Hypovolemic Hyponatremia (see Hyponatremia, [[Hyponatremia]])
Inability of Patient to Sense or Appropriately Respond to Thirst: includes contraindication to use in mechanically ventilated patient
Need to Correct Serum Sodium Rapidly
Dosage/Administration
Start (In Hospital): 15 mg PO qday (with no concomitant PO free water restriction, particularly during the first 24 hrs)
After At least 24 Hrs, Titrate Up To: 30-60 mg PO qday
Adverse Effects
Gastrointestinal Adverse Effects
Constipation (see Constipation, [[Constipation]]): occurs in 7% of patients (vs 2% of placebo-treated patients)
Gastrointestinal Hemorrhage (GI Bleed) (see Gastrointestinal Hemorrhage, [[Gastrointestinal Hemorrhage]]): occurs in 9.5% of patients (vs 0.02% of placebo-treated patients): use of tolvaptan should therefore be carefully considered in cirrhotic patients
Neurologic Adverse Effects
Asthenia (Weakness) (see Asthenia, [[Asthenia]]): occurs in 9% of patients (vs 4% of placebo-treated patients)
Osmotic Demyelination Syndrome (ODS) (see XXXX)
Renal Adverse Effects
Hypernatremia (see Hypernatremia, [[Hypernatremia]])
Pollakiuria/Polyuria (see Polyuria, [[Polyuria]]): occurs in 11% of patients (vs 3% of placebo-treated patients)
Thirst: occurs in 16% of patients (vs 5% of placebo-treated patients)
Other Adverse Effects
Hyperglycemia (see Hyperglycemia, [[Hyperglycemia]]): occurs in 6% of patients (vs 1% of placebo-treated patients)