Drug interactions
Darunavir + Tolvaptan
Severity: Contraindicated
Darunavir and Tolvaptan: contraindicated 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
Darunavir, usually given with ritonavir or cobicistat, inhibits CYP3A4 and is expected to increase tolvaptan exposure. This may cause excessive aquaresis, dehydration, and rapid sodium shifts.
What this interaction means in plain words
Darunavir and Tolvaptan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Darunavir belongs to Anti Virals; Tolvaptan belongs to Endocrine.
Why it happens
CYP3A4 inhibition, boosted by ritonavir or cobicistat, reduces tolvaptan metabolism.
What to do
Avoid the combination; consider alternatives. If needed, monitor serum sodium and volume status closely.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
- Indinavir + Tolvaptan Contraindicated
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Tolvaptan?
MediHelp rates the interaction as contraindicated. Darunavir and Tolvaptan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Darunavir, usually given with ritonavir or cobicistat, inhibits CYP3A4 and is expected to increase tolvaptan exposure. This may cause excessive aquaresis, dehydration, and rapid sodium shifts.
How serious is the interaction between Darunavir and Tolvaptan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; consider alternatives. If needed, monitor serum sodium and volume status closely.
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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