Drug interactions
Furosemide + Tolvaptan
Severity: Moderate
Furosemide 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, when combined with furosemide, may increase fluid loss, causing volume depletion, hypotension and rapid sodium shifts. Electrolyte disturbances and renal function changes are possible.
What this interaction means in plain words
Furosemide 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.
Furosemide belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive diuresis: vasopressin V2 receptor antagonism increases free water excretion while furosemide increases natriuresis.
What to do
Monitor volume status, blood pressure, serum sodium and potassium closely, especially during the first days. Reduce the diuretic dose if dehydration or over-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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide 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 Furosemide with Tolvaptan?
MediHelp rates the interaction as moderate. Furosemide 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, when combined with furosemide, may increase fluid loss, causing volume depletion, hypotension and rapid sodium shifts. Electrolyte disturbances and renal function changes are possible.
How serious is the interaction between Furosemide 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 volume status, blood pressure, serum sodium and potassium closely, especially during the first days. Reduce the diuretic dose if dehydration or over-rapid sodium correction occurs.
What other medicines interact with Furosemide?
MediHelp also lists interactions of Furosemide with, for example, Amifostine, Amikacin, Carbenoxolone. The full list is on the Furosemide page.
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