Restricted:  Must be prescribed by Nephrology, Cardiology or Pulmonology

Indications:
- Hypervolemic hyponatremia (including patients with heart failure (HF))
- Euvolemic hyponatremia (including patients with SIADH)
- Patient admitted from home on Tolvaptan

Contraindications:
- Urgent need to raise serum sodium acutely
- Inability of the patient to sense or appropriately respond to thirst
- Hypovolemic hyponatremia or dehydration
- Concomitant use of strong CYP3A inhibitors (e.g., clarithromycin, indinavir, itraconazole,
ketonazole, nefazodone, nelfinavir, saquinavir, telithromycin )
- Anuric patient or patients with CrCl < 10ml/min (because drug effects on serum sodium
levels are likely lost at very low levels of renal function)

• Recent Citations via Medline (PubMed)
• FDA DRUG INFORMATION
• MICROMEDEX
• FDA Daily Med Package Inserts