Samsca

Samsca is an oral tablet that reduces the level of a hormone that regulates the balance of water and salt (sodium) in the body. High levels of this hormone can cause an imbalance that results in low sodium levels and fluid retention. Samsca is used to treat hyponatremia (low levels of sodium in your blood) in people with heart failure, and certain hormonal imbalances.

Product dosage: 15 mg
Package (num)	Per tab	Price	Buy
20	$13.75	$318.00 $275.00 (14%)	🛒 Add to cart
30	$15.90	$477.00 (0%)	🛒 Add to cart
60	$11.00 Best per tab	$954.00 $660.00 (31%)	🛒 Add to cart
Synonyms Jynarque Tolvaptan

Samsca (tolvaptan) is a selective vasopressin V2-receptor antagonist indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia. It is specifically designed to address serum sodium imbalance by promoting aquaresis—the electrolyte-sparing excretion of free water. By blocking vasopressin binding in the renal collecting ducts, Samsca increases water excretion without significant loss of sodium, potassium, or other electrolytes. This mechanism offers a targeted approach to raising serum sodium concentrations in hospitalized patients who require urgent correction. Proper patient selection and monitoring are essential to mitigate risks, including overly rapid correction of sodium.

Features

• Active ingredient: Tolvaptan
• Pharmacologic class: Vasopressin V2-receptor antagonist
• Available as: 15 mg and 30 mg tablets
• Administration: Oral, once daily
• Onset of aquaresis: Typically within 2–4 hours post-dose
• Duration of effect: Up to 24 hours
• Requires hospitalization for initiation and dose titration
• Must be administered under close medical supervision with frequent serum sodium monitoring

Benefits

• Promotes electrolyte-sparing free water excretion (aquaresis) to correct hyponatremia
• Provides a targeted mechanism of action by selectively blocking vasopressin V2 receptors
• Helps restore serum sodium levels in appropriate patients with euvolemic or hypervolemic hyponatremia
• Supports clinical management of symptomatic hyponatremia when fluid restriction alone is insufficient
• May improve certain clinical parameters in carefully selected hospitalized patients
• Oral administration facilitates use in monitored inpatient settings

Common use

Samsca is used for the treatment of clinically significant hypervolemic and euvolemic hyponatremia in hospitalized patients. This includes hyponatremia associated with heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is not indicated for use in hypovolemic hyponatremia. Treatment should be initiated and re-initiated in a hospital setting where serum sodium can be monitored closely due to the risk of overly rapid correction.

Dosage and direction

Initiate therapy with 15 mg administered 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 the desired level of serum sodium. Do not administer for more than 30 days due to risk of liver injury. Take with or without food. Avoid grapefruit juice during treatment. Dose titration should be performed carefully based on serum sodium concentrations and clinical status.

Precautions

• Must be initiated in a hospital setting due to the need for frequent serum sodium monitoring
• Risk of overly rapid correction of hyponatremia, which can lead to osmotic demyelination syndrome
• Monitor for signs and symptoms regarding volume status and neurological status
• Contraindicated in patients unable to sense or respond to thirst
• Use with caution in patients with renal impairment
• Not recommended for use in patients with hepatic impairment (Child-Pugh Class C)
• Discontinue therapy if significant liver enzyme abnormalities occur

Contraindications

• Hypersensitivity to tolvaptan or any component of the product
• Inability of the patient to sense or respond to thirst
• Hypovolemic hyponatremia
• Concomitant use with strong CYP 3A inhibitors
• Anuric patients

Possible side effect

Common adverse reactions include thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, hyperglycemia, and pyrexia. Serious side effects may include overly rapid correction of sodium, osmotic demyelination, hepatic injury, dehydration, and gastrointestinal bleeding in cirrhotic patients.

Drug interaction

• Strong CYP 3A inhibitors (e.g., ketoconazole, clarithromycin): Contraindicated—may significantly increase tolvaptan exposure
• Moderate CYP 3A inhibitors (e.g., fluconazole): Reduce Samsca dose
• CYP 3A inducers (e.g., rifampin): May decrease tolvaptan exposure
• P-gp inhibitors: May increase tolvaptan concentrations
• Hyperkalemic agents (e.g., potassium-sparing diuretics): May increase risk of hyperkalemia

Missed dose

If a dose is missed, take it as soon as possible on the same day. Do not take two doses on the same day. Resume the regular dosing schedule the following day.

Overdose

Signs and symptoms of overdose are expected to be related to pharmacologic effects, including dehydration, hypovolemia, and hypernatremia. Treatment should consist of discontinuation of Samsca, water ingestion, and close monitoring of electrolyte and fluid balance. In cases of significant dehydration, intravenous fluid replacement may be necessary. There is no specific antidote.

Storage

Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Keep in original container with desiccant. Protect from light and moisture.

Disclaimer

Samsca should be used only under the supervision of a qualified healthcare professional. This information is not exhaustive. Please see full prescribing information for complete details, including boxed warning for liver injury and risk of rapid sodium correction. Treatment decisions should be based on the professional judgment of the clinician in the context of the individual patient.

Reviews

Clinical trials and post-marketing experience support the efficacy of Samsca in raising serum sodium levels in appropriate patient populations when used according to prescribing guidelines. Many clinicians report successful correction of hyponatremia with careful monitoring. However, the risk of hepatic injury and necessity for inpatient initiation limit its use to specific clinical scenarios. Long-term safety beyond 30 days has not been established.