Drug General Information (ID: DDITB1OVJP)
Drug Name			Tolvaptan		Drug Info		Potassium bicarbonate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasopressin Antagonists				Minerals And Electrolytes
Structure

Mechanism of Tolvaptan-Potassium bicarbonate Interaction (Severity Level: Moderate)
Increased risk of hyperkalemia Click to Show/Hide Mechanism Graph
Drug Name		Tolvaptan				Potassium bicarbonate
Mechanism		Hyperkalemia				Hyperkalemia
Key Mechanism Factor 1
		Factor Name		Hyperkalemia
		Factor Description		Hyperkalemia is a condition in which the level of potassium in the blood is higher than normal. While mild cases may not produce symptoms, severe hyperkalemia can lead to fatal arrhythmias if left untreated.
Mechanism Description		Increased risk of hyperkalemia by the combination of Tolvaptan and Potassium bicarbonate

Recommended Action
Management		Serum potassium levels should be checked regularly during concomitant therapy with tolvaptan and other agents that can increase serum potassium such as ACE inhibitors, angiotensin II receptor antagonists, potassium-sparing diuretics, aldosterone antagonists, and miscellaneous agents like cyclosporin, heparin, tacrolimus, and trimethoprim. Particular caution is warranted in patients with renal impairment, diabetes, old age, severe or worsening heart failure, or dehydration. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat.

References
1	Product Information. Samsca (tolvaptan). Otsuka American Pharmaceuticals Inc, Rockville, MD.