AlitretinoinThe serum concentration of Alitretinoin can be increased when it is combined with Tolvaptan.
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Alphacetylmethadol is combined with Tolvaptan.
AmantadineThe serum concentration of Tolvaptan can be increased when it is combined with Amantadine.
AmbrisentanThe serum concentration of Ambrisentan can be increased when it is combined with Tolvaptan.
AmilorideTolvaptan may increase the hyperkalemic activities of Amiloride.
Aminohippuric acidThe serum concentration of Tolvaptan can be increased when it is combined with Aminohippuric acid.
AmiodaroneThe serum concentration of Tolvaptan can be increased when it is combined with Amiodarone.
AmitriptylineThe serum concentration of Tolvaptan can be increased when it is combined with Amitriptyline.
AmlodipineThe serum concentration of Tolvaptan can be increased when it is combined with Amlodipine.
AmprenavirThe serum concentration of Tolvaptan can be decreased when it is combined with Amprenavir.
AmsacrineThe serum concentration of Tolvaptan can be increased when it is combined with Amsacrine.
ApixabanThe serum concentration of Apixaban can be increased when it is combined with Tolvaptan.
AprepitantThe serum concentration of Tolvaptan can be increased when it is combined with Aprepitant.
Arsenic trioxideThe serum concentration of Arsenic trioxide can be increased when it is combined with Tolvaptan.
AstemizoleThe serum concentration of Tolvaptan can be increased when it is combined with Astemizole.
AtazanavirThe serum concentration of Tolvaptan can be increased when it is combined with Atazanavir.
AtenololThe serum concentration of Tolvaptan can be increased when it is combined with Atenolol.
AtomoxetineThe serum concentration of Tolvaptan can be increased when it is combined with Atomoxetine.
AtorvastatinThe serum concentration of Tolvaptan can be increased when it is combined with Atorvastatin.
AxitinibThe serum concentration of Axitinib can be increased when it is combined with Tolvaptan.
AzelastineThe serum concentration of Tolvaptan can be increased when it is combined with Azelastine.
Azilsartan medoxomilTolvaptan may increase the hyperkalemic activities of Azilsartan medoxomil.
AzithromycinThe serum concentration of Tolvaptan can be increased when it is combined with Azithromycin.
BenazeprilTolvaptan may increase the hyperkalemic activities of Benazepril.
BenzocaineThe serum concentration of Tolvaptan can be increased when it is combined with Benzocaine.
BepridilThe serum concentration of Tolvaptan can be increased when it is combined with Bepridil.
BetamethasoneThe serum concentration of Betamethasone can be increased when it is combined with Tolvaptan.
BexaroteneThe serum concentration of Tolvaptan can be decreased when it is combined with Bexarotene.
BezitramideThe risk or severity of adverse effects can be increased when Bezitramide is combined with Tolvaptan.
BiperidenThe serum concentration of Tolvaptan can be increased when it is combined with Biperiden.
BoceprevirThe serum concentration of Tolvaptan can be increased when it is combined with Boceprevir.
BortezomibThe serum concentration of Tolvaptan can be increased when it is combined with Bortezomib.
BosentanThe serum concentration of Tolvaptan can be decreased when it is combined with Bosentan.
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Tolvaptan.
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Tolvaptan.
BromocriptineThe serum concentration of Tolvaptan can be increased when it is combined with Bromocriptine.
BuprenorphineThe risk or severity of adverse effects can be increased when Buprenorphine is combined with Tolvaptan.
BuspironeThe serum concentration of Tolvaptan can be increased when it is combined with Buspirone.
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Tolvaptan.
CabazitaxelThe serum concentration of Tolvaptan can be increased when it is combined with Cabazitaxel.
CaffeineThe serum concentration of Tolvaptan can be increased when it is combined with Caffeine.
CamptothecinThe serum concentration of Camptothecin can be increased when it is combined with Tolvaptan.
CanagliflozinThe serum concentration of Canagliflozin can be increased when it is combined with Tolvaptan.
CandesartanTolvaptan may increase the hyperkalemic activities of Candesartan.
CandesartanThe serum concentration of Tolvaptan can be increased when it is combined with Candesartan.
CandoxatrilTolvaptan may increase the hyperkalemic activities of Candoxatril.
CaptoprilTolvaptan may increase the hyperkalemic activities of Captopril.
CaptoprilThe serum concentration of Tolvaptan can be increased when it is combined with Captopril.
CarbamazepineThe serum concentration of Tolvaptan can be decreased when it is combined with Carbamazepine.
CarbamazepineThe serum concentration of Carbamazepine can be increased when it is combined with Tolvaptan.
CarfentanilThe risk or severity of adverse effects can be increased when Carfentanil is combined with Tolvaptan.
CarfilzomibThe serum concentration of Carfilzomib can be increased when it is combined with Tolvaptan.
CarvedilolThe serum concentration of Tolvaptan can be increased when it is combined with Carvedilol.
CaspofunginThe serum concentration of Tolvaptan can be increased when it is combined with Caspofungin.
CeritinibThe serum concentration of Tolvaptan can be increased when it is combined with Ceritinib.
CerivastatinThe serum concentration of Cerivastatin can be increased when it is combined with Tolvaptan.
ChloroquineThe serum concentration of Tolvaptan can be increased when it is combined with Chloroquine.
ChlorpromazineThe serum concentration of Tolvaptan can be increased when it is combined with Chlorpromazine.
ChlorpropamideThe serum concentration of Tolvaptan can be increased when it is combined with Chlorpropamide.
ChlorprothixeneThe serum concentration of Tolvaptan can be increased when it is combined with Chlorprothixene.
CholesterolThe serum concentration of Tolvaptan can be increased when it is combined with Cholesterol.
Cholic AcidThe serum concentration of Tolvaptan can be decreased when it is combined with Cholic Acid.
CilazaprilTolvaptan may increase the hyperkalemic activities of Cilazapril.
CilazaprilThe serum concentration of Tolvaptan can be increased when it is combined with Cilazapril.
CimetidineThe serum concentration of Tolvaptan can be decreased when it is combined with Cimetidine.
CimetidineThe serum concentration of Cimetidine can be increased when it is combined with Tolvaptan.
CiprofloxacinThe serum concentration of Tolvaptan can be increased when it is combined with Ciprofloxacin.
CisplatinThe serum concentration of Cisplatin can be increased when it is combined with Tolvaptan.
CitalopramThe serum concentration of Tolvaptan can be increased when it is combined with Citalopram.
ClarithromycinThe serum concentration of Tolvaptan can be increased when it is combined with Clarithromycin.
ClemastineThe serum concentration of Tolvaptan can be increased when it is combined with Clemastine.
ClobazamThe serum concentration of Clobazam can be increased when it is combined with Tolvaptan.
ClofazimineThe serum concentration of Tolvaptan can be increased when it is combined with Clofazimine.
ClomifeneThe serum concentration of Clomifene can be increased when it is combined with Tolvaptan.
ClomipramineThe serum concentration of Tolvaptan can be increased when it is combined with Clomipramine.
ClonidineThe serum concentration of Clonidine can be increased when it is combined with Tolvaptan.
ClopidogrelThe serum concentration of Clopidogrel can be increased when it is combined with Tolvaptan.
ClotrimazoleThe serum concentration of Tolvaptan can be increased when it is combined with Clotrimazole.
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Tolvaptan.
CobicistatThe serum concentration of Tolvaptan can be increased when it is combined with Cobicistat.
CobimetinibThe serum concentration of Cobimetinib can be increased when it is combined with Tolvaptan.
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Tolvaptan.
ColchicineThe serum concentration of Tolvaptan can be increased when it is combined with Colchicine.
ColforsinThe serum concentration of Tolvaptan can be increased when it is combined with Colforsin.
ConivaptanThe serum concentration of Tolvaptan can be increased when it is combined with Conivaptan.
Conjugated Equine EstrogensThe serum concentration of Conjugated Equine Estrogens can be increased when it is combined with Tolvaptan.
CrizotinibThe serum concentration of Tolvaptan can be increased when it is combined with Crizotinib.
CyclophosphamideThe serum concentration of Tolvaptan can be increased when it is combined with Cyclophosphamide.
CyclosporineThe serum concentration of Tolvaptan can be increased when it is combined with Cyclosporine.
Dabigatran etexilateThe serum concentration of Dabigatran etexilate can be increased when it is combined with Tolvaptan.
DabrafenibThe serum concentration of Tolvaptan can be decreased when it is combined with Dabrafenib.
DabrafenibThe serum concentration of Dabrafenib can be increased when it is combined with Tolvaptan.
DaclatasvirThe serum concentration of Tolvaptan can be increased when it is combined with Daclatasvir.
DactinomycinThe serum concentration of Tolvaptan can be increased when it is combined with Dactinomycin.
DapagliflozinThe serum concentration of Dapagliflozin can be increased when it is combined with Tolvaptan.
DarunavirThe serum concentration of Tolvaptan can be increased when it is combined with Darunavir.
DasatinibThe serum concentration of Tolvaptan can be increased when it is combined with Dasatinib.
DaunorubicinThe serum concentration of Tolvaptan can be decreased when it is combined with Daunorubicin.
DaunorubicinThe serum concentration of Daunorubicin can be increased when it is combined with Tolvaptan.
DebrisoquinThe serum concentration of Debrisoquin can be increased when it is combined with Tolvaptan.
DeferasiroxThe serum concentration of Tolvaptan can be decreased when it is combined with Deferasirox.
DelavirdineThe serum concentration of Tolvaptan can be increased when it is combined with Delavirdine.
DesipramineThe serum concentration of Tolvaptan can be increased when it is combined with Desipramine.
DesloratadineThe serum concentration of Tolvaptan can be increased when it is combined with Desloratadine.
DesmopressinThe therapeutic efficacy of Desmopressin can be decreased when used in combination with Tolvaptan.
DexamethasoneThe serum concentration of Tolvaptan can be decreased when it is combined with Dexamethasone.
DexamethasoneThe serum concentration of Dexamethasone can be increased when it is combined with Tolvaptan.
DextromethorphanThe serum concentration of Tolvaptan can be increased when it is combined with Dextromethorphan.
DextromoramideThe risk or severity of adverse effects can be increased when Dextromoramide is combined with Tolvaptan.
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Tolvaptan.
DezocineThe risk or severity of adverse effects can be increased when Dezocine is combined with Tolvaptan.
DiazepamThe serum concentration of Diazepam can be increased when it is combined with Tolvaptan.
DiclofenacThe serum concentration of Tolvaptan can be increased when it is combined with Diclofenac.
DiethylstilbestrolThe serum concentration of Diethylstilbestrol can be increased when it is combined with Tolvaptan.
DigitoxinThe serum concentration of Digitoxin can be increased when it is combined with Tolvaptan.
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Tolvaptan.
DigoxinThe serum concentration of Tolvaptan can be decreased when it is combined with Digoxin.
DihydrocodeineThe risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Tolvaptan.
DihydroergotamineThe serum concentration of Tolvaptan can be increased when it is combined with Dihydroergotamine.
DihydroetorphineThe risk or severity of adverse effects can be increased when Dihydroetorphine is combined with Tolvaptan.
DihydromorphineThe risk or severity of adverse effects can be increased when Dihydromorphine is combined with Tolvaptan.
DihydrotestosteroneThe serum concentration of Dihydrotestosterone can be increased when it is combined with Tolvaptan.
DiltiazemThe serum concentration of Tolvaptan can be increased when it is combined with Diltiazem.
DiphenoxylateThe risk or severity of adverse effects can be increased when Diphenoxylate is combined with Tolvaptan.
DipyridamoleThe serum concentration of Tolvaptan can be increased when it is combined with Dipyridamole.
DocetaxelThe serum concentration of Docetaxel can be increased when it is combined with Tolvaptan.
DomperidoneThe serum concentration of Domperidone can be increased when it is combined with Tolvaptan.
DoxazosinThe serum concentration of Tolvaptan can be increased when it is combined with Doxazosin.
DoxepinThe serum concentration of Tolvaptan can be increased when it is combined with Doxepin.
DoxorubicinThe serum concentration of Tolvaptan can be decreased when it is combined with Doxorubicin.
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Tolvaptan.
DoxycyclineThe serum concentration of Tolvaptan can be increased when it is combined with Doxycycline.
DPDPEThe risk or severity of adverse effects can be increased when DPDPE is combined with Tolvaptan.
DronabinolThe serum concentration of Tolvaptan can be increased when it is combined with Dronabinol.
DronedaroneThe serum concentration of Tolvaptan can be increased when it is combined with Dronedarone.
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Tolvaptan.
EfavirenzThe serum concentration of Tolvaptan can be decreased when it is combined with Efavirenz.
ElbasvirThe serum concentration of Tolvaptan can be increased when it is combined with Elbasvir.
EletriptanThe serum concentration of Eletriptan can be increased when it is combined with Tolvaptan.
EnalaprilTolvaptan may increase the hyperkalemic activities of Enalapril.
EnalaprilThe serum concentration of Tolvaptan can be increased when it is combined with Enalapril.
EnalaprilatTolvaptan may increase the hyperkalemic activities of Enalaprilat.
EnzalutamideThe serum concentration of Tolvaptan can be decreased when it is combined with Enzalutamide.
EpinastineThe serum concentration of Epinastine can be increased when it is combined with Tolvaptan.
EplerenoneTolvaptan may increase the hyperkalemic activities of Eplerenone.
EprosartanTolvaptan may increase the hyperkalemic activities of Eprosartan.
ErgonovineThe serum concentration of Tolvaptan can be increased when it is combined with Ergonovine.
ErgotamineThe serum concentration of Tolvaptan can be increased when it is combined with Ergotamine.
ErlotinibThe serum concentration of Erlotinib can be increased when it is combined with Tolvaptan.
ErythromycinThe serum concentration of Tolvaptan can be increased when it is combined with Erythromycin.
Eslicarbazepine acetateThe serum concentration of Tolvaptan can be decreased when it is combined with Eslicarbazepine acetate.
EstradiolThe serum concentration of Estradiol can be increased when it is combined with Tolvaptan.
EstramustineThe serum concentration of Tolvaptan can be increased when it is combined with Estramustine.
EstriolThe serum concentration of Tolvaptan can be decreased when it is combined with Estriol.
EstriolThe serum concentration of Estriol can be increased when it is combined with Tolvaptan.
EstroneThe serum concentration of Tolvaptan can be decreased when it is combined with Estrone.
EstroneThe serum concentration of Estrone can be increased when it is combined with Tolvaptan.
Ethinyl EstradiolThe serum concentration of Ethinyl Estradiol can be increased when it is combined with Tolvaptan.
EthylmorphineThe risk or severity of adverse effects can be increased when Ethylmorphine is combined with Tolvaptan.
EtoposideThe serum concentration of Tolvaptan can be increased when it is combined with Etoposide.
EtorphineThe risk or severity of adverse effects can be increased when Etorphine is combined with Tolvaptan.
EtravirineThe serum concentration of Tolvaptan can be decreased when it is combined with Etravirine.
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Tolvaptan.
EzetimibeThe serum concentration of Ezetimibe can be increased when it is combined with Tolvaptan.
FelodipineThe serum concentration of Tolvaptan can be increased when it is combined with Felodipine.
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Tolvaptan.
FesoterodineThe serum concentration of Fesoterodine can be increased when it is combined with Tolvaptan.
FexofenadineThe serum concentration of Tolvaptan can be increased when it is combined with Fexofenadine.
FidaxomicinThe serum concentration of Fidaxomicin can be increased when it is combined with Tolvaptan.
FluconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Fluconazole.
FluoxetineThe serum concentration of Tolvaptan can be increased when it is combined with Fluoxetine.
FlupentixolThe serum concentration of Tolvaptan can be increased when it is combined with Flupentixol.
FluphenazineThe serum concentration of Tolvaptan can be increased when it is combined with Fluphenazine.
FlurazepamThe serum concentration of Tolvaptan can be increased when it is combined with Flurazepam.
Fluticasone furoateThe serum concentration of Fluticasone furoate can be increased when it is combined with Tolvaptan.
FluvoxamineThe serum concentration of Tolvaptan can be increased when it is combined with Fluvoxamine.
ForasartanTolvaptan may increase the hyperkalemic activities of Forasartan.
FosamprenavirThe serum concentration of Tolvaptan can be increased when it is combined with Fosamprenavir.
FosaprepitantThe serum concentration of Tolvaptan can be increased when it is combined with Fosaprepitant.
FosinoprilTolvaptan may increase the hyperkalemic activities of Fosinopril.
FosphenytoinThe serum concentration of Tolvaptan can be decreased when it is combined with Fosphenytoin.
Fusidic AcidThe serum concentration of Tolvaptan can be increased when it is combined with Fusidic Acid.
GefitinibThe serum concentration of Tolvaptan can be increased when it is combined with Gefitinib.
GemcitabineThe serum concentration of Gemcitabine can be increased when it is combined with Tolvaptan.
GenisteinThe serum concentration of Tolvaptan can be increased when it is combined with Genistein.
GlyburideThe serum concentration of Tolvaptan can be increased when it is combined with Glyburide.
GlycerolThe serum concentration of Tolvaptan can be increased when it is combined with Glycerol.
Gramicidin DThe serum concentration of Tolvaptan can be increased when it is combined with Gramicidin D.
GrazoprevirThe serum concentration of Grazoprevir can be increased when it is combined with Tolvaptan.
GrepafloxacinThe serum concentration of Tolvaptan can be increased when it is combined with Grepafloxacin.
HaloperidolThe serum concentration of Tolvaptan can be increased when it is combined with Haloperidol.
HeroinThe risk or severity of adverse effects can be increased when Heroin is combined with Tolvaptan.
HydrocodoneThe risk or severity of adverse effects can be increased when Hydrocodone is combined with Tolvaptan.
HydrocortisoneThe serum concentration of Tolvaptan can be increased when it is combined with Hydrocortisone.
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Tolvaptan.
IbuprofenThe serum concentration of Ibuprofen can be increased when it is combined with Tolvaptan.
IdelalisibThe serum concentration of Tolvaptan can be increased when it is combined with Idelalisib.
ImatinibThe serum concentration of Tolvaptan can be increased when it is combined with Imatinib.
ImipramineThe serum concentration of Tolvaptan can be increased when it is combined with Imipramine.
IndacaterolThe serum concentration of Indacaterol can be increased when it is combined with Tolvaptan.
IndinavirThe serum concentration of Tolvaptan can be increased when it is combined with Indinavir.
IndomethacinThe serum concentration of Tolvaptan can be increased when it is combined with Indomethacin.
IrbesartanTolvaptan may increase the hyperkalemic activities of Irbesartan.
IrinotecanThe serum concentration of Irinotecan can be increased when it is combined with Tolvaptan.
IsavuconazoniumThe serum concentration of Tolvaptan can be increased when it is combined with Isavuconazonium.
IsradipineThe serum concentration of Tolvaptan can be increased when it is combined with Isradipine.
ItraconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Itraconazole.
IvacaftorThe serum concentration of Tolvaptan can be increased when it is combined with Ivacaftor.
IvermectinThe serum concentration of Tolvaptan can be increased when it is combined with Ivermectin.
KetamineThe serum concentration of Tolvaptan can be increased when it is combined with Ketamine.
KetazolamThe serum concentration of Ketazolam can be increased when it is combined with Tolvaptan.
KetobemidoneThe risk or severity of adverse effects can be increased when Ketobemidone is combined with Tolvaptan.
KetoconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Ketoconazole.
LamivudineThe serum concentration of Lamivudine can be increased when it is combined with Tolvaptan.
LamotrigineThe serum concentration of Lamotrigine can be increased when it is combined with Tolvaptan.
LansoprazoleThe serum concentration of Tolvaptan can be increased when it is combined with Lansoprazole.
LapatinibThe serum concentration of Tolvaptan can be increased when it is combined with Lapatinib.
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Tolvaptan.
LenalidomideThe serum concentration of Lenalidomide can be increased when it is combined with Tolvaptan.
LenvatinibThe serum concentration of Lenvatinib can be increased when it is combined with Tolvaptan.
LevetiracetamThe serum concentration of Levetiracetam can be increased when it is combined with Tolvaptan.
LevofloxacinThe serum concentration of Tolvaptan can be increased when it is combined with Levofloxacin.
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Levomethadyl Acetate is combined with Tolvaptan.
LevomilnacipranThe serum concentration of Levomilnacipran can be increased when it is combined with Tolvaptan.
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Tolvaptan.
LevothyroxineThe serum concentration of Tolvaptan can be decreased when it is combined with Levothyroxine.
LidocaineThe serum concentration of Tolvaptan can be increased when it is combined with Lidocaine.
LinagliptinThe serum concentration of Linagliptin can be increased when it is combined with Tolvaptan.
LiothyronineThe serum concentration of Tolvaptan can be decreased when it is combined with Liothyronine.
LiotrixThe serum concentration of Tolvaptan can be decreased when it is combined with Liotrix.
LisinoprilTolvaptan may increase the hyperkalemic activities of Lisinopril.
LisinoprilThe serum concentration of Tolvaptan can be increased when it is combined with Lisinopril.
LofentanilThe risk or severity of adverse effects can be increased when Lofentanil is combined with Tolvaptan.
LomitapideThe serum concentration of Tolvaptan can be increased when it is combined with Lomitapide.
LoperamideThe serum concentration of Tolvaptan can be increased when it is combined with Loperamide.
LopinavirThe serum concentration of Tolvaptan can be increased when it is combined with Lopinavir.
LoratadineThe serum concentration of Tolvaptan can be increased when it is combined with Loratadine.
LosartanTolvaptan may increase the hyperkalemic activities of Losartan.
LosartanThe serum concentration of Tolvaptan can be increased when it is combined with Losartan.
LovastatinThe serum concentration of Tolvaptan can be increased when it is combined with Lovastatin.
LuliconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Luliconazole.
LumacaftorThe serum concentration of Tolvaptan can be decreased when it is combined with Lumacaftor.
MannitolThe serum concentration of Mannitol can be increased when it is combined with Tolvaptan.
MaprotilineThe serum concentration of Tolvaptan can be increased when it is combined with Maprotiline.
MebendazoleThe serum concentration of Tolvaptan can be increased when it is combined with Mebendazole.
MefloquineThe serum concentration of Tolvaptan can be increased when it is combined with Mefloquine.
Megestrol acetateThe serum concentration of Tolvaptan can be increased when it is combined with Megestrol acetate.
MeprobamateThe serum concentration of Tolvaptan can be increased when it is combined with Meprobamate.
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Tolvaptan.
Methadyl AcetateThe risk or severity of adverse effects can be increased when Methadyl Acetate is combined with Tolvaptan.
MethotrexateThe serum concentration of Methotrexate can be increased when it is combined with Tolvaptan.
MethylprednisoloneThe serum concentration of Methylprednisolone can be increased when it is combined with Tolvaptan.
MetoprololThe serum concentration of Tolvaptan can be increased when it is combined with Metoprolol.
MibefradilThe serum concentration of Tolvaptan can be increased when it is combined with Mibefradil.
MiconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Miconazole.
MidazolamThe serum concentration of Tolvaptan can be decreased when it is combined with Midazolam.
MidazolamThe serum concentration of Midazolam can be increased when it is combined with Tolvaptan.
MifepristoneThe serum concentration of Tolvaptan can be increased when it is combined with Mifepristone.
MirabegronThe serum concentration of Mirabegron can be increased when it is combined with Tolvaptan.
MitomycinThe serum concentration of Tolvaptan can be increased when it is combined with Mitomycin.
MitotaneThe serum concentration of Tolvaptan can be decreased when it is combined with Mitotane.
MitoxantroneThe serum concentration of Tolvaptan can be decreased when it is combined with Mitoxantrone.
MitoxantroneThe serum concentration of Mitoxantrone can be increased when it is combined with Tolvaptan.
ModafinilThe serum concentration of Tolvaptan can be decreased when it is combined with Modafinil.
MoexiprilTolvaptan may increase the hyperkalemic activities of Moexipril.
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Tolvaptan.
MorphineThe serum concentration of Morphine can be increased when it is combined with Tolvaptan.
Mycophenolate mofetilThe serum concentration of Mycophenolate mofetil can be increased when it is combined with Tolvaptan.
NadololThe serum concentration of Nadolol can be increased when it is combined with Tolvaptan.
NafcillinThe serum concentration of Tolvaptan can be decreased when it is combined with Nafcillin.
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Tolvaptan.
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Tolvaptan.
NaloxoneThe serum concentration of Naloxone can be increased when it is combined with Tolvaptan.
NaltrexoneThe serum concentration of Tolvaptan can be increased when it is combined with Naltrexone.
NaringeninThe serum concentration of Tolvaptan can be increased when it is combined with Naringenin.
NefazodoneThe serum concentration of Tolvaptan can be increased when it is combined with Nefazodone.
NelfinavirThe serum concentration of Tolvaptan can be increased when it is combined with Nelfinavir.
NeostigmineThe serum concentration of Tolvaptan can be increased when it is combined with Neostigmine.
NetupitantThe serum concentration of Tolvaptan can be increased when it is combined with Netupitant.
NevirapineThe serum concentration of Tolvaptan can be increased when it is combined with Nevirapine.
NicardipineThe serum concentration of Tolvaptan can be increased when it is combined with Nicardipine.
NifedipineThe serum concentration of Tolvaptan can be decreased when it is combined with Nifedipine.
NifedipineThe serum concentration of Nifedipine can be increased when it is combined with Tolvaptan.
NilotinibThe serum concentration of Tolvaptan can be increased when it is combined with Nilotinib.
NintedanibThe serum concentration of Nintedanib can be increased when it is combined with Tolvaptan.
NisoldipineThe serum concentration of Tolvaptan can be increased when it is combined with Nisoldipine.
NitrazepamThe serum concentration of Tolvaptan can be increased when it is combined with Nitrazepam.
NitrendipineThe serum concentration of Tolvaptan can be increased when it is combined with Nitrendipine.
NizatidineThe serum concentration of Nizatidine can be increased when it is combined with Tolvaptan.
NorethisteroneThe serum concentration of Tolvaptan can be decreased when it is combined with Norethisterone.
NormethadoneThe risk or severity of adverse effects can be increased when Normethadone is combined with Tolvaptan.
OlanzapineThe serum concentration of Olanzapine can be increased when it is combined with Tolvaptan.
OlaparibThe serum concentration of Tolvaptan can be increased when it is combined with Olaparib.
OlmesartanTolvaptan may increase the hyperkalemic activities of Olmesartan.
OmapatrilatTolvaptan may increase the hyperkalemic activities of Omapatrilat.
OmbitasvirThe serum concentration of Ombitasvir can be increased when it is combined with Tolvaptan.
OmeprazoleThe serum concentration of Tolvaptan can be increased when it is combined with Omeprazole.
OpiumThe risk or severity of adverse effects can be increased when Opium is combined with Tolvaptan.
OsimertinibThe serum concentration of Tolvaptan can be increased when it is combined with Osimertinib.
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Tolvaptan.
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Tolvaptan.
P-NitrophenolThe serum concentration of Tolvaptan can be increased when it is combined with P-Nitrophenol.
PaclitaxelThe serum concentration of Tolvaptan can be increased when it is combined with Paclitaxel.
PalbociclibThe serum concentration of Tolvaptan can be increased when it is combined with Palbociclib.
Palmitic AcidThe serum concentration of Tolvaptan can be increased when it is combined with Palmitic Acid.
PanobinostatThe serum concentration of Panobinostat can be increased when it is combined with Tolvaptan.
PantoprazoleThe serum concentration of Tolvaptan can be increased when it is combined with Pantoprazole.
ParoxetineThe serum concentration of Tolvaptan can be increased when it is combined with Paroxetine.
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Tolvaptan.
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Tolvaptan.
PentobarbitalThe serum concentration of Tolvaptan can be decreased when it is combined with Pentobarbital.
PerindoprilTolvaptan may increase the hyperkalemic activities of Perindopril.
PerindoprilThe serum concentration of Tolvaptan can be increased when it is combined with Perindopril.
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Tolvaptan.
PhenobarbitalThe serum concentration of Tolvaptan can be decreased when it is combined with Phenobarbital.
PhenobarbitalThe serum concentration of Phenobarbital can be increased when it is combined with Tolvaptan.
PhenytoinThe serum concentration of Tolvaptan can be decreased when it is combined with Phenytoin.
PhenytoinThe serum concentration of Phenytoin can be increased when it is combined with Tolvaptan.
PimozideThe serum concentration of Tolvaptan can be increased when it is combined with Pimozide.
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Tolvaptan.
Platelet Activating FactorThe serum concentration of Tolvaptan can be decreased when it is combined with Platelet Activating Factor.
PomalidomideThe serum concentration of Pomalidomide can be increased when it is combined with Tolvaptan.
PonatinibThe serum concentration of Ponatinib can be increased when it is combined with Tolvaptan.
PosaconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Posaconazole.
PravastatinThe serum concentration of Tolvaptan can be increased when it is combined with Pravastatin.
PrazosinThe serum concentration of Tolvaptan can be increased when it is combined with Prazosin.
PrednisoloneThe serum concentration of Prednisolone can be increased when it is combined with Tolvaptan.
PrednisoneThe serum concentration of Tolvaptan can be increased when it is combined with Prednisone.
PrimidoneThe serum concentration of Tolvaptan can be decreased when it is combined with Primidone.
ProbenecidThe serum concentration of Tolvaptan can be increased when it is combined with Probenecid.
ProgesteroneThe serum concentration of Tolvaptan can be decreased when it is combined with Progesterone.
ProgesteroneThe serum concentration of Progesterone can be increased when it is combined with Tolvaptan.
PromethazineThe serum concentration of Tolvaptan can be increased when it is combined with Promethazine.
PropafenoneThe serum concentration of Tolvaptan can be increased when it is combined with Propafenone.
PropranololThe serum concentration of Tolvaptan can be increased when it is combined with Propranolol.
ProtriptylineThe serum concentration of Tolvaptan can be increased when it is combined with Protriptyline.
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Tolvaptan.
QuercetinThe serum concentration of Tolvaptan can be increased when it is combined with Quercetin.
QuetiapineThe serum concentration of Quetiapine can be increased when it is combined with Tolvaptan.
QuinacrineThe serum concentration of Tolvaptan can be increased when it is combined with Quinacrine.
QuinaprilTolvaptan may increase the hyperkalemic activities of Quinapril.
QuinidineThe serum concentration of Tolvaptan can be increased when it is combined with Quinidine.
QuinineThe serum concentration of Tolvaptan can be increased when it is combined with Quinine.
RamiprilTolvaptan may increase the hyperkalemic activities of Ramipril.
RanitidineThe serum concentration of Tolvaptan can be increased when it is combined with Ranitidine.
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Tolvaptan.
ReboxetineThe serum concentration of Tolvaptan can be increased when it is combined with Reboxetine.
RegorafenibThe serum concentration of Tolvaptan can be increased when it is combined with Regorafenib.
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Tolvaptan.
RescinnamineTolvaptan may increase the hyperkalemic activities of Rescinnamine.
ReserpineThe serum concentration of Tolvaptan can be decreased when it is combined with Reserpine.
ReserpineThe serum concentration of Reserpine can be increased when it is combined with Tolvaptan.
RifabutinThe serum concentration of Tolvaptan can be decreased when it is combined with Rifabutin.
RifampicinThe serum concentration of Tolvaptan can be decreased when it is combined with Rifampicin.
RifampicinThe serum concentration of Rifampicin can be increased when it is combined with Tolvaptan.
RifapentineThe serum concentration of Tolvaptan can be decreased when it is combined with Rifapentine.
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Tolvaptan.
RilpivirineThe serum concentration of Tolvaptan can be increased when it is combined with Rilpivirine.
RisperidoneThe serum concentration of Risperidone can be increased when it is combined with Tolvaptan.
RitonavirThe serum concentration of Tolvaptan can be increased when it is combined with Ritonavir.
RivaroxabanThe serum concentration of Rivaroxaban can be increased when it is combined with Tolvaptan.
RolapitantThe serum concentration of Tolvaptan can be increased when it is combined with Rolapitant.
RomidepsinThe serum concentration of Romidepsin can be increased when it is combined with Tolvaptan.
Salicylic acidThe serum concentration of Salicylic acid can be increased when it is combined with Tolvaptan.
SaprisartanTolvaptan may increase the hyperkalemic activities of Saprisartan.
SaquinavirThe serum concentration of Tolvaptan can be increased when it is combined with Saquinavir.
SaralasinTolvaptan may increase the hyperkalemic activities of Saralasin.
ScopolamineThe serum concentration of Tolvaptan can be increased when it is combined with Scopolamine.
SelegilineThe serum concentration of Tolvaptan can be increased when it is combined with Selegiline.
SelexipagThe serum concentration of Selexipag can be increased when it is combined with Tolvaptan.
SertralineThe serum concentration of Tolvaptan can be increased when it is combined with Sertraline.
SildenafilThe serum concentration of Tolvaptan can be increased when it is combined with Sildenafil.
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Tolvaptan.
SiltuximabThe serum concentration of Tolvaptan can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Tolvaptan can be increased when it is combined with Simeprevir.
SimvastatinThe serum concentration of Tolvaptan can be increased when it is combined with Simvastatin.
SirolimusThe serum concentration of Tolvaptan can be decreased when it is combined with Sirolimus.
SitagliptinThe serum concentration of Sitagliptin can be increased when it is combined with Tolvaptan.
Sodium ChlorideThe risk or severity of adverse effects can be increased when Sodium Chloride is combined with Tolvaptan.
SofosbuvirThe serum concentration of Sofosbuvir can be increased when it is combined with Tolvaptan.
SorafenibThe serum concentration of Tolvaptan can be increased when it is combined with Sorafenib.
SparfloxacinThe serum concentration of Sparfloxacin can be increased when it is combined with Tolvaptan.
SphingosineThe serum concentration of Sphingosine can be increased when it is combined with Tolvaptan.
SpiraprilTolvaptan may increase the hyperkalemic activities of Spirapril.
SpironolactoneTolvaptan may increase the hyperkalemic activities of Spironolactone.
SpironolactoneThe serum concentration of Tolvaptan can be increased when it is combined with Spironolactone.
St. John's WortThe serum concentration of Tolvaptan can be decreased when it is combined with St. John&#39;s Wort.
StaurosporineThe serum concentration of Tolvaptan can be increased when it is combined with Staurosporine.
StiripentolThe serum concentration of Tolvaptan can be increased when it is combined with Stiripentol.
StreptozocinThe serum concentration of Tolvaptan can be decreased when it is combined with Streptozocin.
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Tolvaptan.
SulfinpyrazoneThe serum concentration of Tolvaptan can be increased when it is combined with Sulfinpyrazone.
SulfisoxazoleThe serum concentration of Tolvaptan can be increased when it is combined with Sulfisoxazole.
SumatriptanThe serum concentration of Tolvaptan can be increased when it is combined with Sumatriptan.
SunitinibThe serum concentration of Tolvaptan can be increased when it is combined with Sunitinib.
TacrineThe serum concentration of Tolvaptan can be increased when it is combined with Tacrine.
TacrolimusThe serum concentration of Tolvaptan can be decreased when it is combined with Tacrolimus.
TacrolimusThe serum concentration of Tacrolimus can be increased when it is combined with Tolvaptan.
TamoxifenThe serum concentration of Tolvaptan can be decreased when it is combined with Tamoxifen.
TamoxifenThe serum concentration of Tamoxifen can be increased when it is combined with Tolvaptan.
TapentadolThe risk or severity of adverse effects can be increased when Tapentadol is combined with Tolvaptan.
TasosartanTolvaptan may increase the hyperkalemic activities of Tasosartan.
Taurocholic AcidThe serum concentration of Tolvaptan can be increased when it is combined with Taurocholic Acid.
Technetium Tc-99m sestamibiThe serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Tolvaptan.
TelaprevirThe serum concentration of Tolvaptan can be increased when it is combined with Telaprevir.
TelithromycinThe serum concentration of Tolvaptan can be increased when it is combined with Telithromycin.
TelmisartanTolvaptan may increase the hyperkalemic activities of Telmisartan.
TelmisartanThe serum concentration of Tolvaptan can be increased when it is combined with Telmisartan.
TemocaprilTolvaptan may increase the hyperkalemic activities of Temocapril.
TemsirolimusThe serum concentration of Tolvaptan can be increased when it is combined with Temsirolimus.
TerazosinThe serum concentration of Tolvaptan can be increased when it is combined with Terazosin.
TerfenadineThe serum concentration of Tolvaptan can be increased when it is combined with Terfenadine.
TesmilifeneThe serum concentration of Tolvaptan can be decreased when it is combined with Tesmilifene.
TestosteroneThe serum concentration of Tolvaptan can be increased when it is combined with Testosterone.
TicagrelorThe serum concentration of Ticagrelor can be increased when it is combined with Tolvaptan.
TiclopidineThe serum concentration of Tolvaptan can be increased when it is combined with Ticlopidine.
TimololThe serum concentration of Timolol can be increased when it is combined with Tolvaptan.
TocilizumabThe serum concentration of Tolvaptan can be decreased when it is combined with Tocilizumab.
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Tolvaptan.
ToremifeneThe serum concentration of Toremifene can be increased when it is combined with Tolvaptan.
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Tolvaptan.
TrandolaprilTolvaptan may increase the hyperkalemic activities of Trandolapril.
Trastuzumab emtansineThe serum concentration of Trastuzumab emtansine can be increased when it is combined with Tolvaptan.
TrazodoneThe serum concentration of Tolvaptan can be decreased when it is combined with Trazodone.
TriamtereneTolvaptan may increase the hyperkalemic activities of Triamterene.
TrifluoperazineThe serum concentration of Tolvaptan can be increased when it is combined with Trifluoperazine.
TriflupromazineThe serum concentration of Tolvaptan can be increased when it is combined with Triflupromazine.
TrimethoprimThe serum concentration of Tolvaptan can be decreased when it is combined with Trimethoprim.
TrimipramineThe serum concentration of Tolvaptan can be increased when it is combined with Trimipramine.
TroleandomycinThe serum concentration of Tolvaptan can be increased when it is combined with Troleandomycin.
UlipristalThe serum concentration of Ulipristal can be increased when it is combined with Tolvaptan.
UmeclidiniumThe serum concentration of Umeclidinium can be increased when it is combined with Tolvaptan.
ValsartanTolvaptan may increase the hyperkalemic activities of Valsartan.
VecuroniumThe serum concentration of Vecuronium can be increased when it is combined with Tolvaptan.
VenlafaxineThe serum concentration of Tolvaptan can be increased when it is combined with Venlafaxine.
VerapamilThe serum concentration of Tolvaptan can be increased when it is combined with Verapamil.
VinblastineThe serum concentration of Tolvaptan can be decreased when it is combined with Vinblastine.
VinblastineThe serum concentration of Vinblastine can be increased when it is combined with Tolvaptan.
VincristineThe serum concentration of Vincristine can be increased when it is combined with Tolvaptan.
VincristineThe serum concentration of Tolvaptan can be decreased when it is combined with Vincristine.
VinorelbineThe serum concentration of Tolvaptan can be increased when it is combined with Vinorelbine.
VismodegibThe serum concentration of Vismodegib can be increased when it is combined with Tolvaptan.
VoriconazoleThe serum concentration of Tolvaptan can be increased when it is combined with Voriconazole.
ZidovudineThe serum concentration of Zidovudine can be increased when it is combined with Tolvaptan.
ZimelidineThe serum concentration of Tolvaptan can be increased when it is combined with Zimelidine.
ZiprasidoneThe serum concentration of Tolvaptan can be increased when it is combined with Ziprasidone.
Food InteractionsNot Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Vasopressin receptor activity
Specific Function:
Receptor for arginine vasopressin. The activity of this receptor is mediated by G proteins which activate adenylate cyclase. Involved in renal water reabsorption.
Gene Name:
AVPR2
Uniprot ID:
P30518
Molecular Weight:
40278.57 Da
References
  1. Aperis G, Alivanis P: Tolvaptan: a new therapeutic agent. Rev Recent Clin Trials. 2011 May;6(2):177-88. [PubMed:20868352 ]
  2. Dixon MB, Lien YH: Tolvaptan and its potential in the treatment of hyponatremia. Ther Clin Risk Manag. 2008 Dec;4(6):1149-55. [PubMed:19337422 ]
Kind
Protein
Organism
Human
Pharmacological action
no
Actions
antagonist
General Function:
Vasopressin receptor activity
Specific Function:
Receptor for arginine vasopressin. The activity of this receptor is mediated by G proteins which activate a phosphatidyl-inositol-calcium second messenger system. Has been involved in social behaviors, including affiliation and attachment.
Gene Name:
AVPR1A
Uniprot ID:
P37288
Molecular Weight:
46799.105 Da
References
  1. Nemerovski C, Hutchinson DJ: Treatment of hypervolemic or euvolemic hyponatremia associated with heart failure, cirrhosis, or the syndrome of inappropriate antidiuretic hormone with tolvaptan: a clinical review. Clin Ther. 2010 Jun;32(6):1015-32. doi: 10.1016/j.clinthera.2010.06.015. [PubMed:20637957 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Aperis G, Alivanis P: Tolvaptan: a new therapeutic agent. Rev Recent Clin Trials. 2011 May;6(2):177-88. [PubMed:20868352 ]
  2. Dixon MB, Lien YH: Tolvaptan and its potential in the treatment of hyponatremia. Ther Clin Risk Manag. 2008 Dec;4(6):1149-55. [PubMed:19337422 ]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
no
Actions
substrateinhibitor
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:
ABCB1
Uniprot ID:
P08183
Molecular Weight:
141477.255 Da
References
  1. Shoaf SE, Ohzone Y, Ninomiya S, Furukawa M, Bricmont P, Kashiyama E, Mallikaarjun S: In vitro P-glycoprotein interactions and steady-state pharmacokinetic interactions between tolvaptan and digoxin in healthy subjects. J Clin Pharmacol. 2011 May;51(5):761-9. doi: 10.1177/0091270010376193. Epub 2010 Aug 2. [PubMed:20679500 ]
Comments
comments powered by Disqus
Drug created on March 19, 2008 10:17 / Updated on September 28, 2016 02:27