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
Tolvaptan is not generally associated with hyperkalemia in the way the legacy suggestion implies, though serum potassium may rise modestly. Tolvaptan causes aquaresis and volume loss, which may add to hypotension and renal function changes with sacubitril-valsartan.
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.
Sacubitril-valsartan belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Additive effects on volume status and renal hemodynamics, with a possible small potassium increase from tolvaptan.
What to do
Monitor serum potassium, sodium, creatinine and blood pressure when starting tolvaptan; avoid fluid restriction that leads to dehydration.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
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. Tolvaptan is not generally associated with hyperkalemia in the way the legacy suggestion implies, though serum potassium may rise modestly. Tolvaptan causes aquaresis and volume loss, which may add to hypotension and renal function changes with sacubitril-valsartan.
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, sodium, creatinine and blood pressure when starting tolvaptan; avoid fluid restriction that leads to dehydration.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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