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  • Generic Name: (tolvaptan)
    Other Brands: N/A
  • Last Revised: 08/2014
    • What is this medication and its most common uses?

      Samsca is a medicine used to help increase low blood sodium (salt) levels in people who have conditions such as heart failure or certain hormone imbalances.

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Samsca works to increase blood salt levels by removing extra body water as urine.

      What are the beneficial effects of this medication and when should I begin to have results?

      What: Samsca has been shown to significantly increase blood sodium levels.

      When: Everyone responds differently to treatment, so try to be patient and follow your healthcare provider’s directions. It is important that you take Samsca exactly as your healthcare provider has prescribed.

      How do I know it is working?

      Your healthcare provider may order tests regularly to check how well this medication is working.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Samsca can cause blood sodium levels to rise too fast. This can increase your risk of a serious and life-threatening condition called osmotic demyelination syndrome (ODS). You may be at increased risk of developing ODS if you have liver disease, have not eaten enough for a long period of time, have very low blood sodium levels, or if you drink excessive amounts of alcohol. Tell your healthcare provider immediately if you experience symptoms such as trouble speaking or swallowing, drowsiness, confusion, changes in mood, trouble controlling body movement, weakness in muscles of your arms and legs, or seizures.
      Treatment with Samsca should be started and re-started only in a hospital, where the sodium levels in your blood can be checked closely.

      More common side effects may include: thirst, dry mouth, weakness, constipation, making large amounts of urine and urinating often, increased blood sugar levels.

      Less common side effects may include:

      Serious liver problems with symptoms such as loss of appetite, nausea, vomiting, fever, feeling unwell, unusual tiredness, itching, right upper stomach area pain, dark urine, or yellowing of your skin or the whites of your eyes.

      Dehydration (loss of too much body fluid) with symptoms such as vomiting, diarrhea, feeling dizzy or faint.

    • Who should not take this medication?

      Do not take Samsca if you are allergic to it or any of its ingredients.

      Do not take Samsca if the sodium level in your blood must be increased right away.

      Do not take Samsca if you cannot replace fluids by drinking or if you cannot tell if you are thirsty.

      Do not take Samsca if you are dizzy, faint, or if your kidneys are not working normally because you have lost too much body fluid.

      Do not take Samsca if you are currently taking any of the following medicines: antibiotics (such as clarithromycin or telithromycin), antifungals (such as ketoconazole or itraconazole), anti-HIV medicines (such as ritonavir, indinavir, nelfinavir, or saquinavir), or antidepressants (such as nefazodone).

      Do not take Samsca if your body is not able to make urine.

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Samsca. Also, talk to your healthcare provider about your complete medical history, especially if you have kidney problems and your body cannot make urine, liver problems, cannot feel if you are thirsty, are taking a medicine called desmopressin, or if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Adults: The usual starting dose is 15 milligrams once a day. Your healthcare provider may adjust your dose as needed, until the desired effect is achieved.

    • How should I take this medication?

      Take Samsca exactly as prescribed by your healthcare provider. Do not change your dose or stop taking Samsca without first talking to your healthcare provider.

      Take Samsca once a day with or without food.

      To prevent losing too much body water, have water available to drink at all times while you are taking Samsca.

      Unless your healthcare provider tells you otherwise, drink when you are thirsty.

      If your healthcare provider tells you to keep taking Samsca after you leave a hospital, it is important that you do not stop and re-start Samsca on your own. You may need to go back to a hospital to re-start Samsca.

    • What should I avoid while taking this medication?

      Do not drink grapefruit juice while you are taking Samsca. This can cause you to have too much Samsca in your blood.

      Do not miss or skip doses of Samsca.

    • What are the possible food and drug interactions associated with this medication?

      If Samsca is used with certain other drugs, the effects of either could be increased, decreased, or altered. Samsca may interact with numerous medications. Therefore, it is very important that you tell your healthcare provider about any other medications you are taking.

    • May I receive this medication if I am pregnant or breastfeeding?

      The effects of Samsca during pregnancy and breastfeeding are unknown. Do not breastfeed while you are taking Samsca. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What should I do if I miss a dose of this medication?

      If you miss a dose of Samsca, take it as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular dosing schedule. Do not take two doses at once.

    • How should I store this medication?

      Store at room temperature.

    • Who should I contact in case of emergency or overdose?
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      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
      back to top Use your PDR® Pharmacy Discount Card when you or a family member fills a prescription and ask for your PDR® Discount every
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