Drug interactions
Amiodarone + Tolvaptan
Severity: Moderate
Amiodarone 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
Amiodarone may raise tolvaptan concentrations, increasing the risk of excessively rapid sodium rise and thirst, dehydration or hypotension. Tolvaptan is mainly a CYP3A4 substrate and a P-gp substrate.
What this interaction means in plain words
Amiodarone 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.
Amiodarone belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Amiodarone inhibits P-glycoprotein and weakly inhibits CYP3A4, reducing tolvaptan clearance.
What to do
Monitor serum sodium frequently and fluid status, and adjust the tolvaptan dose if the sodium rises too quickly.
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 Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
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 Amiodarone with Tolvaptan?
MediHelp rates the interaction as moderate. Amiodarone 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. Amiodarone may raise tolvaptan concentrations, increasing the risk of excessively rapid sodium rise and thirst, dehydration or hypotension. Tolvaptan is mainly a CYP3A4 substrate and a P-gp substrate.
How serious is the interaction between Amiodarone 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 sodium frequently and fluid status, and adjust the tolvaptan dose if the sodium rises too quickly.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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