Drug interactions
Sacubitril / valsartan + Tolvaptan
Severity: Moderate
Sacubitril / valsartan 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
Valsartan blocks the renin-angiotensin system and can cause hyperkalemia, and tolvaptan may also increase potassium. The combination may raise the risk of high potassium, especially with renal impairment or heart failure.
What this interaction means in plain words
Sacubitril / valsartan 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.
Why it happens
Angiotensin receptor blockade reduces aldosterone-mediated potassium excretion, adding to the potassium increase from tolvaptan.
What to do
Monitor serum potassium and renal function regularly, particularly after initiation or dose changes. Adjust therapy if hyperkalemia develops.
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
Frequently asked questions
Can I take Sacubitril / valsartan with Tolvaptan?
MediHelp rates the interaction as moderate. Sacubitril / valsartan 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. Valsartan blocks the renin-angiotensin system and can cause hyperkalemia, and tolvaptan may also increase potassium. The combination may raise the risk of high potassium, especially with renal impairment or heart failure.
How serious is the interaction between Sacubitril / valsartan 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 potassium and renal function regularly, particularly after initiation or dose changes. Adjust therapy if hyperkalemia develops.
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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