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You should not use tolvaptan if you are allergic to it, or if:

  • you are unable to urinate;
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  • you are severely dehydrated and feel like you might pass out; or
  • you have autosomal dominant polycystic kidney disease (unless you receive tolvaptan through a special program that includes frequent liver function tests).

Some medicines can cause unwanted or dangerous effects when used with tolvaptan. Your doctor may change your treatment plan if you also use:

  • nefazodone;
  • an antibiotic--clarithromycin, telithromycin;
  • antifungal medicine--itraconazole, ketoconazole; or
  • HIV/AIDS medication--indinavir, nelfinavir, ritonavir, saquinavir.

Tell your doctor if:

  • you have kidney disease or urination problems;
  • you have liver disease (especially cirrhosis);
  • you also take desmopressin (dDAVP), or a diuretic or "water pill";
  • you are malnourished; or
  • you have been drinking large amounts of alcohol.

It is not known whether tolvaptan will harm an unborn baby. Tell your doctor if you are pregnant.
It may not be safe to breast-feed while using Samsca. Ask your doctor about any risk.

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