Drug interactions
Tolvaptan + Verapamil
Severity: Moderate
Tolvaptan and Verapamil: 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
Verapamil is a moderate CYP3A4 inhibitor and increases tolvaptan exposure. This can lead to excessive aquaresis, thirst, dehydration and a too-rapid rise in serum sodium.
What this interaction means in plain words
Tolvaptan and Verapamil 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 belongs to Endocrine; Verapamil belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4-mediated metabolism of tolvaptan.
What to do
Reduce the tolvaptan dose as labeling advises with moderate CYP3A4 inhibitors. Monitor serum sodium and fluid status closely.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil 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 Tolvaptan with Verapamil?
MediHelp rates the interaction as moderate. Tolvaptan and Verapamil 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. Verapamil is a moderate CYP3A4 inhibitor and increases tolvaptan exposure. This can lead to excessive aquaresis, thirst, dehydration and a too-rapid rise in serum sodium.
How serious is the interaction between Tolvaptan and Verapamil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the tolvaptan dose as labeling advises with moderate CYP3A4 inhibitors. Monitor serum sodium and fluid status closely.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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