Tolvaptan

Overview

Tolvaptan, sold under the brand name Samsca among others, is an aquaretic drug that functions as a selective, competitive vasopressin receptor 2 (V₂) antagonist used to treat hyponatremia (low blood sodium levels) associated with congestive heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH). Tolvaptan was approved by the U.S. Food and Drug Administration (FDA) on May 19, 2009, and is sold by Otsuka Pharmaceutical Co. under the trade name Samsca. Tolvaptan, as Jynarque, was granted approval for medical use in the United States in April 2018.[1][2] WP

The U.S. Food and Drug Administration (FDA) granted tolvaptan a fast track designation for clinical trials investigating its use for the treatment of polycystic kidney disease. The FDA granted Jynarque an orphan drug designation in April 2012, for the treatment of autosomal dominant polycystic kidney disease.[3][4] WP

Tolvaptan is available as a generic medication.[5][6] WP

Uses, dosage and effects

Medical uses

Tolvaptan (Samsca) is indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia.[7] WP

Tolvaptan (Jynarque) is indicated for slow kidney-function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD).[8] WP

Tolvaptan phosphate is a prodrug of tolvaptan, developed for intravenous administration. Tolvaptan phosphate is converted into the active drug tolvaptan in the human body following administration.[9] WP

Risks and side effects

Side effects

The FDA has determined that tolvaptan should not be used for longer than 30 days and should not be used in patients with underlying liver disease because it can cause liver injury, potentially leading to liver failure. When using to treat hyponatremia, it may cause too rapid correction of hyponatremia resulting in fatal osmotic demyelination syndrome.[10][11] WP

Pharmacology

Pharmacology

Tolvaptan is a selective vasopressin V₂ receptor antagonist.[7][8] WP

Chemistry

Formula

C26H25ClN2O3 PC

CAS number

150683-30-0 PC

Molar mass (g/mol)

448.9 PC

IUPAC name (computed by PubChem)

N-[4-(7-chloro-5-hydroxy-2,3,4,5-tetrahydro-1-benzazepine-1-carbonyl)-3-methylphenyl]-2-methylbenzamide PC

SMILES

CC1=CC=CC=C1C(=O)NC2=CC(=C(C=C2)C(=O)N3CCCC(C4=C3C=CC(=C4)Cl)O)C PC

InChIKey

GYHCTFXIZSNGJT-UHFFFAOYSA-N PC

PubChem CID

216237

Harm reduction information

No harm reduction data is on file for this compound yet. That means no dose, timing or combination data from PsychonautWiki or TripSit. Please don't guess a dose from similar compounds. If you have taken it and feel unwell, contact emergency services or a poison control center.

User reports

Pop culture

No references added yet.

Sources

1. Journal / agency Drug Approval Package: Samsca (Tolvaptan) Tablets NDA #022275. 21 July 2009
2. Journal / agency Drug Approval Package: Jynarque (tolvaptan). 8 June 2018
3. Other Otsuka Maryland Research Institute, Inc. Granted Fast Track Designation For Tolvaptan In PKD
4. Journal / agency Tolvaptan Orphan Drug Designations and Approvals. 6 April 2012
5. Journal / agency Drugs@FDA: FDA-Approved Drugs
6. Journal / agency Tolvaptan Accord: Pending EC decision. 26 January 2023
7. Journal / agency Samsca- tolvaptan tablet. 28 May 2019
8. Journal / agency Jynarque- tolvaptan kit Jynarque- tolvaptan tablet. 31 March 2020
9. Other Otsuka Obtains Approval in Japan for SAMTASU® for I.V. Infusion, a V2 -Receptor Antagonist for the Treatment of Cardiac Edema. March 28, 2022
10. Journal / agency U.S. Food and Drug Administration." Samsca (Tolvaptan): Drug Safety Communication. N.p., 30 Apr. 2013. Web. 1 June 2014
11. Other Goodman & Gilman's the pharmacological basis of therapeutics. 5 December 2017

Text and values on this page are quoted from Wikipedia (CC BY-SA 4.0), PubChem (public domain). Each value links to the exact revision it came from.