Samsca: Effective Hyponatremia Correction with Tolvaptan Therapy
Samsca
| Product dosage: 15 mg | |||
|---|---|---|---|
| Package (num) | Per tab | Price | Buy |
| 20 | 16.09 $ | 372.06 $ 321.75 $ (14%) | 🛒 Add to cart |
| 30 | 18.60 $ | 558.09 $ (0%) | 🛒 Add to cart |
| 60 | 12.87 $
Best per tab | 1116.18 $ 772.20 $ (31%) | 🛒 Add to cart |
Synonyms | |||
Samsca (tolvaptan) is an oral selective vasopressin V2-receptor antagonist indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia. It is specifically designed to address serum sodium imbalances in hospitalized patients who require urgent correction, offering a targeted mechanism that promotes aquaresis—the electrolyte-sparing excretion of free water. By blocking vasopressin’s effect on the renal collecting ducts, Samsca helps increase serum sodium concentrations in a controlled manner, supporting patient stabilization and improved clinical outcomes under careful medical supervision.
Features
- Contains tolvaptan, a selective vasopressin V2-receptor antagonist
- Available in 15 mg and 30 mg oral tablets
- Promotes aquaresis—excretion of free water without substantial sodium or potassium loss
- Initiation requires inpatient setting for serum sodium monitoring
- Dosing adjustment based on serum sodium levels and clinical response
- Not for use in patients with hypovolemic hyponatremia
- Requires avoidance of grapefruit juice during therapy
Benefits
- Effectively raises serum sodium levels in appropriate patients with euvolemic or hypervolemic hyponatremia
- Reduces fluid overload symptoms in conditions like SIADH, heart failure, or cirrhosis
- Provides a targeted mechanism of action, minimizing off-target electrolyte disturbances
- May help shorten hospital stays through prompt and controlled sodium correction
- Supports clinical management of hyponatremia with a predictable pharmacokinetic profile
- Oral administration allows for ease of use in monitored settings
Common use
Samsca is commonly used in hospitalized patients with clinically significant euvolemic hyponatremia (e.g., syndrome of inappropriate antidiuretic hormone secretion—SIADH) or hypervolemic hyponatremia (e.g., in heart failure or cirrhosis), where urgent correction of serum sodium is necessary. It is not indicated for patients with hypovolemic hyponatremia. Treatment should always begin in a controlled environment where sodium levels, neurologic status, and volume status can be closely monitored.
Dosage and direction
Initiate treatment with 15 mg orally once daily. Dose may be increased to 30 mg once daily after at least 24 hours, to a maximum of 60 mg once daily, as needed to achieve desired serum sodium concentration. Administer with or without food. Avoid fluid restriction during the first 24 hours of therapy. Monitor serum sodium and volume status frequently, especially during initiation and titration. Treatment duration should be limited to 30 days or less due to risk of liver injury.
Precautions
Monitor serum sodium concentration and neurologic status closely during treatment, especially in susceptible patients (e.g., those with severe malnutrition, alcoholism, or advanced liver disease) to avoid overly rapid correction, which may cause osmotic demyelination. Assess volume status regularly. Use with caution in patients with renal impairment. Not recommended in patients with underlying liver disease, including cirrhosis, due to potential for hepatotoxicity. Avoid use in patients unable to sense or respond to thirst.
Contraindications
Samsca is contraindicated in patients with hypovolemic hyponatremia, anuria, inability to sense or respond to thirst, and concomitant use of strong CYP 3A inhibitors. It is also contraindicated in patients with a history of hypersensitivity to tolvaptan or any component of the product.
Possible side effects
Common side effects include thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, hyperglycemia, and fever. Serious side effects may include overly rapid correction of sodium leading to osmotic demyelination, hepatic injury, GI bleeding in cirrhotic patients, dehydration, and hypovolemia. Discontinue if signs or symptoms of liver injury occur.
Drug interaction
Strong CYP 3A inhibitors (e.g., ketoconazole, clarithromycin) increase tolvaptan exposure and are contraindicated. Moderate CYP 3A inhibitors (e.g., fluconazole) may also increase exposure—consider dose reduction. CYP 3A inducers (e.g., rifampin) may decrease tolvaptan levels. Avoid grapefruit juice during therapy. Use with caution alongside other medications affecting serum sodium or kidney function.
Missed dose
If a dose is missed, administer as soon as possible on the same day. Do not administer two doses on the same day. Resume the regular dosing schedule the following day.
Overdose
Signs of overdose may include pronounced aquaresis, dehydration, hypovolemia, and hypernatremia. Discontinue Samsca and provide supportive care, including water replacement and correction of electrolyte abnormalities based on clinical presentation. Dialysis is not expected to enhance elimination.
Storage
Store at room temperature (20°C–25°C); excursions permitted between 15°C–30°C. Keep in original container with desiccant; protect from moisture. Keep out of reach of children and pets.
Disclaimer
Samsca should only be used under the direction of a qualified healthcare professional. This information is for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or treatment.
Reviews
Clinical trials and post-marketing experience support the efficacy of Samsca in raising serum sodium levels in indicated patient populations. Many clinicians report successful use in appropriate hospital settings with careful monitoring. However, its use is limited by the risk of hepatotoxicity and the necessity for inpatient initiation. Patient experiences often note increased urination and thirst, consistent with the drug’s pharmacologic action.