Drug Detail:Conivaptan (Conivaptan [ koe-nye-vap-tan ])
Drug Class: Vasopressin antagonists
Usual Adult Dose for Hyponatremia
Initial dose: Loading dose of 20 mg IV once over 30 minutes; followed by 20 mg continuous IV infusion over 24 hours
- Following initial day of treatment, administer 20 mg continuous IV infusion over 24 hours for an additional 1 to 3 days; may titrate to a maximum of 40 mg continuous IV infusion over 24 hours if serum sodium is not rising at the desired rate
Comments:
- The total duration of infusion (after the loading dose) should not exceed 4 days.
- Frequently monitor serum sodium and volume status during administration.
Use: To raise serum sodium in hospitalized patients with euvolemic or hypervolemic hyponatremia
Usual Adult Dose for Hyponatremia, euvolemic
Initial dose: Loading dose of 20 mg IV once over 30 minutes; followed by 20 mg continuous IV infusion over 24 hours
- Following initial day of treatment, administer 20 mg continuous IV infusion over 24 hours for an additional 1 to 3 days; may titrate to a maximum of 40 mg continuous IV infusion over 24 hours if serum sodium is not rising at the desired rate
Comments:
- The total duration of infusion (after the loading dose) should not exceed 4 days.
- Frequently monitor serum sodium and volume status during administration.
Use: To raise serum sodium in hospitalized patients with euvolemic or hypervolemic hyponatremia
Renal Dose Adjustments
Mild to moderate renal impairment (CrCl 30 to 80 mL/min): No adjustment recommended.
Severe renal impairment (CrCl less than 30 mL/min): Not recommended.
Liver Dose Adjustments
Mild liver impairment: Data not available
Moderate to severe liver impairment (Child-Pugh Class B or C):
- Initial loading dose: 10 mg IV over 30 minutes followed by 10 mg per day as a continuous IV infusion for 2 to 4 days
- May titrate up to 20 mg per day if serum sodium is not rising at desired rate
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- For IV use only; administer through large veins, changing infusion site every 24 hours to minimize risk of vascular irritation.
- For use in hospitalized patients only
- Do not administer this drug with any other product in the same IV line or container.
Storage requirements:
- Avoid excessive heat.
- Protect from freezing.
- Protect from light until ready to use.
Reconstitution/preparation techniques:
- The manufacturer product information should be consulted.
IV compatibility:
- The manufacturer product information should be consulted.
General:
- This drug has not been shown to be effective for the treatment of signs/symptoms of heart failure and is not approved for this indication.
- It has not been established that raising serum sodium with this drug provides a symptomatic benefit to patients.
Monitoring:
- Metabolic: Frequently monitor serum sodium and volume status.
Patient advice:
- Avoid breastfeeding while using this drug.
