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conivaptan (Vaprisol)
Trademark: Vaprisol, FDA approved 2005
Indications:
- treatment of euvolemic hyponatremia (SIADH)
Contraindications:
1) hypovolemia
2) congestive heart failure
Dosage:
1) 20 mg IV over 30 minutes, followed by
2) IV infusion of another 20 mg over 24 hours for 1-4 days
3) may titrate up to 40 mg/day [2]
Pharmacokinetics:
1) metabolized by cyt P450 3A4
Adverse effects:
1) infusion site reactions (50%)
2) headache, hypokalemia, GI distress
3) hypertension, hypotension
Drug interactions:
1) coadministration of potent CYP3A4 inhibitors can increase levels of conivaptan & is contraindicated
- ketoconazole, itraconazole, clarithromycin, ritonavir, indinavir
2) monitor digoxin levels
Mechanism of action:
1) arginine vasopressin antagonist
2) increases in serum sodium of > 4 meq/L after 1st dose in 52% of patients Manufacturers: Astellas Pharma US
General
vasopressin receptor antagonist (vaptan)
Database Correlations
PUBCHEM correlations
References
- Prescriber's Letter 13(2): 2006
Detail-Document#: 220215
(subscription needed) http://www.prescribersletter.com
- Internal Medicine World Report 2006; 21(2)