Last update March 9, 2021

Tolvaptan

Low Risk

Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Diuretic and selective vasopressin V2 receptor antagonist.
Prescribed for the treatment of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Administered orally in one or two daily doses.

We did not find published data regarding the excretion of this substance through breast milk at the time this last update was completed.

Due to its pharmacokinetic properties (large volume of distribution, moderately high molecular weight and high percentage of protein binding (Osuka 2019 y 2014), it would be very unlikely for significant quantities to pass into breast milk.

It has been used in children, infants and even neonates for treating nephrotic syndrome, polycystic kidney disease and after cardiac surgery (Delbet 2020, Schaefer 2019, Kerling 2019, Koksoy 2018, Alzarka 2018, Tejero 2018, Katayama 2017, Gilbert 2017).

Alternatives

We do not have alternatives for Tolvaptan.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Tolvaptan in other languages or writings:

Group

Tolvaptan belongs to this group or family:

Tradenames

Main tradenames from several countries containing Tolvaptan in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 56 (42 - 80) %
Molecular weight 449 daltons
Protein Binding 98 - 99 %
VD 3 l/Kg
pKa 11.76 -
Tmax 2 - 4 hours
9 (8 - 12) hours

References

  1. Delbet JD, Parmentier C, Ulinski T. Tolvaptan therapy to treat severe hyponatremia in pediatric nephrotic syndrome. Pediatr Nephrol. 2020 Jul;35(7):1347-1350. Abstract
  2. Otsuka. Tolvaptan. Drug Summary. 2019 Full text (in our servers)
  3. Kerling A, Toka O, Rüffer A, Müller H, Habash S, Weiss C, Dittrich S, Moosmann J. First experience with Tolvaptan for the treatment of neonates and infants with capillary leak syndrome after cardiac surgery. BMC Pediatr. 2019 Feb 12;19(1):57. Abstract
  4. Schaefer F, Mekahli D, Emma F, Gilbert RD, Bockenhauer D, Cadnapaphornchai MA, Shi L, Dandurand A, Sikes K, Shoaf SE. Tolvaptan use in children and adolescents with autosomal dominant polycystic kidney disease: rationale and design of a two-part, randomized, double-blind, placebo-controlled trial. Eur J Pediatr. 2019 Jul;178(7):1013-1021. Abstract
  5. Tejero Hernández MA, García Martínez E, Arroyo Marin MJ, Gómez Guzmán E. [Tolvaptan in a pediatric cardiorenal syndrome: What is its role?] Arch Argent Pediatr. 2018 Apr 1;116(2):e279-e282. Abstract
  6. Alzarka B, Usala R, Whitehead MT, Ahn SY. Hyponatremia: An Unusual Presentation in a Neonate With Chromosome 1q21.1 Deletion Syndrome. Front Pediatr. 2018 Oct 11;6:273. Abstract
  7. Koksoy AY, Kurtul M, Ozsahin AK, Cayci FS, Tayfun M, Bayrakci US. Tolvaptan Use to Treat SIADH in a Child. J Pediatr Pharmacol Ther. 2018 Nov-Dec;23(6):494-498. Abstract
  8. Gilbert RD, Evans H, Olalekan K, Nagra A, Haq MR, Griffiths M. Tolvaptan treatment for severe neonatal autosomal-dominant polycystic kidney disease. Pediatr Nephrol. 2017 May;32(5):893-896. Abstract
  9. Katayama Y, Ozawa T, Shiono N, Masuhara H, Fujii T, Watanabe Y. Safety and effectiveness of tolvaptan for fluid management after pediatric cardiovascular surgery. Gen Thorac Cardiovasc Surg. 2017 Nov;65(11):622-626. Abstract
  10. Otsuka. Tolvaptán. Ficha técnica. 2014 Full text (in our servers)

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