Conivaptan

Conivaptan is a prescription medication used to help increase low sodium levels in the blood. Conivaptan belongs to a group of drugs called vasopressin antagonists. These raise salt levels in the blood by removing extra body water as urine. Removing fluid from the body helps to increase the level of sodium in the blood.

This medication comes in an injectable form to be given directly into a vein (IV) by a healthcare professional.  

Common side effects of conivaptan include reactions at site of infusion, headache, constipation, diarrhea, vomiting, and thirst.

Conivaptan is part of the drug class:

• Vasopressin antagonists

Conivaptan 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.

Conivaptan is used to treat hyponatremia (low sodium levels). Conivaptan improves urine flow without causing the body to lose too much sodium as you urinate.

Conivaptan may also be used for purposes not listed in this medication guide.

Since conivaptan is given by a healthcare professional, you are not likely to miss a dose.

Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of fluid and electrolyte problems like mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, very bad dizziness or passing out, fast heartbeat, more thirst, seizures, feeling very tired or weak, not hungry, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or very bad upset stomach or throwing up.
• Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
• Trouble swallowing or speaking.
• Swelling in the arms or legs.
• Fever.
• Very bad headache.
• This medicine may cause tissue damage if the drug leaks from the vein. Tell your nurse if you have any redness, burning, pain, swelling, blisters, skin sores, or leaking of fluid where the drug is going into your body.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Irritation where this medicine is used.
• Headache.
• More thirst.
• Hard stools (constipation).
• Loose stools (diarrhea).
• Upset stomach or throwing up.
• Not able to sleep.
• Throat pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

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Euvolemic or hypervolemic hyponatremia: IV: 20 mg infused over 30 minutes as a loading dose, followed by a continuous infusion of 20 mg over 24 hours (0.83 mg/hour) for 2 to 4 days; may increase to a maximum dose of 40 mg over 24 hours (1.7 mg/hour) if serum sodium not rising sufficiently; total duration of therapy not to exceed 4 days. Note: If patient requires 40 mg/24 hours, may administer two consecutive 20 mg/100 mL premixed solutions over 24 hours (ie, 20 mg over 12 hours followed by 20 mg over 12 hours).

Initial dose: Loading dose of 20 mg IV once over 30 minutes; followed by 20 mg continuous IV infusion over 24 hours
-Following initial day of treatment, administer 20 mg continuous IV infusion over 24 hours for an additional 1 to 3 days; may titrate to a maximum of 40 mg continuous IV infusion over 24 hours if serum sodium is not rising at the desired rate

Comments:
-The total duration of infusion (after the loading dose) should not exceed 4 days.
-Frequently monitor serum sodium and volume status during administration.

Use: To raise serum sodium in hospitalized patients with euvolemic or hypervolemic hyponatremia

Data not available

Animal studies have revealed evidence of decreased neonatal viability and weaning indices, decreased body weight, and delayed reflex and physical development (including sexual maturation) when this drug was administered at a dose of 2.5 mg/kg/day. Fetal accumulation and delays in delivery may also be possible. No fetal or maternal adverse effects were observed when administered IV up to 12 mg/kg/day. There are no controlled data in human pregnancy. US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

The manufacturer makes no recommendation regarding use during pregnancy. US FDA pregnancy category: Not assigned. Risk summary: No data available on use of this drug in pregnant women to inform a drug-related risk. Comments: May impair female fertility; unknown whether these effects are reversible.