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Buy Samsca (Tolvaptan) tablets online on NCCME

How and where to order Tolvaptan (Samsca) 15 mg tablets online:

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Indications and usage:

Samsca (Tolvaptan) is a selective vasopressin V2-receptor antagonist indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia [serum sodium < 125 mEq/L or less marked hyponatremia that is symptomatic and has resisted correction with fluid restriction], including patients with heart failure and Syndrome of Inappropriate Antidiuretic Hormone (SIADH).

Important Limitations:

  • Patients requiring intervention to raise serum sodium urgently to prevent or to treat seriousneurological symptoms should not be treated with Samsca.
  • It has not been established that Tolvaptan provides a symptomatic benefit to patients.


    Dosage and administration:

  • Samsca (Tolvaptan) should be initiated and re-initiated in a hospital.
  • The recommended starting dose is 15 mg once daily. Dosage may be increased at intervals >= 24 hr to 30 mg once daily, and to a maximum of 60 mg once daily as needed to raise serum sodium.


    Dosage forms and strengths:

    Samsca (Tolvaptan) tablets: 15 mg and 30 mg.


    Overdosage:

    Single oral doses up to 480 mg and multiple doses up to 300 mg once daily for 5 days have been well tolerated in studies in healthy subjects. There is no specific antidote for tolvaptan intoxication. The signs and symptoms of an acute overdose can be anticipated to be those of excessive pharmacologic effect: a rise in serum sodium concentration, polyuria, thirst, and dehydration/hypovolemia.


    Contraindications:

  • Use in patients with autosomal dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS
  • Need to raise serum sodium acutely
  • Patients who are unable to respond appropriately to thirst
  • Hypovolemic hyponatremia
  • Concomitant use of strong CYP3A inhibitors
  • Anuria
  • Hypersensitivity


    Warnings and precautions:

  • Monitor serum sodium and neurologic status as serious neurologic sequelae can result from over rapid correction of sodium
  • Because of the potential increased risk of gastrointestinal bleeding in patients with cirrhosis, use in patients with cirrhosis only when the need to treat outweighs this risk
  • Dehydration and hypovolemia may require intervention
  • Avoid use with hypertonic saline
  • Avoid use with CYP 3A inducers and moderate CYP 3A inhibitors
  • Consider dose reduction if co-administered with P-gp inhibitors
  • Monitor serum potassium in patients with potassium > 5 mEq/L or on drugs known to increase potassium


    Adverse reactions, side effects:

    Most common adverse reactions ( >= 5% placebo) are thirst, dry mouth, asthenia, constipation, pollakiuria or polyuria, and hyperglycemia.


    Use in specific populations:

  • Pregnancy: Based on animal data, may cause fetal harm
  • Nursing mothers: Discontinue drug or nursing taking into consideration importance of drug to mother
  • Pediatric Use: There are no studies


    Where to buy tolvaptan online:

    To purchase Tolvaptan (Samsca) 15 mg tablets from reliable online pharmacies and drugstores please use resources described above on this webpage.

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