tolvaptan

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

curcumin

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

citalopram

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

efavirenz

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

primidone

may diminish the serum concentration when combined with tolvaptan

may diminish the serum concentration when combined with tolvaptan

isoniazid

may diminish the serum concentration when combined with tolvaptan

propofol

may diminish the serum concentration when combined with tolvaptan

selexipag

may diminish the serum concentration when combined with tolvaptan

desmopressin

may decrease the therapeutic effect when combined with desmopressin

sodium chloride

may increase the adverse effect when combined with tolvaptan

grapefruit

It may enhance the effect when combined with grapefruit by CYP3A4 metabolism

griseofulvin

It may diminish the effect when combined with griseofulvin by CYP3A4 metabolism

miconazole vaginal

It may enhance the effect when combined with miconazole vaginal by affecting CYP3A4 metabolism

enzalutamide

CYP3A strong enhancers of the small intestine may reduce the bioavailability of tolvaptan

nirmatelvir/ritonavir

may enhance the serum concentration of CYP3A4 inhibitors

sodium chloride nasal

sodium chloride increases the toxicity of tolvaptan

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

losartan

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with ace inhibitors

quinapril

may increase the hyperkalemic effect when combined with ace inhibitors

ramipril

may increase the hyperkalemic effect when combined with ace inhibitors

rescinnamine

may increase the hyperkalemic effect when combined with ace inhibitors

spirapril

may increase the hyperkalemic effect when combined with ace inhibitors

may diminish the serum concentration when combined with tolvaptan

efavirenz

may diminish the serum concentration when combined with tolvaptan

digoxin

may enhance the serum concentration when combined with digoxin

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

amiloride

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

dexamethasone

It may enhance the metabolism when combined with dexamethasone

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

losartan

may enhance the hyperkalemic effect

cilazapril

may enhance the hyperkalemic effect

enalapril

may enhance the hyperkalemic effect

enalaprilat

may enhance the hyperkalemic effect

lisinopril

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

amiloride

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

paclitaxel

when both drugs are combined, there may be a high metabolism of tolvaptan 

lorlatinib

the effect of tolvaptan is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism

carvedilol

it enhances the serum potassium levels

telmisartan

it may enhance the serum potassium levels

primidone

may decrease the serum concentration

may decrease the serum concentration

may decrease the serum concentration

efavirenz

may decrease the serum concentration

isoniazid

may decrease the serum concentration

may decrease the serum concentration

donepezil transdermal

may decrease the serum concentration

efavirenz

may decrease the serum concentration

prednisolone

may decrease the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

isoniazid

may increase the serum concentration

mexiletine

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

curcumin

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

diacerein

may increase the serum concentration

may increase the serum concentration

tranylcypromine

may increase the serum concentration

Frequency defined

>10%

Samsca

Pollakiuria (4-11%)
Urinary output increased (11%)
Dry mouth (13%)
Thirst (16%)
Nausea (21%)

Jynarque

Dizziness (11.3%)
Diarrhea (13.3%)
Fatigue (13.6%)
Dry mouth (16%)
Thirst (63.7%)
Increased urination (69.5%)

1-10%

Samsca

Pyrexia (4%)
Anorexia (4%)
Hyperglycemia (6%)
Constipation (7%)
Weakness (9%)
GI bleeding (10%)

Jynarque

Palpitations (3.5%)
Hyperuricemia (3.9%)
Rash (4.2%)
Dry skin (4.9%)
Abdominal distension (4.9%)
Decreased appetite (7.2%)
Dyspepsia (7.9%)

Post marketing Reports

Investigations: Hypernatremia

Hepatobiliary disorders: Liver failure

Neurologic: Osmotic demyelination syndrome

Immune system disorders: anaphylactic shock and rash

Black Box Warning:

tolvaptan has a black box warning, which is the most serious warning issued by the US Food and Drug Administration (FDA). The black box warning for tolvaptan is related to the risk of liver injury and failure.

The warning states that tolvaptan can cause potentially fatal liver injury, including hepatic failure requiring liver transplantation. The risk is highest in patients with underlying liver disease, but it can occur in patients without pre-existing liver disease as well.

Contraindication/Caution:

Contraindication:

Known hypersensitivity: tolvaptan should not be used in patients who have a known hypersensitivity to tolvaptan or any of its components.
Severe liver impairment: tolvaptan is contraindicated in patients with severe liver impairment, such as those with cirrhosis or a Child-Pugh score greater than or equal to 10.
Concomitant use with strong CYP3A inhibitors: tolvaptan is contraindicated in patients taking strong inhibitors of the enzyme CYP3A, such as ketoconazole, itraconazole, clarithromycin, ritonavir, and others, as these drugs can increase tolvaptan blood levels and increase the risk of adverse effects.
Anuria: tolvaptan should not be used in patients who are unable to produce urine (anuria).
Hypovolemic hyponatremia: tolvaptan is not recommended for the treatment of hypovolemic hyponatremia, which is a type of hyponatremia caused by fluid loss.
Pregnancy: tolvaptan is classified as a pregnancy category C medication, meaning that it may be harmful to a developing fetus and should be used with caution during pregnancy.
Breastfeeding: tolvaptan is not recommended for use in breastfeeding mothers, as it may be excreted in breast milk and could potentially harm a nursing infant.

Caution:

Moderate liver impairment: tolvaptan should be used with caution in patients with moderate liver impairment, such as those with a Child-Pugh score of 7-9.
Concomitant use with CYP3A inducers: tolvaptan should be used with caution in patients taking drugs that induce the enzyme CYP3A, such as rifampin, carbamazepine, phenytoin, and others, as these drugs can decrease tolvaptan blood levels and reduce its effectiveness.
Dehydration: tolvaptan may increase urine output, which can lead to dehydration.
Hyperkalemia: tolvaptan can increase serum potassium levels, particularly in patients with underlying kidney disease. Patients should be monitored for hyperkalemia, and the dose of tolvaptan may need to be adjusted accordingly.
Hypotension: tolvaptan can cause a decrease in blood pressure, particularly in patients with underlying heart disease or taking medications that lower blood pressure. Patients should be monitored for hypotension, and the dose of tolvaptan may need to be adjusted accordingly.
Elderly patients: Elderly patients may be more sensitive to the effects of tolvaptan and may be at increased risk of adverse effects.
Hyponatremia due to SIADH: tolvaptan may be less effective in treating hyponatremia caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Comorbidities:

Heart failure: tolvaptan may be used in patients with heart failure and hyponatremia.
Liver cirrhosis: Hyponatremia is a common complication of liver cirrhosis, and tolvaptan may be used to treat this condition. However, tolvaptan is contraindicated in patients with severe liver impairment.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH): tolvaptan may be used to treat hyponatremia caused by SIADH, although it may be less effective in this condition.
Cancer: Some types of cancer, particularly lung cancer, can cause hyponatremia. tolvaptan may be used in these patients, although it is not approved specifically for this indication.
Central nervous system disorders: Certain conditions that affect the CNS, such as meningitis, encephalitis, or brain tumors, can cause hyponatremia. tolvaptan may be used to treat hyponatremia in these patients.

Pregnancy consideration: pregnancy category: not assigned

Lactation: It is not known whether tolvaptan is excreted in human milk.

Pregnancy category:

Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.
Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women.
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women.
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women.
Category N: There is no data available for the drug under this category.

Pharmacology:

tolvaptan is a selective vasopressin V2 receptor antagonist, which means that it blocks the action of the hormone vasopressin on the V2 receptors in the kidneys. Vasopressin regulates the body’s water balance by increasing water reabsorption in the kidneys. By blocking the action of vasopressin on the V2 receptors, tolvaptan promotes water excretion and increases urine output, leading to an increase in serum sodium levels.

tolvaptan is rapidly absorbed after oral administration, with peak plasma concentrations reached within 2-4 hours. The drug is metabolized by liver, primarily by the enzyme CYP3A4, and is eliminated mainly via the feces. tolvaptan has a half-life of about 12-15 hours in healthy individuals, but this may be prolonged in patients with liver or kidney impairment.

tolvaptan is primarily used for the treatment of hyponatremia, which is a condition characterized by low sodium levels in the blood. Hyponatremia can be caused by a variety of underlying conditions, such as heart failure, liver cirrhosis. tolvaptan can be effective in increasing serum sodium levels and improving symptoms in patients with hyponatremia, although it is associated with a risk of liver injury and should be used with caution in patients with liver impairment.

Pharmacodynamics:

tolvaptan is a selective vasopressin V2 receptor antagonist that works by blocking the action of arginine vasopressin (AVP), a hormone that regulates the balance of water and electrolytes in the body. By blocking the AVP receptors in the renal collecting ducts, tolvaptan increases water excretion and decreases the concentration of electrolytes such as sodium in the urine.

The pharmacodynamics of tolvaptan are primarily related to its effect on the renal system. tolvaptan works by inhibiting the reabsorption of water in the kidney, leading to an increase in urine output and a decrease in plasma sodium concentration. This effect is dose-dependent and can be observed within hours of administration.

In patients with hyponatremia (low sodium levels in the blood), tolvaptan has been shown to increase serum sodium levels by promoting the excretion of excess water.

Pharmacokinetics:

Absorption

tolvaptan is rapidly absorbed after oral administration, with peak plasma concentrations reached within 2 to 4 hours. Food can delay the absorption of tolvaptan but does not significantly affect its bioavailability.

Distribution

tolvaptan is highly protein-bound (99%) and has a large volume of distribution, indicating that it is extensively distributed throughout the body.

Metabolism

tolvaptan is extensively metabolized by cytochrome P450 (CYP) enzymes, primarily CYP3A4 and CYP2C9. The major metabolites of tolvaptan are the 1-O-glucuronide and the 6-hydroxymethyl metabolites, both of which are pharmacologically inactive.

Elimination and excretion

tolvaptan is primarily eliminated by renal excretion, with about 70% of a dose excreted unchanged in the urine. The remainder of the dose is eliminated in the feces (21%) and through metabolism (9%).

Administration:

tolvaptan should be taken with water, and food does not significantly affect its absorption.
The recommended starting dose of tolvaptan for the treatment of hyponatremia is typically 15 mg once daily. The dose can be increased to 30 mg once daily after at least 24 hours if the serum sodium concentration does not increase by at least 4 mEq/L or if symptoms of hyponatremia persist.
The maximum recommended daily dose of tolvaptan is 60 mg.
tolvaptan should be taken at the same time each day to maintain consistent drug levels in the blood.
tolvaptan should not be crushed or chewed, and the tablets should be swallowed whole.
tolvaptan may interact with other medications, so patients should inform their healthcare provider of all medications they are taking, including over the counter and herbal supplements.
Patients should be monitored regularly for changes in serum sodium concentration and for signs of liver dysfunction, especially during the first 18 days of treatment, as tolvaptan has been associated with an increased risk of hepatotoxicity.
tolvaptan should be discontinued if there is evidence of liver injury or if the serum alanine aminotransferase (ALT) level increases to three times the upper limit of normal.

Patient information leaflet

Generic Name: tolvaptan

Pronounced: [ tol-VAP-tan]

Why do we use tolvaptan?

Hyponatremia: tolvaptan is FDA-approved for the treatment of euvolemic or hypervolemic hyponatremia associated with cirrhosis, heart failure, and the syndrome of antidiuretic hormone secretion (SIADH). It works by increasing the excretion of free water and reducing water retention, leading to an increase in serum sodium levels.
Autosomal dominant polycystic kidney disease (ADPKD): tolvaptan has also been approved for the treatment of ADPKD, which is a genetic disorder characterized by the growth of numerous cysts in the kidneys. tolvaptan has been shown to slow the progression of kidney disease in patients with ADPKD by reducing the growth of kidney cysts.
Ascites: tolvaptan may be used off-label for the treatment of ascites, which is the accumulation of fluid in the abdominal cavity that can occur in patients with liver cirrhosis. tolvaptan can reduce fluid accumulation and improve symptoms in some patients with ascites.
Heart failure: tolvaptan has been investigated for its potential use in the treatment of acute decompensated heart failure, but its use in this context is not yet FDA-approved.

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» Home » Drug Database » Vasopressin Antagonist » tolvaptan

tolvaptan

Brand Name :

Samsca, Jynarque

Synonyms :

tolvaptan

Class :

Vasopressin Antagonists; Vasopressin-Related

Dosage Forms & Strengths

tablet (Samsca)

30mg

15mg

tablet (Jynarque)

90mg

60mg

45mg

30mg

15mg

Safety and efficacy not established

Refer to the adult dosing regimen

DRUG INTERACTION

tolvaptan

&

beta carotene/vitamin C/minerals
aloe vera gel/urea
aloe vera gel/glycerine
alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
alprazolam/propranolol
alprazolam /sertraline
ibuprofen/dextropropoxyphene
ambroxol/cetirizine/phenylephrine/ guaiphenesin/menthol
dextropropoxyphene/dexchlorpheniramine maleate/bromhexine
promegestone
batroxobin
bencyclane
benfluorex
acetylpheneturide
abarelix
abetimus
naftidrofuryl
nalorphine
oxiracetam
letosteine
lafutidine
leuprorelin
levodropropizine
glutaral
losartan/ramipril
gallopamil
lanatoside c
lauromacrogol
gestodene
aceclofenac/methyl salicylate/menthol/linseed oil/capsaicin
aceclofenac/paracetamol/tizanidine
alginic acid/magaldrate/simethicone
aceclofenac/paracetamol
aceclofenac/rabeprazole
alginic acid
pantoprazole and domperidone
urokinase
rimiterol
olanzapine/fluoxetine
normethadone/hydroxyephedrine
myrtol
moxonidine
propylhexedrine
sodium hypochlorite solution
sodium chloride/sodium citrate
Hepatitis B Vaccine (Recombinant [Adjuvanted])
Hepatitis B Vaccine (Recombinant)
aceclofenac and serratiopeptidase
levosulpiride
niaprazine
tromantadine
trimetazidine
vinburnine
mizoribine
molgramostim
mosapride
eugenol
tolperisone
etamsylate
etynodiol
mizolastine
metenolone
reproterol
rebamipide
mephenoxalone
metandienone
furosemide/spironolactone
hydroxycarbamide
tenonitrozole
fenoverine
fenquizone
tiapride
tibolone
furazolidone
furosemide & amiloride
fosfestrol
fluclorolone
flubendazole
tertatolol
tetracosactide
tetryzoline
tolciclate
trapidil
troxipide
temoporfin
telbivudine
teprenone
hexamidine
mebhydrolin
mepartricin
fencamfamin
medazepam
theodrenaline
thiamazole
thiocolchicoside
psilocybin
veralipride
pyritinol
opipramol
oprelvekin
betamethasone + gentamicin
betamethasone + neomycin
betamethasone + salicylic acid
oxedrine
bopindolol
orgotein (investigational)
oxaceprol
ormeloxifene
bevantolol
bifemelane
clebopride
demoxytocin
cicletanine
cefsulodin
chlortalidon
sisomicin
somatrem
carbazochrome
caroverine
cathine
ipriflavone
isepamicin
silymarin
simethicone
sermorelin
diloxanide
dimethindene
diosmin/hesperidin
calamine
canrenone
captodiame
imidapril
cefetamet
cefodizime
cefoperazone + sulbactam
ivermectin + albendazole
serrapeptase
bromisoval
beraprost
pridinol
proglumide
bamipine
barnidipine
bamifylline
benzbromarone
betamethasone/fusidic acid
para-chlorophenol
pantethine
nomifensine
pemoline
parnaparin
pentolinium
nialamide
novobiocin
nicergoline
octocrylene
octisalate
oftasceine
oxolamine
oxyphencyclimine
penfluridol
pentoxyverine
phenoxymethylpenicillin
picloxydine
pilsicainide hydrochloride
piperazine
pirarubicin
policresulen
prifinium bromide
prethcamide
pristinamycin
pirenzepine
piribedil
pimethixene
pargyline
phosphatidyl choline
phthalylsulfathiazole
phytomenadione
pranlukast
pinazepam
oxyphenonium
noxytiolin
periciazine
pethidine
phenindamine
histidine
isoleucine
proline
lauric acid
lymecycline
hypromellose
abiraterone acetate and niraparib
ichthammol
levamisole
naftazone
nefopam
oxprenolol
oxybuprocaine
elranatamab-bcmm
lapyrium
isoaminile
iotrolan
mazindol
masoprocol
lypressin
meradimate
molsidomine
monobenzone
mequinol/gluconolactone/ lactobionic acid/ arbutin
medifoxamine
mebutamate
metergoline
methantheline
methdilazine
metocurine
micronomicin
metaraminol
mephenesin
menadione
medrysone
metixene
levobetaxolol
guaiacol glycerol ether
eucalyptol
sodium tetradecyl sulfate
sugammadex
carbetocin
certoparin
chlorcyclizine/pseudoephedrine
cephapirin
indecainide
iobitridol
iomeprol
chlorphenesin
msud analog
msud maxamum
iceland moss
glutethimide
hexachlorophene
haloprogin
deferoxamine
ethchlorvynol
dexpanthenol topical
etilefrine
deslanoside
carbocromen
diazolidinylurea
dibenzepin
etofamide
guanoxan
halazepam
guanadrel sulfate
dapiprazole
soapwort
debrisoquine
l-tryptophan
chlormerodrin
chlorquinaldol
cetrimonium
carbocisteine
chlorcyclizine/codeine
technetium Tc-99m tetrofosmin
technetium Tc-99m disofenin
technetium Tc-99m gluceptate
technetium Tc-99m labeled red blood cells
amylmetacresol/dextromethorphan hydrobromide
anileridine phosphate
pyrethrins
pyrantel pamoate
quinagolide
spiramycin
standard hyperkalemic cardioplegia solution
technetium tc-99m mertiatide
technetium tc-99m medronate
bemotrizinol / bisoctrizole
benfotiamine
bemotrizinol + titanium dioxide + zinc oxide
technetium Tc-99m oxidronate
technetium Tc-99m pentetate
technetium Tc-99m pyrophosphate
benziodarone
octinoxate/bisoctrizole
bicisate dihydrochloride
technetium Tc-99m bicisate
norelgestromin/ethinyl estradiol
norgestimate/ethinyl estradiol
ximelagatran (investigational)
xamoterol
trioxsalen
poly-urea urethane
rilmenidine
pemirolast
oxitriptan
beclomethasone, intranasal
thimerosal
camphor gel
camphor
mumps virus vaccine, live
rubella virus vaccine, live
aluminum chloride (dental)
alum irrigation
framycetin, phenylephrine, and gramicidin
ombitasvir, paritaprevir, ritonavir, and dasabuvir
olipudase alfa
etonogestrel/ethinyl estradiol
mycophenolate
fluoroestradiol F 18
donor organ cardioplegia solution
fluciclovine F 18
fusidic acid (ophthalmic)
fusidic acid and hydrocortisone
framycetin, dexamethasone, and gramicidin
fludeoxyglucose F-18
fluorouracil/salicylic acid
indium In-111 oxyquinoline
indium In-111 pentetreotide
indium In-111 capromab pendetide
lusutrombopag
mitomycin (ophthalmic)
mifepristone and misoprostol
minoxidil (systemic)
methyl aminolevulinate (topical)
methyl folate, methylcobalamin, and acetylcysteine
ciclesonide/formoterol/tiotropium
nedocromil (Oral Inhalation)
batefenterol (Investigational)
neostigmine and glycopyrrolate
nepafenac ophthalmic
netupitant/palonosetron
meperidine and promethazine
mepivacaine and levonordefrin
maltodextrin
medical cannabis
medium chain triglycerides
mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
moxifloxacin ophthalmic
neomycin/fluocinolone
nadroparin
iodine I-125 iothalamate
amikacin liposome (oral inhalation)
bupivacaine liposome
natamycin
lopinavir and ritonavir
lysine
macitentan and tadalafil
mitomycin pyelocalyceal
moclobemide
mometasone and indacaterol
efinaconazole
blue-green algae
indocyanine green
follitropin beta
lumasiran
glycerin/lidocaine
edrophonium/atropine
indigo carmine
lutropin alfa
instant glucose/intravenous dextrose
iobenguane I-123
ixekizumab
isosulfan blue dye
levofloxacin ophthalmic
levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
ethinyl estradiol/levonorgestrel transdermal
hydroquinone
hydroxypropyl methylcellulose
icodextrin
lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
iodinated I 125 albumin
iodinated I 131 albumin
lipid emulsion (plant oil-based)
levonorgestrel intrauterine
levonorgestrel oral/ethinyl estradiol
lactic acid and sodium-PCA
lactated Ringer solution
ketotifen (systemic)
lanolin
leuprolide and norethindrone
levodopa and benserazide
gonadorelin acetate
hemodialysis solutions
nirsevimab-alip
gentian violet
gallium ga-68 dotatate
fusidic acid and betamethasone
gallium citrate Ga-67
gadopentetate dimeglumine
gadofosveset
follitropin delta
follitropin alfa and lutropin alfa
follitropin alfa
rocatinlimab
grass pollens allergen extract
flotufolastat F18
fluorescein ophthalmic
barium
balanced salt solution
air polymer type A intrauterine device
clodronate
bentoquatam
clobetasone
alfacalcidol
citric acid/glucono-delta-lactone/magnesium carbonate
benzoin
desirudin
immune globulin IV (IGIV)
dequalinium
pseudoephedrine/desloratadine
clofedanol
cyproterone and ethinyl estradiol
dextranomer and hyaluronic acid or derivatives
diatrizoate meglumine and diatrizoate sodium
glucosamine sulfate, chondroitin sulfate and Msm
squill
gotu kola
blessed thistle
bitter melon
apraclonidine
chlophedianol/dexbrompheniramine/pseudoephedrine
wild jujube
chitosan
cilazapril/hydrochlorothiazide
dexbrompheniramine and phenylephrine
diethylene triamine penta-acetic acid
dexchlorpheniramine and pseudoephedrine
lily of the valley
diflucortolone
corydalis
lemon balm
MSM
calcium polystyrene sulfonate
caprylidene
peppermint oil
efavirenz/lamivudine/tenofovir DF
emtricitabine/tenofovir DF /efavirenz
dutasteride/tamsulosin
milk thistle
centaury
horseweed
lycopus
agrimony
alfalfa
kava
cetrorelix
cetylpyridinium
chlophedianol and dexbrompheniramine
betahistine
choline C-11
boric acid vaginal suppository
aluminum acetate
aluminum chloride hexahydrate
14-C urea breath test
absorbable collagen
valoctocogene roxaparvovec-rvox
amlodipine and celecoxib
aspirin and omeprazole
azilsartan and chlorthalidone
landiolol (Pending FDA approval)
isosorbide dinitrate/hydralazine
losartan/hydrochorothiazide
udenafil
dextromethorphan/quinidine
onasemnogene abeparvovec
orphenadrine/aspirin/caffeine
trace elements
sodium phenylbutyrate/ taurursodiol
fish oil triglycerides
infant formula
glutamine
chloroquine phosphate
afatinib
quinidine gluconate
methylergonovine
prothrombin complex concentrate, human
BCG intravesical live
capivasertib
cedazuridine
carbonyl iron
iron dextran complex
lovotibeglogene autotemcel (FDA Approval Pending)
sodium benzoate/sodium phenylacetate
mineral oil otic
zolmitriptan transdermal
midazolam intranasal
fosinopril/hydrochlorothiazide
caplacizumab
arginine
sodium phenylbutyrate
meloxicam/rizatriptan
manganese
acetaminophen/pamabrom/pyridoxine
varicella zoster immune globulin, human
amitriptyline/perphenazine
narsoplimab (Pending FDA Approval)
amlodipine/perindopril
imiglucerase
canagliflozin/metformin
tafamidis meglumine
somatrogon-ghla
glimepiride/rosiglitazone
becaplermin
lithium
loxapine inhaled
nicotine transdermal
tixagevimab and cilgavimab (Investigational)
muromonab CD3
ansuvimab
coal tar bath products
fibrin sealant
arimoclomol (FDA Approval Pending)
varenicline intranasal
aducanumab
oxycodone/naloxone
ritlecitinib
sodium polystyrene sulfonate
calcipotriene/betamethasone
calcium hydroxylapatite
cantharidin topical
doxepin cream
clocortolone
formaldehyde topical
sodium sulfide topical
collagenase
selegiline transdermal
foscarbidopa/foslevodopa (FDA approval pending)
saxagliptin/metformin
linagliptin/metformin
linzagolix (FDA approval pending)
efgartigimod/hyaluronidase SC
elamipretide (Pending FDA approval)
rozanolixizumab
diazoxide
glimepiride/pioglitazone
cipaglucosidase alfa
dihydroergotamine intranasal
delandistrogene moxeparvovec
beremagene geperpavec
hyaluronic acid and derivatives
hyaluronic acid, non-animal stabilized
eplontersen (FDA Approval Pending)
nitric oxide gas
sodium phenylbutyrate and taurursodiol
treprostinil SC
viltolarsen
albuterol/ipratropium
budesonide inhaled
budesonide rectal
palovarotene (FDA Approval Pending)
sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
amino acids mixture
aminobenzoate potassium
elivaldogene autotemcel
naproxen and sumatriptan
sumatriptan intranasal
alglucerase
metformin/rosiglitazone
ertugliflozin/metformin
elosulfase alfa
calcium carbonate/magnesium hydroxide
starch suppository
abicipar pegol (FDA Approval Pending)
riboflavin 5′-phosphate ophthalmic
povidone ophthalmic
glycerin oropharyngeal
dimethicone topical
menthol topical, dimethicone topical
pramoxine topical, menthol topical and dimethicone topical
phosphorated carbohydrate
brilliant blue G ophthalmic
brolucizumab intravitreal
purified water, ophthalmic
hydroxyethyl cellulose ophthalmic
ranibizumab intravitreal implant
sodium chloride hypertonic, ophthalmic 
cetirizine ophthalmic
phentolamine ophthalmic
ganciclovir ophthalmic
triamcinolone intravitreal
ocriplasmin intravitreal
atoltivimab/maftivimab/odesivimab
pegcetacoplan intravitreal
triamcinolone acetonide extended-release injectable suspension
tobramycin/loteprednol ophthalmic
2-octyl cyanoacrylate
vitamins A & D topical
diphenhydramine/allantoin topical
pyrethrins/piperonyl butoxide
lodoxamide ophthalmic
obeticholic acid
fluocinolone intravitreal implant
sincalide
linaclotide
nedocromil ophthalmic
cysteamine ophthalmic
avacincaptad pegol intravitreal
azelastine ophthalmic
bacitracin ophthalmic
propylene glycol ophthalmic
rimexolone ophthalmic
metoclopramide intranasal
mirikizumab (FDA approval pending)
netarsudil ophthalmic
cenegermin
dexamethasone ophthalmic insert
prednisolone ophthalmic
phenylephrine and cocoa butter rectal
phenylephrine and witch hazel topical
phenylephrine, pramoxine, glycerin and petrolatum rectal
bisacodyl rectal
aluminum hydroxide/magnesium carbonate
aluminum hydroxide/magnesium hydroxide
hyoscyamine spray
methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
phenylephrine
chlorophyll
castor oil
cholic acid
phenol oropharyngeal
articaine/epinephrine
antithymocyte globulin equine
aluminum hydroxide/magnesium trisilicate
methenamine/hyoscyamine
hydrocortisone topical/pramoxine topical
sodium fluoride topical
mesna
C1 esterase inhibitor recombinant
menthol and pectin
menthol oropharyngeal
pectin oropharyngeal
gepirone
Goldenseal
polyethylene glycol and electrolytes
polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
brompheniramine/pseudoephedrine/dextromethorphan
brompheniramine phenylephrine
acetaminophen/doxylamine/phenylephrine
doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
acetaminophen/doxylamine/dextromethorphan
acetaminophen/doxylamine/dextromethorphan/phenylephrine
eslicarbazepine
fluticasone and salmeterol
codeine, acetaminophen, butalbital and caffeine
codeine, chlorpheniramine and phenylephrine
iodine
povidone iodine
butalbital/aspirin/caffeine/codeine
polyethylene glycol 400/propylene glycol ophthalmic 
pegvaliase
amivantamab
iopamidol
codeine and pseudoephedrine
emtricitabine, rilpivirine, tenofovir DF
penicillin G aqueous
miconazole topical
miconazole vaginal
ciprofloxacin inhaled (Pending FDA approval)
ceftazidime/avibactam
ceftolozane/tazobactam
aztreonam inhalation
amphotericin B cholesteryl sulfate
miconazole oral
elvitegravir/cobicistat/emtricitabine/tenofovir DF
isavuconazonium sulfate
dapivirine intravaginal (FDA Approval Pending)
lamivudine/raltegravir
codeine/triprolidine/pseudoephedrine
cadexomer iodine
brompheniramine/pseudoephedrine
codeine/acetaminophen
codeine/guaifenesin
beclomethasone inhaled
epoetin beta/methoxy polyethylene glycol
voreloxin(Orphan Drug)
rociletinib
pitcher plant
phosphatidylserine
telotristat ethyl
copper CU 64 dotatate
urea topical
exenatide subdermal implant
asenapine transdermal
ethiodized oil
urea oral
miglustat
acalisib(Investigational)
acetophenazine
guggul
aceneuramic acid
mestranol/norethindrone
reishi
lactitol
vonoprazan fumarate
motherwort
silver nitrate
salicylic acid/sulfur shampoo
salicylic acid topical
ketorolac ophthalmic
ketoconazole topical
Japanese encephalitis virus vaccine
dibucaine topical ointment
ketorolac intranasal
ketorolac/phenylephrine ophthalmic
rotavirus oral vaccine, live
guarana
hops
krill oil
salicylic acid/coal tar shampoo
sufentanil SL
pancrelipase
passion flower
pepdite one plus
nivolumab and relatlimab
relatlimab (Pending FDA Approval)
benzalkonium chloride/benzocaine
ketotifen, drug-eluting contact lens
calcitriol topical
oxymetazoline topical
alclometasone topical
capsaicin topical
diclofenac/misoprostol
diclofenac ophthalmic
diclofenac topical
pramoxine/calamine topical
veverimer
tolazoline
olopatadine ophthalmic
lutetium lu 177-dota-tate
lutetium lu 177 vipivotide tetraxetan
strontium 89 chloride
interferon alfa n3
lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
samarium sm 153 lexidronam
cytomegalovirus immune globulin (CMV IG)
antithymocyte globulin rabbit
inolimomab (Pending FDA Approval)
olopatadine intranasal
olopatadine intranasal/mometasone, intranasal
benzocaine/butamben/tetracaine topical
antipyrine/benzocaine/phenylephrine
dyclonine/menthol
surufatinib
fruquintinib
tepotinib 
dostarlimab
hepatitis B immune globulin (HBIG)
remestemcel-L
benzocaine/menthol oropharyngeal
interferon beta 1b
tetracaine/oxymetazoline intranasal
benzocaine oropharyngeal
benzalkonium chloride/menthol/petrolatum topical
inamrinone
alpha 1 proteinase inhibitor
potassium bicarbonate/potassium citrate
potassium phosphate/sodium acid phosphate
asparaginase Erwinia chrysanthemi recombinant
motixafortide
pegloticase
etesevimab
Rho(D) immune globulin
tetanus immune globulin (TIG)
reltecimod (pending FDA approval)
avasopasem
trimethoprim/polymyxin B ophthalmic
naphazoline ophthalmic
sulfacetamide topical
sirolimus intravitreal (pending FDA approval)
sirolimus protein bound
sirolimus topical
glycopyrronium tosylate topical
sofpironium
olmesartan, amlodipine and hydrochlorothiazide
dovitinib (Pending FDA Approval)
epinephrine inhaled
quizartinib (Pending FDA Approval)
ranibizumab intravitreal injection
sodium hyaluronate
bacitracin and lidocaine topical
brimonidine topical
benzoyl peroxide and tretinoin topical
talquetamab
betrixaban
acetaminophen/caffeine/pyrilamine
fentanyl transmucosal
bacitracin topical
buprenorphine,long-acting injection
buprenorphine buccal
nalmefene intranasal
sulbactam/durlobactam
metronidazole topical 
daratumumab/hyaluronidase
glofitamab
rituximab-hyaluronidase
drospirenone/ethinyl estradiol/levomefolate
loncastuximab tesirine
ingenol mebutate topical
momelotinib
trastuzumab/deruxtecan
trastuzumab/hyaluronidase
trastuzumab duocarmazine
lifileucel
umbralisib
eflornithine/sulindac
cytarabine/daunorubicin liposomal
doxorubicin liposomal
epcoritamab
lanadelumab  
esomeprazole/naproxen 
terbinafine topical
ravulizumab
clotrimazole topical
choline magnesium trisalicylate
tacrolimus ointment
mechlorethamine topical
donislecel
pozelimab (Pending FDA Approval)
human rabies immune globulin (HRIG)
melphalan flufenamide
sintilimab (Pending FDA Approval)
oportuzumab monatox (Pending FDA Approval)
sotorasib
irinotecan liposomal
sulfur topical
silver sulfadiazine
capsaicin transdermal
sutimlimab
tretinoin topical
acetaminophen rectal
menthol topical
naftifine
oatmeal, colloidal topical
oxiconazole
methylsalicylate/menthol topical
C1 inhibitor human
lifitegrast ophthalmic
prednisolone/sulfacetamide ophthalmic
mannitol inhalation
ofloxacin otic
petrolatum & mineral oil topical
clascoterone topical
gefapixant (Pending FDA Approval)
colesevelam
technetium Tc 99m succimer
nebivolol/valsartan
ciprofloxacin/fluocinolone acetonide, otic
finafloxacin otic
magnesium hydroxide/mineral oil
phenylephrine/mineral oil/petrolatum rectal
carbamide peroxide oral
atropine ophthalmic
sodium sulfacetamide/sulfur
sulfacetamide ophthalmic
lucinactant
benzonatate
besifloxacin ophthalmic
benzhydrocodone/acetaminophen
beractant
trimagnesium citrate anhydrous
vitamin b2
carbamide peroxide otic
mineral oil topical
ethyl alcohol intranasal
boric acid/alcohol otic
absorbable gelatin compressed sponge, USP
absorbable gelatin sponge, USP
vincristine liposomal
technetium Tc 99m albumin aggregated injection
metaproterenol
budesonide inhaled/formoterol/glycopyrrolate inhaled
epinephrine racemic
umeclidinium bromide/vilanterol inhaled
indacaterol, inhaled/glycopyrrolate inhaled
betaine  
laronidase 
estrogens esterified/methyltestosterone            
cerliponase alfa
ertugliflozin/sitagliptin
hawthorn
shepherd’s purse
thiamine
naphazoline/glycerin ophthalmic
oxymetazoline ophthalmic
dorzolamide
dexamethasone intraocular
dexamethasone/ciprofloxacin
dexamethasone ophthalmic
metipranolol ophthalmic
timolol ophthalmic
boron
fezolinetant
pegunigalsidase alfa-iwxj
biotin
pantothenic acid
silicon
sodium acid phosphate
hypochlorous acid topical
methenamine/sodium acid phosphate
aviptadil 
bremelanotide
glucagon intranasal
metformin and repaglinide
bai ji
pau d’arco
juzentaihoto
mistletoe
quercetin
rosemary
sheng di huang
chasteberry
maitake
grapefruit
lentinan
juniper
nettle
parsley
rose hips
tongkat ali
horny goat weed
damiana
yohimbe
insulin NPH
aprocitentan
noni Juice
sodium iodide I-131
green tea
sea cucumber
wheat germ extract
fenofibrate micronized 
rogisen
danshen
lutein
witch hazel
dextroamphetamine transdermal
amphetamine/dextroamphetamine
hoodia
kolanut
boswellia
opuntia ficus indica
lavender
nadh
tea tree oil
metformin/sitagliptin 
dapagliflozin/ metformin/saxagliptin  
antihemophilic factor recombinant
inclisiran
bempedoic acid/ezetimibe
volanesorsen
omega 3 carboxylic acids
pericyazine
levomepromazine (methotrimeprazine)
betaxolol ophthalmic
respiratory syncytial virus vaccine, adjuvanted
phenylephrine hydrochloride and tropicamide ophthalmic
alirocumab
neomycin/polymyxin B/gramicidin ophthalmic
factor IX
gentamicin topical
ansofaxine (Pending FDA Approval)
zuranolone
factor IX, recombinant
factor IX complex
factor XIII A-subunit, recombinant
factor X, human
mesalamine rectal
etrasimod
anti-inhibitor coagulant complex
factor IX, recombinant/albumin fusion protein
fibrinogen, human
aminocaproic acid
metyrosine
nonoxynol-9 vaginal
progesterone intravaginal gel
ipecac syrup
botulinum antitoxin, heptavalent
pentetate calcium trisodium
crotalidae polyvalent immune FAB (ovine)
dehydrated alcohol injection
gold sodium thiomalate (Discontinued)
lactic acid/citric acid/potassium bitartrate vaginal
von Willebrand factor, recombinant
luspatercept
digoxin immune FAB (Antidote)
crotalidae immune FAB (equine)
magnesium (Antidote)
pyridoxine (Antidote)
edetate calcium disodium
albumin IV
nitroglycerin sublingual
obiltoxaximab
anthrax immune globulin
nitroglycerin topical
dextrose
nesiritide
estradiol vaginal
bazedoxifene/conjugated estrogens
botulism immune globulin iv
amoxicillin/omeprazole/rifabutin
synthetic human angiotensin II
nitroglycerin IV
nitroglycerin translingual
nitroprusside sodium
tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
sodium citrate/citric acid
pemetrexate
methicillin
plasminogen 
acai
american ginseng
cordyceps
tramadol/acetaminophen
belladonna alkaloids/phenobarbital
erythromycin topical/benzoyl peroxide
glucosamine sulfate
panax ginseng (suppl/herb)
tolnaftate
sulopenem etzadroxil/probenecid
sulfur hexafluoride
sotrovimab
arbaclofen
rifampin/isoniazid
clindamycin /tretinoin topical
benzoyl peroxide/clindamycin topical
apremilast
antivenins, centuroides (scorpion)
bamlanivimab and etesevimab
vilobelimab
gadobenate
pentosan polysulfate sodium
methylsalicylate/menthol/camphor topical
antivenin, black widow spider
benzoyl peroxide and hydrocortisone
clindamycin topical
isometheptene, dichloralphenazone and acetaminophen
acetaminophen and phenyltoloxamine
erythromycin topical
erythromycin ophthalmic
alpha hydroxy acids, topical
buprenorphine transdermal
butalbital/acetaminophen/caffeine
buprenorphine/samidorphan
buprenorphine subdermal implant
celecoxib/tramadol
drospirenone/ethinyl estradiol
resorcinol/sulfur
eflornithine
rifampin/isoniazid/pyrazinamide
tofersen
devil’s claw
ticarcillin/clavulanate
atropine/pralidoxime
aprepitant
suramin
phenelzine
artichoke
american dogwood
attapulgite
atlantic cedar
axalimogene filolisbac
sodium thiosulfate & sodium nitrite
ataluren
omidubicel-onlv
capsicum
ginger
cryoprecipitate
bictegravir/emtricitabine/tenofovir DF
emtricitabine/tenofovir DF
fo-ti
siberian ginseng
granulocytes
zinc substituted heme C
zinc trihydroxide
ashwagandha 
cat’s claw
glandular products
SAMe
shark cartilage
altovis
feverfew
horse chestnut
magnesium aspartate
octacosanol
pleurisy root
star anise
butterbur
elderberry
licorice (Suppl/herb)
aconite
pentetate zinc trisodium
menthol topical/zinc oxide topical
corn-starch/kaolin/zinc oxide topical
5-htp
butcher’s broom
articulin
bearberry
goldenrod
progesterone, natural
black cohosh
wild yam
cranberry
dong quai
phytoestrogens
norethindrone
false Unicorn Root
raspberry Leaf
asafoetida
turmeric
dehydroepiandrosterone (DHEA)
hyaluronan
aliskiren/amlodipine
octreotide (Antidote)
tranexamic acid injection
duocal
neocate infant formula
pediatric Eo28
aloe
red clover
propolis
androstenedione
heartsease
comfrey
bilberry
chamomile
eyebright
calendula
sage
yucca
polypody
odevixibat
vinpocetine
olanzapine/samidorphan
creatine
yerba mate
spesolimab
azficel-T
tiludronate
estetrol and drospirenone
pseudoephedrine/fexofenadine
lincomycin
neomycin oral
fluocinolone acetonide, otic
tretinoin/ hydroquinone/ fluocinolone
halobetasol topical
hydrocortisone/iodoquinol
penicillin G procaine /penicillin G benzathine
hydrocortisone probutate topical
colistin/neomycin/hydrocortisone/thonzonium otic
ebola zaire vaccine
hepatitis a/b vaccine
vibegron
lindane
nystatin topical
respiratory syncytial virus (RSV) vaccine
chikungunya vaccine
tenecteplase
reteplase
anthrax vaccine adsorbed, adjuvanted
meningococcal ABCWY pentavalent vaccine
eculizumab
cholestyramine
tinzaparin
taurolidine/citrate/heparin
protein C concentrate
antithrombin alfa
antithrombin III
multivitamins, vision
ibuprofen/chlorpheniramine/pseudoephedrine
acetaminophen/ibuprofen
ibuprofen/pseudoephedrine
paclitaxel protein-bound
acetic acid vaginal
acetic acid otic
hydrocodone/ ibuprofen
methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
ibuprofen and phenylephrine
acetylcysteine (Antidote)
iron/folic acid/vitamin/mineral
iobenguane I-131
dolutegravir/rilpivirine
chlorhexidine topical
chlorhexidine oral
thyroid desiccated
proparacaine ophthalmic
podophyllum resin
phendimetrazine
phenoxybenzamine
polidocanol
phentermine and topiramate
piflufolastat F18
piperacillin/tazobactam
prednisolone and gentamicin ophthalmic
promethazine and codeine
poractant alfa
protamine sulfate
aflibercept intravitreal
prednicarbate
promethazine/dextromethorphan
codeine, phenylephrine, and promethazine
potassium phosphate
glatiramer acetate
gentamicin (Ophthalmic)
leniolisib
rezafungin
fluorometholone
dalfampridine
hydrocortisone topical 
empagliflozin and linagliptin
triamcinolone topical
minocycline topical
minocycline dental
ketotifen ophthalmic
darunavir and cobicistat
lidocaine topical
neomycin/polymyxin B/bacitracin/lidocaine (OTC)
lidocaine/ hydrocortisone
lidocaine anesthetic
lidocaine ophthalmic
lidocaine/tetracaine
desonide
dabigatran
fexofenadine
fluoride
decitabine and cedazuridine
dasiglucagon
hydroxypropyl cellulose ophthalmic
epoetin alfa
ibritumomab tiuxetan
trimethobenzamide
dexamethasone/ tobramycin
tafasitamab
valacyclovir
mebendazole
levoleucovorin
flaxseed
germanium
glutathione
lycopene
pygeum
horseradish
ziv-aflibercept
micafungin
trofinetide
taliglucerase alfa
tildrakizumab
sulopenem (Pending FDA Approval)
thyrotropin alfa
birch
thrombin, topical
tivozanib
tafluprost
methohexital
urea and hydrocortisone
unoprostone ophthalmic
trihexyphenidyl
ezetimibe
evolocumab
trifluridine and tipiracil
methenamine
misoprostol
miltefosine
rimantadine
maralixibat
coenzyme Q10
chlorella
garlic
forskolin
zavegepant
menotropins
margetuximab
meprobamate
melarsoprol
evening primrose oil
lemongrass
molindone
fenugreek
phytosterols
red yeast rice
uridine triacetate
tropicamide
incobotulinumtoxinA
Grape Seed Extract
carbachol ophthalmic
cosyntropin
cyclopentolate and phenylephrine
carteolol ophthalmic
pentazocine/naloxone
pentazocine/acetaminophen
casimersen
carisoprodol, aspirin, and codeine
carisoprodol
carboprost tromethamine
flurandrenolide
brinzolamide/brimonidine
betamethasone topical
omaveloxolone
bardoxolone
allogeneic processed thymus tissue
fluocinolone topical
tacrolimus topical
ruxolitinib topical
pimecrolimus topical
sofosbuvir, velpatasvir and voxilaprevir
sofosbuvir/velpatasvir
mitotane
elbasvir/grazoprevir
wheat dextrin
vanadium
iron/folic acid/vitamin/mineral
molybdenum
sparsentan
velmanase alfa-tycv
pegcetacoplan
ferrous sulfate
cyclosporine ophthalmic
ferric pyrophosphate
ammonium lactate
etelcalcetide
iodoquinol
sucroferric oxyhydroxide
doxercalciferol
terconazole vaginal
cortisone
pyronaridine
tetrahydrozoline, ophthalmic
tenapanor
tesamorelin
benazepril/hydrochlorothiazide
nadolol and bendroflumethiazide
spironolactone and hydrochlorothiazide
COVID-19 Vaccine, mRNA
atosiban
bisoprolol and hydrochlorothiazide
ephedrine/guaifenesin
clonidine/chlorthalidone
captopril/hydrochlorothiazide
amlodipine/valsartan/hydrochlorothiazide
hydrochlorothiazide and irbesartan
candesartan/hydrochlorothiazide
ciclesonide intranasal
cromolyn sodium ophthalmic
methyldopa/hydrochlorothiazide
valsartan/hydrochlorothiazide
hydrochlorothiazide and triamterene
moexipril/hydrochlorothiazide
mometasone/intranasal
ofloxacin ophthalmic
cysteamine
metoprolol/hydrochlorothiazide
amlodipine/olmesartan
eprosartan/hydrochlorothiazide
amlodipine/telmisartan
hydrochlorothiazide/aliskiren
betamethasone/clotrimazole
telmisartan/hydrochlorothiazide
benazepril/amlodipine
bezlotoxumab
propranolol/hydrochlorothiazide
bupropion/naltrexone
burosumab
acetylcholine chloride intraocular solution
bupivacaine and meloxicam
budesonide and formoterol (inhalation)
valerian
entacapone/levodopa/carbidopa
carbidopa/levodopa
calaspargase pegol
cabotegravir
cefixime
calfactant
brinzolamide
daprodustat
brimonidine and timolol
brodalumab
buprenorphine and naloxone
hydrocortisone acetic acid otic
butorphanol
butoconazole
adapalene and benzoyl peroxide
acrivastine and pseudoephedrine
neomycin/polymyxin B/bacitracin topical
midodrine
baloxavir marboxil
bacitracin, neomycin, polymyxin B, and hydrocortisone topical
avatrombopag
glucagon
atenolol/chlorthalidone
adefovir
activated charcoal
avalglucosidase alfa
aclidinium and formoterol
iclaprim (Pending FDA Approval)
ampicillin/sulbactam
quinupristin/dalfopristin
lamivudine/zidovudine/abacavir
acetaminophen and caffeine
acetaminophen/pamabrom
abacavir and lamivudine
anifrolumab
elacestrant
anidulafungin
acetohydroxamic acid
alogliptin/pioglitazone
anthralin
pirtobrutinib
gabapentin
galsulfase
gadoterate meglumine
ferric gluconate
ferric derisomaltose
ethanolamine oleate
eteplirsen
vasopressin
desmopressin
meropenem/vaborbactam
ecallantide
econazole topical
dornase alfa
aspirin/dipyridamole
dipyridamole
difenoxin and atropine
diflorasone
difluprednate ophthalmic
eptinezumab
diethylpropion
dexchlorpheniramine
dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate
bexagliflozin
galcanezumab
fremanezumab
tapinarof topical
darifenacin
dalbavancin
darbepoetin alfa
azilsartan
colestipol
corticorelin
crotamiton
crofelemer
allogeneic cultured keratinocytes/fibroblasts in bovine collagen
tapentadol
cyclopentolate
polymyxin B/bacitracin topical
tavaborole
tagraxofusp
crisaborole
crizanlizumab
satralizumab
spinosad
sacubitril/valsartan
sargramostim
sebelipase alfa
regadenoson
ribociclib/letrozole
ragweed allergen extract
radium-223 dichloride
secnidazole
setmelanotide
polycarbophil
plecanatide
sacituzumab govitecan
pertuzumab
pertuzumab/trastuzumab/hyaluronidase
pamidronate
halcinonide
glecaprevir/pibrentasvir
glucarpidase
golodirsen
dextrose (antidote)
hexaminolevulinate
iohexol
ferric citrate
elapegademase
emicizumab
erenumab
danaparoid
dantrolene
eflapegrastim
edaravone
amcinonide
carglumic acid
alcaftadine ophthalmic
agalsidase beta
afamelanotide
fosdenopterin
lidocaine and chlorhexidine
levorphanol
calcifediol
factor VIIa, recombinant
triheptanoin
peanut oral allergen powder
teprotumumab
poly-L-lactic acid/carboxymethylcellulose/mannitol
xenon Xe 129 hyperpolarized
ublituximab
anacaulase
glatiramer
peginterferon beta-1a
interferon beta-1a
onabotulinumtoxinA
cycloserine
ethionamide
cabotegravir and rilpivirine
vericiguat
omidenepag isopropyl
azelastine/fluticasone intranasal
benzyl peroxide
vutrisiran
brimonidine
testosterone topical
lenacapavir
tebentafusp
mosunetuzumab
faricimab
ganirelix
nadofaragene firadenovec
ozenoxacin
guaifenesin
adagrasib
guselkumab
adalimumab-aacf
nonoxynol-9
nifurtimox
nusinersen
nitazoxanide
mavacamten
calcipotriene
bimatoprost
obinutuzumab
amifostine
oxycodone/aspirin
oxycodone/ibuprofen
oteseconazole
oxychlorosene
porfimer
pramoxine /hydrocortisone topical
podofilox
quinapril/hydrochlorothiazide
acetaminophen/pamabrom/pyrilamine
levobunolol
paregoric
idursulfase
lesinurad and allopurinol
latanoprost/netarsudil ophthalmic
lactase enzyme
bioadherent oral
latanoprost and timolol
latanoprostene bunod
ledipasvir/sofosbuvir
imipenem/cilastatin/relebactam
imipenem/cilastatin
hemin
deucravacitinib
house dust mite allergen extract
halobetasol topical/tazarotene
remimazolam
somatropin
remifentanil
ethotoin
etidronate
empagliflozin, linagliptin, and metformin
elvitegravir/cobicistat/emtricitabine/tenofovir AF
empagliflozin/metformin
evinacumab
finasteride and tadalafil
flortaucipir (18F)
proparacaine/ fluorescein ophthalmic
fluorescein/benoxinate ophthalmic
fluphenazine
alogliptin/metformin
alogliptin/pioglitazone
alitretinoin topical
dextrose/ sodium citrate/fructose
dasabuvir
ombitasvir/paritaprevir/ritonavir
hydrocodone/chlorpheniramine/pseudoephedrine
hydroxyamphetamine/tropicamide
acamprosate
gadobutrol
teclistamab
tremelimumab
futibatinib
etranacogene dezaparvovec
olutasidenib
naproxen and diphenhydramine
naratriptan
gadopiclenol
gadoxetate
gadoversetamide
naphazoline/pheniramine
naphazoline
nalbuphine
vosoritide
vitamin K1 (phytonadione)
moxidectin
basiliximab
fecal microbiota, live-jslm
ibuprofen/famotidine
famotidine
raxibacumab
omalizumab
measles, mumps, rubella, and varicella vaccine, live (Rx)
senna/docusate
dinoprostone
measles mumps and rubella vaccine, live
immune globulin IM (IGIM)
dyclonine
doravirine, lamivudine, and tenofovir disoproxil fumarate
elexacaftor/tezacaftor/ivacaftor
ivacaftor/tezacaftor
treosulfan
tranexamic acid
norethindrone acetate/estradiol/elagolix
artesunate
trientine
trifarotene
ziconotide
vonoprazan/amoxicillin/clarithromycin
pyrithione zinc
zinc oxide topical
naphazoline/zinc sulfate/glycerin ophthalmic
voretigene neparvovec
nirmatrelvir/ritonavir
bebetelovimab
sodium chloride
relugolix/estradiol/norethindrone
defibrotide
prothionamide
liraglutide/insulin degludec
etilfrine
alpha-lipoic acid
ramosetron
olodaterol/tritropium
cimetropium
umeclidinium
itopride
secretin
naftopidil
trimeprazine
benperidol
chlormethiazole
multivitamins
secukinumab
glycopyrrolate inhaled and formoterol
amitriptyline and chlordiazepoxide
tirzepatide
relugolix/estradiol/norethindrone
mupirocin
alvimopan
chlordiazepoxide
insulin regular human
insulin aspart protamine/insulin aspart
insulin isophane human/insulin regular human
insulin degludec/insulin aspart
teplizumab
chlordiazepoxide/clidinium
aspirin, sodium bicarbonate, and citric acid
aluminum hydroxide, magnesium hydroxide, and simethicone
glycopyrrolate inhaled
olodaterol/tiotropium
umeclidinium bromide
timolol/dorzolamide
travoprost ophthalmic
loxapine
eptifibatide
hydrocodone/acetaminophen
omega 3 fatty acids
trandolapril/verapamil
abciximab
artificial saliva
diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine
diphtheria, haemophilus B, pertussis, polio, tetanus vaccine
haemophilus influenzae type b vaccine/hepatitis b vaccine
butalbital/aspirin/caffeine 
colchicine/probenecid
atovaquone and proguanil
ursodiol
chenodiol
casirivimab/imdevimab
tixagevimab/cilgavimab
molnupiravir
bebtelovimab
calcium, magnesium, potassium and sodium oxybate
sodium oxybate
diphtheria, polio, pertussis acellular, tetanus vaccine
pseudoephedrine loratadine
sodium chloride nasal
hydroxychloroquine sulfate
atorvastatin and ezetimibe
teriparatide
alendronate and cholecalciferol
alprostadil (IV)
romosozumab
risedronate
alendronate
glyburide/metformin
clorazepate
rosuvastatin/ezetimibe
paclitaxel/encequidar
valsartan/amlodipine
enalapril/hydrochlorothiazide
enalapril and felodipine
amiloride/hydrochlorothiazide
triamterene/hydrochlorothiazide
lisinopril/hydrochlorothiazide
tegaserod
rhein
ritanserin
sulfaphenazole
sulconazole
taurursodiol
bromeperidol
carbapenems
fotemustine
difelikefalin
bromopride
alizapride
olopatadine
oxomemazine
paraldehyde
oxcarbazepine
kratom
elexacaftor
oritavancin
miocamycin
curcumin sulfate
seproxetine
clotrimazole
remacemide
piperine
ditiocarb
danoprevir
oxetacaine
topiroxostat
indisulam
tofisopam
noscapine
thiopental
tioconazole
nicotinamide
rutin
mequitazine
somatostatin
vapreotide
econazole
saracatinib
lestaurtinib
efonidipine
zimelidine
indalpine
desvenlafaxine
benidipine
dapoxetine
tesmilifene
pergolide
sitaxentan
resveratrol
bifonazole
tildipirosin
solithromycin
selamectin
imiquimod topical
fluorouracil topical
peginterferon alfa-2b
interferon alfa-2b
alteplase
tanshinone I
rosmarinic acid
caryophyllene
ursolic acid
cepharanthine
veliflapon
mirikizumab
cp-96345
famprofazone
peoniflorin
fepradinol
licofelone
polmacoxib
ebselen
taxifolin
betulinic acid
flurbiprofen axetil
talniflumate
morniflumate
nitroaspirin
firocoxib
ns-398
cimicoxib
robenacoxib
sc-236
imidazole salicylate
trolamine salicylate
pirprofen
benorilate
ethenzamide
mofebutazone
proquazone
carbaspirin calcium
guacetisal
proglumetacin
propyphenazone
pranoprofen
bendazac
tenidap
lonazolac
nifenazone
flunoxaprofen
difenpiramide
feprazone
bufexamac
alminoprofen
suxibuzone
fentiazac
tinoridine
tepoxalin
indobufen
flunixin
propacetamol
clonixin
droxicam
epirizole
etofenamate
ibuproxam
indoprofen
kebuzone
felbinac
zaltoprofen
azapropazone
zomepirac
niflumic acid
magnesium salicylate
suprofen
nepafenac
bromfenac
ciprofloxacin and hydrocortisone (otic) (Rx)
hydrocortisone/neomycin/polymyxin otic (Rx)
vigabatrine
valproate sodium injection
tezepelumab (Rx)
triamcinolone acetonide/nystatin
triamcinolone suprachoroidal (Rx)
triamcinolone, intranasal
ciclesonide inhaled
diosmin
tirbanibulin
padeliporfin
roxadustat
aminosalicylic acid
rasburicase
tetracaine
articaine
ropivacaine
nitrous oxide
sulfapyridine
sulfanilamide
mafenide
isometheptene
amyl nitrite
antipyrine
isosorbide dinitrate
prilocaine
nitroglycerin
tobacco
batefenterol
hexoprenaline
pf-00610355
racepinephrine
protokylol
doxofylline
phenylpropanolamine
isoetharine
ephedra sinica root
dipivefrin
arbutamine
norepinephrine
fenoterol
clenbuterol
pirbuterol
epinephrine
ritodrine
procaterol
orciprenaline
bitolterol
abediterol
fluticasone furoate, umeclidinium and vilanterol
fluticasone furoate and vilanterol
mometasone and formoterol
pramoxine topical (OTC)
menthol/pramoxine (topical)
tetrastarch
plasma protein fraction
hetastarch
rokitamycin
ridaforolimus
oleandomycin
patupilone
mitemcinal
midecamycin
mirvetuximab soravtansine
lorvotuzumab mertansine
kitasamycin
flurithromycin
eprinomectin
epofolate
epothilone D
coltuximab ravtansine
dirithromycin
doramectin
cethromycin
carbomycin
paramethasone
dexamethasone isonicotinate
quinupristin
sarilumab
dalfopristin
curcumin
luliconazole
procaine
chloroprocaine
phencyclidine
tenocyclidine
profenamine
halothane
lfenprodil
calcium levulinate
agmatine
calcium pangamate
calcium glubionate
edodekin alfa
beloranib
aflibercept
endostar
volociximab
roquinimex
anecortave acetate
squalamine
brolucizumab
trebananib
semaxanib
endostatin
halofuginone
resveratol
ranibizumab
fumagilin
bevacizumab
hyperforin
aminohippuric acid
opicapone
pafolacianine
bempedoic acid
belantamab mafodotin
prasterone
glecaprevir
levomenol
parachlorophenol
gadoxetic acid
cholecystokinin
caspofungin
ouabain
rifampicin
taurocholic acid
methylphosphinic acid
revefenacin
isoprenaline
posiphen
acotiamide
triflupromazine
pegvisomant
pipecuronium
regramostim
phenserine
diethylcarbamazine
cinchocaine
pancuronium
bambuterol
hexafluronium
aprotinin
tyrothricin
decamethonium
ipidacrine
tubocurarine
paraoxon
ginkgo biloba
methanesulfonyl fluoride
dichlorvos
fenthion
metrifonate
coumaphos
huperzine A
distigmine
neostigmine
isoflurophate
tasosartan
fimasartan
methylthioninium
minaprine
gallamine triethiodide
ambenonium
abiraterone
mibefradil

tolvaptan +

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

curcumin

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

may enhance the serum concentration when combined with tolvaptan

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

citalopram

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

efavirenz

tolvaptan: they may enhance the serum concentration of CYP3A Inhibitors

primidone

may diminish the serum concentration when combined with tolvaptan

may diminish the serum concentration when combined with tolvaptan

isoniazid

may diminish the serum concentration when combined with tolvaptan

propofol

may diminish the serum concentration when combined with tolvaptan

selexipag

may diminish the serum concentration when combined with tolvaptan

desmopressin

may decrease the therapeutic effect when combined with desmopressin

sodium chloride

may increase the adverse effect when combined with tolvaptan

grapefruit

It may enhance the effect when combined with grapefruit by CYP3A4 metabolism

griseofulvin

It may diminish the effect when combined with griseofulvin by CYP3A4 metabolism

miconazole vaginal

It may enhance the effect when combined with miconazole vaginal by affecting CYP3A4 metabolism

enzalutamide

CYP3A strong enhancers of the small intestine may reduce the bioavailability of tolvaptan

nirmatelvir/ritonavir

may enhance the serum concentration of CYP3A4 inhibitors

sodium chloride nasal

sodium chloride increases the toxicity of tolvaptan

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

losartan

may increase the hyperkalemic effect when combined with angiotensin II receptor blockers

may increase the hyperkalemic effect when combined with ace inhibitors

quinapril

may increase the hyperkalemic effect when combined with ace inhibitors

ramipril

may increase the hyperkalemic effect when combined with ace inhibitors

rescinnamine

may increase the hyperkalemic effect when combined with ace inhibitors

spirapril

may increase the hyperkalemic effect when combined with ace inhibitors

may diminish the serum concentration when combined with tolvaptan

efavirenz

may diminish the serum concentration when combined with tolvaptan

digoxin

may enhance the serum concentration when combined with digoxin

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

amiloride

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

may increase the hyperkalemic effect when combined with potassium-sparing diuretics

dexamethasone

It may enhance the metabolism when combined with dexamethasone

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

losartan

may enhance the hyperkalemic effect

cilazapril

may enhance the hyperkalemic effect

enalapril

may enhance the hyperkalemic effect

enalaprilat

may enhance the hyperkalemic effect

lisinopril

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

amiloride

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

may enhance the hyperkalemic effect

paclitaxel

when both drugs are combined, there may be a high metabolism of tolvaptan 

lorlatinib

the effect of tolvaptan is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism

carvedilol

it enhances the serum potassium levels

telmisartan

it may enhance the serum potassium levels

primidone

may decrease the serum concentration

may decrease the serum concentration

may decrease the serum concentration

efavirenz

may decrease the serum concentration

isoniazid

may decrease the serum concentration

may decrease the serum concentration

donepezil transdermal

may decrease the serum concentration

efavirenz

may decrease the serum concentration

prednisolone

may decrease the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

isoniazid

may increase the serum concentration

mexiletine

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

curcumin

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

may increase the serum concentration

diacerein

may increase the serum concentration