Drug interactions
Fludrocortisone + Tolvaptan
Severity: Moderate
Fludrocortisone 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
Fludrocortisone has a mineralocorticoid effect causing sodium and water retention, which opposes the aquaretic action of tolvaptan. A minor pharmacokinetic effect via CYP3A4 is less important clinically.
What this interaction means in plain words
Fludrocortisone 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.
Fludrocortisone belongs to Endocrine; Tolvaptan belongs to Endocrine.
Why it happens
Pharmacodynamic opposition through mineralocorticoid-mediated sodium retention, with possible weak CYP3A4 induction.
What to do
Monitor serum sodium and fluid status closely, since tolvaptan can correct sodium too rapidly; adjust tolvaptan dosing per sodium response.
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 Fludrocortisone
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 Fludrocortisone with Tolvaptan?
MediHelp rates the interaction as moderate. Fludrocortisone 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. Fludrocortisone has a mineralocorticoid effect causing sodium and water retention, which opposes the aquaretic action of tolvaptan. A minor pharmacokinetic effect via CYP3A4 is less important clinically.
How serious is the interaction between Fludrocortisone 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, since tolvaptan can correct sodium too rapidly; adjust tolvaptan dosing per sodium response.
What other medicines interact with Fludrocortisone?
MediHelp also lists interactions of Fludrocortisone with, for example, Mifepristone, Aldesleukin, Amphotericin b. The full list is on the Fludrocortisone page.
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