Nephrology · Vasopressin V2 receptor antagonist
Tolvaptan
Dose
SIADH: 15 mg PO OD, titrate to 30–60 mg. ADPKD: split dose 45 mg + 15 mg, titrate.
Use
Hypervolaemic/euvolaemic hyponatraemia; slows ADPKD progression.
Monitoring
Sodium at 4–6 h then 6-hourly (limit rise to <8–10 mmol/L per 24 h), LFTs monthly in ADPKD.
Side effects
- • Overly rapid sodium correction (ODS risk)
- • Thirst, polyuria
- • Hepatotoxicity in ADPKD dosing
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
