Drug interactions
Berotralstat + Tolvaptan
Severity: Moderate
Berotralstat 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
Berotralstat inhibits P-glycoprotein and may raise tolvaptan exposure, since tolvaptan is a P-gp substrate. Higher tolvaptan levels can intensify aquaresis, thirst and the risk of overly rapid serum sodium rise.
What this interaction means in plain words
Berotralstat 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.
Berotralstat belongs to Miscellaneous; Tolvaptan belongs to Endocrine.
Why it happens
Berotralstat inhibits P-gp efflux, reducing tolvaptan efflux and increasing its systemic exposure.
What to do
Monitor serum sodium and fluid status closely when starting or stopping berotralstat. Reduce the tolvaptan dose if excessive aquaresis or rapid sodium correction occurs.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Other interactions of Berotralstat
- Berotralstat + Ergotamine Major
- Berotralstat + Nilotinib Major
- Berotralstat + Pimozide Major
- Berotralstat + Quinidine Major
- Berotralstat + Quinine Major
- Berotralstat + Tacrolimus Major
Frequently asked questions
Can I take Berotralstat with Tolvaptan?
MediHelp rates the interaction as moderate. Berotralstat 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. Berotralstat inhibits P-glycoprotein and may raise tolvaptan exposure, since tolvaptan is a P-gp substrate. Higher tolvaptan levels can intensify aquaresis, thirst and the risk of overly rapid serum sodium rise.
How serious is the interaction between Berotralstat 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 and fluid status closely when starting or stopping berotralstat. Reduce the tolvaptan dose if excessive aquaresis or rapid sodium correction occurs.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan page.
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