Drug interactions
Amiloride + Tolvaptan
Severity: Moderate
Amiloride and Tolvaptan: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tolvaptan is an aquaretic and does not itself cause potassium retention, but labeling notes that potassium levels should be monitored with potassium-sparing agents. Amiloride may produce hyperkalemia, and rapid changes in sodium and volume with tolvaptan can complicate management.
What this interaction means in plain words
Amiloride and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amiloride belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Amiloride reduces renal potassium excretion, and tolvaptan has been associated with serum potassium increases through an incompletely defined mechanism.
What to do
Monitor serum potassium, sodium and renal function closely after initiation and dose changes. Reduce or stop amiloride if hyperkalemia develops.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amiloride
- Amiloride + Eplerenone Contraindicated
- Amiloride + Spironolactone Contraindicated
- Amiloride + Triamterene Contraindicated
- Aceclofenac + Amiloride Major
- Acemetacin + Amiloride Major
- Amiloride + Amlodipine-benazepril Major
Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Amiloride with Tolvaptan?
MediHelp rates the interaction as moderate. Amiloride and Tolvaptan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tolvaptan is an aquaretic and does not itself cause potassium retention, but labeling notes that potassium levels should be monitored with potassium-sparing agents. Amiloride may produce hyperkalemia, and rapid changes in sodium and volume with tolvaptan can complicate management.
How serious is the interaction between Amiloride and Tolvaptan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium, sodium and renal function closely after initiation and dose changes. Reduce or stop amiloride if hyperkalemia develops.
What other medicines interact with Amiloride?
MediHelp also lists interactions of Amiloride with, for example, Eplerenone, Spironolactone, Triamterene. The full list is on the Amiloride page.
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