We may start to see orders for Ure-Na, an oral powder classified as a medical food and used for treatment of euvolemic or hypervolemic hyponatremia, including SIADH. The dose is 15-60 grams/day, and adverse effects include hypernatremia and stomach upset. It has shown to increase sodium levels up to a range comparable to tolvaptan, although study information is limited. The cost is about $3.80 for a 15 gram dose, compared to tolvaptan at almost $400/dose. There is a pharmacist consult for sodium monitoring similar to tolvaptan, for new orders and dosage changes, a baseline sodium should be obtained, followed by an 8 hour post-dose sodium level, then additional monitoring is per pharmacist judgement, with a daily sodium level obtained.