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Hyponat O 15mg (Tolvaptan) 10 Tablets/Strip


Hyponat O 15mg (Tolvaptan) 10 Tablets/Strip

Hyponat O 15mg (Tolvaptan)

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Product Name
Hyponat O 15mg (Tolvaptan) 10 Tablets/Strip
Also known as Samsca or Jinarc
Active Ingredient
Tolvaptan 15mg
Manufacturer
Cadila Healthcare
Product Type
Vasopressin receptor 2 antagonist
Product expiry date we are currently shipping
Dec 2019

Hyponat O tablets 15mg contain tolvaptan, a vasopressin antagonist that is used to treat the chronic kidney disease, autosomal dominant polycystic kidney disease (ADPKD), to improve impaired kidney function and reduce symptoms. 

Hyponat O general information

What is Hyponat O used for?

Hyponat O tablets 15mg are used to treat autosomal dominant polycystic kidney disease (ADPKD) in those with chronic kidney disease (CKD) stages 1 to 3, with evidence of rapidly progressing disease. Polycystic kidney disease is caused by the breakdown of the normal kidney cell structure and the development of fluid filed cysts.  ADPKD is a common genetically inherited disorder that causes the development of slow-growing large fluid-filled cysts in the kidneys.  Eventually the cysts become so large that they put pressure on surrounding tissues and compromise the normal functioning of the kidneys, often resulting kidney failure and end stage kidney disease, requiring transplant or dialysis.  Symptoms of ADPKD include high blood pressure, pain in the back and side of the body, swollen abdomen, blood and sometimes also protein in the urine, kidney stones, frequent bladder infection and renal insufficiency, which is impaired kidney function.  In some cases cysts can also develop in other areas, particularly the liver.  Hyponat O tablets 15mg help slow the development of cyst formation and the progression of renal insufficiency. 

How does Hyponat O work?

Hyponat O tablets 15mg contain tolvaptan, a vasopressin antagonist that is used to treat autosomal dominant polycystic kidney disease (ADPKD) in those at high risk of rapid progression with potentially serious outcomes.  ADPKD is caused by mutations in the polycystic kidney disease 1 (PKD1) or 2 (PKD2) genes, which are important genes for normal kidney function and are thought to be involved in producing proteins involved in cellular signalling.  These proteins are called polycystin-1 (PC1), which is a transmembrane protein that is thought to act as a receptor, and polycystin-2 (PC2) is an as ion channel that transport calcium between the inside and outside of the cell, which is an important signalling mechanism.  It is thought that PC1 and PC2 are located in the cilia (tiny hairs) in the tubules of the kidney that regulate fluid flow in the lumen of the tubules by triggering membrane signalling mechanisms involving calcium ions and enzymes like adenylate cyclase and tyrosine kinase1, 2. Mutations in the PKD1 or 2 PKD2 genes disrupts the intracellular signalling and enzyme pathways, which results in stimulation of renal tubular epithelial cell proliferation and fluid secretion, both cellular features of ADPKD. 

The hormone arginine vasopressin (AVP), also known as antidiuretic hormone promotes water retention in the body.  AVP acts directly on the tubules of the kidney at the distal portion of the nephron, which is the functional unit of the kidney, at the collecting duct where the water and salt concentration of the urine is regulated.  Binding of AVP to specific cell surface receptors (AV2) in the nephron, triggers a membrane bound enzyme, adenylate cyclase to produce cAMP (cyclic adenosine monophosphate), which activates an intracellular signal transduction mechanism to open water channels (aquaporins) through which water is absorbed from the urine into the blood.  cAMP also triggers proliferation of kidney cyst cells and secretion of fluid into these cysts.  Tolvaptan in Hyponat O tablets 15mg blocks the binding of AVP at the V2 receptors and prevents the signalling cascade that leads to fluid filled cyst formation; it also increases urine excretion back to normal levels.  Tolvaptan in Hyponat O tablets 15mg slows down the development of cysts in patients with ADPKD and reduces risk of disease progression, by reducing kidney volume, cyst proliferation and increasing urine production, which reduces symptoms of the disease.

What does Hyponat O contain?

Hyponat O tablets 15mg contain the active ingredient tolvaptan, a vasopressin antagonist that is used to treat autosomal dominant polycystic kidney disease (ADPKD).

Treating polycystic kidney disease with Hyponat O

Hyponat O tablets 15mg contain tolvaptan, a vasopressin antagonist that is used to treat autosomal dominant polycystic kidney disease (ADPKD) in those with chronic kidney disease (CKD) stages 1 to 3, with evidence of rapidly progressing disease.  Polycystic kidney disease is caused by the breakdown of the normal kidney cell structure and the development of fluid filed cysts.  ADPKD is a common genetically inherited disorder that causes the development of slow-growing large fluid-filled cysts in the kidneys.  Eventually the cysts become so large that they put pressure on surrounding tissues and compromise the normal functioning of the kidneys, reducing kidney function, and often resulting kidney failure and end stage kidney disease, requiring transplant or dialysis.  Symptoms of ADPKD include high blood pressure, pain in the back and side of the body, swollen abdomen, blood and sometimes also protein in the urine, kidney stones, frequent bladder infection and renal insufficiency, which is impaired kidney function.  The genetic mutations found in ADPKD disrupt the intracellular signalling pathways in kidney cells, which results in stimulation of renal tubular epithelial cell proliferation that form the cysts and fluid secretion into the cysts, both cellular features of ADPKD that are activated by the binding of the hormone arginine vasopressin (AVP) (also known as diuretic hormone) to specific receptors on renal tubules at the distal portions of the nephron.  Tolvaptan in Hyponat O tablets 15mg slows down the development of cysts in patients with ADPKD and reduces risk of disease progression, by reducing kidney volume, cyst proliferation and increasing urine production, which reduces symptoms of the disease.

What are the side effects of Hyponat O?

The most commonly reported side effects when taking Hyponat O tablets 15mg include thirst, polyuria (large volume of urine production), nocturia (excessive night time urination), and pollakiuria (frequent urination), dehydration, decreased appetite, polydipsia (excessive thirst), hyperglycaemia (high blood sugar), increased blood levels of sodium and uric acid, insomnia, headache, dizziness, palpitations, dyspnoea, fatigue, asthenia (weakness), weight loss.  

When should Hyponat O not be used?

You should not use Hyponat O tablets 15mg if you:

  • are allergic to tolvaptan or any ingredients in Hyponat O
  • are pregnant or are breastfeeding
  • have liver injury or raised levels of liver enzymes in your blood
  • have trouble producing urine or have an enlarged prostate
  • have trouble drinking sufficient water or don’t perceive or respond to thirst
  • have a condition associated with a very low blood volume, like severe dehydration or bleeding
  • have hypernatraemia (high blood sodium)
  • have high blood levels of uric acid that can cause gout, without discussion with your doctor, as Hyponat O can decrease clearance of uric acid from the blood
  • have diabetes without discussion with your doctor, as Hyponat O can increase blood sugar
  • are taking medicines that interact with Hyponat O, including antibiotics like erythromycin, clarithromycin and rifampin, antifungals like ketoconazole and itraconazole, antivirals like ritonavir and ritonavir for HIV, antiepileptics like carbamazepine and phenytoin, grapefruit juice, calcium channel blockers like diltiazemfor high blood pressure, St. John's Wort, medications that increase blood sodium or contain large amounts of salt, like tablets that dissolve in water and indigestion remedies, digoxin for heart failure, statins for high cholesterol, methotrexate for cancer or arthritis, the antibiotic ciprofloxacin, sulfasalazine for inflammatory bowel disease or rheumatoid arthritis, the antidiabetic metformin, vasopressin analogues like desmopressin (used to increase blood clotting factors or to control urine output or bedwetting)

What medications interact with Hyponat O?

Several medications interact with Hyponat O tablets 15mg and should either not be taken while you are taking Hyponat O or only after discussion and instruction from your doctor:

  • Drugs that cause a serious reaction with Hyponat O: diuretics may cause dehydration, medications that increase blood sodium or contain large amounts of salt, like tablets that dissolve in water and indigestion remedies
  • Drugs that affect Hyponat O: antibiotics like erythromycin, clarithromycin and rifampin, antifungals like ketoconazole and itraconazole, antivirals like ritonavir and ritonavir for HIV, antiepileptics like carbamazepine and phenytoin, grapefruit juice, calcium channel blockers like diltiazem for high blood pressure, St. John's Wort, diuretics
  • Drugs that are affected by Hyponat O: digoxin for heart failure, statins for high cholesterol, methotrexate for cancer or arthritis, the antibiotic ciprofloxacin, sulfasalazine for inflammatory bowel disease or rheumatoid arthritis, the antidiabetic metformin, vasopressin analogues like desmopressin (used to increase blood clotting factors or to control urine output or bedwetting)

How should Hyponat O be taken?

You should take your Hyponat O tablets 15mg swallowed whole with a glass of water.  The dose you take should be as recommended by your doctor and is split into two doses, one bigger than the other.  The higher dose should be taken in the morning at least 30 minutes before a meal.  The second lower dose can be taken with or without food, 8 hours after the first dose.  You should continue to take your Hyponat O tablets 15mg for as long as recommended by your doctor.

How long should you take Hyponat O?

You should continue to take your Hyponat O tablets 15mg for as long as recommended by your doctor.

Missed dose of Hyponat O

If you miss a dose of Hyponat O tablets 15mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Hyponat O be stored?

You should store your Hyponat O below 25°C in a cool dry place. 

References

  1. Tan Y-C, Blumenfeld J, Rennert H. Autosomal dominant polycystic kidney disease: Genetics, mutations and microRNAs. Biochimica et Biophysica Acta 1812 (2011) 1202–1212
  2. Takiar V, Caplan M J. Polycystic Kidney Disease: Pathogenesis and Potential Therapies. Biochim Biophys Acta. 2011 October ; 1812(10):

 

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