HomeAnswersInternal MedicinehyponatremiaMy symptoms of hyponatremia are not improving even after taking tablet Tolvaptan 30 mg. What to do?

Can I take tablet Tolvaptan 30 mg in the long run for my hyponatremia problem?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At February 10, 2022
Reviewed AtJanuary 9, 2023

Patient's Query

Hello doctor,

I am suffering from hyponatremia, senile dementia, and insomnia. I am presently taking the following medicines:

1. Tablet Lamez (Lamotrigine) 12.5 mg.

2. Tablet Bisoprolol 2.5 mg.

3. Tablet Memantine 5 mg.

4. Tablet Nexito Plus (Clonazepam + Escitalopram Oxalate).

5. Tablet Tolvaptan 30 mg once daily along with salt capsule 6 mg.

After taking the tablet Tolvaptan 30 mg, my serum sodium level improved somewhat; but it is not elevating more even after continuing with tablet Tolvaptan 30 mg. I am also restricting my daily water intake upto a maximum of 1200 ml.

Serum sodium level gets down when I stop taking tablet Tolvaptan 30 mg. I am already taking this medicine for the past two months. Should I have to take it for a lifetime?

I do not have any thyroid problem. Please give your advice on continuing with tablet Tolvaptan 30 mg in the long run.

Answered by Dr. Arpit Varshney

Hello,

Welcome to icliniq.com.

I have read your concern in detail and will surely help you out. I would suggest that rather than focusing on curing hyponatremia, we should focus on its cause. Hyponatremia is a known complication of tablet Nexito plus.

You are taking tablet Tolvaptan 30 mg, which is helping you with your sodium levels. But it is not upto the mark because you are also consuming tablet Nexito plus alongside.

Please stop taking tablet Nexito plus, your sodium levels will normalize, and your tablet Tolvaptan 30 mg will also be discontinued after two months.

Hope this helps.

Kindly revert in case of further queries.

Patient's Query

Hello doctor,

Thanks for your suggestion.

My problem is that I am almost unable to sleep without taking tablet Nexito Plus as I also have an anxiety disorder. I have tried the tablet Atarax for sleep, but it doesn't work.

Kindly suggest any alternative sleeping medicine so that I can discontinue the tablet Nexito Plus. I have symptoms of occasional sinus bradycardia.

Answered by Dr. Arpit Varshney

Hello,

Welcome back to icliniq.com.

You can discontinue tablet Nexito plus and start following medications;

1. Tablet Librium 10 mg (Benzodiazepine) at night, half an hour before sleep.

2. Tablet Melatonin 3 mg half an hour before sleep.

Tablet Librium is for anxiety, and melatonin is for inducing a smooth sleep. With these two medications, you will have a sound sleep without worrying about hyponatremia. Take these medications for one week and contact me after a week; let me know how your sleep has been for one week. I will modify the dose and drugs after the response of one week. You can then continue with the medications.

For any further queries, feel free to contact me at icliniq.com.

Wish you good health.

Hope this helps.

Kindly revert in case of further queries.

Patient's Query

Hello doctor,

Thanks for your help.

Kindly confirm the medication that I need to take.

1.Tablet Lamez (Lamotrigine) 12.5 mg.

2. Tablet Bisoprolol (Beta-adrenergic receptor blocking agent) 2.5 mg.

3. Tablet Memantine 5 mg.

4. Tablet Tolvaptan 30 mg once daily along with salt capsule 6 mg.

5. Tablet Librium 10 mg (Benzodiazepine).

6. Tablet Melatonin 3 mg.

I want to mention that tablets Librium and Melatonin are not available without a doctor's prescription. What are the brand names of Librium and Melatonin tablets available in the market? I have tablet Clonazepam 0.5 mg in stock. Can it be used in place of Librium? Would you please help me provide prescriptions for the same? Kindly suggest what to do.

Answered by Dr. Arpit Varshney

Hello,

Welcome back to icliniq.com.

My first concern is on your taking the tablet Bisoprolol if you have sinus bradycardia. This medicine will worsen bradycardia.

I will suggest you take tablet Librium. Tablet Librium is the brand name; the name or salt is Chlordiazepoxide. It is a very efficient drug. If you cannot get it, you can take tablet Clonazepam, but tablet Librium is better.

Tablet Melatonin is itself a salt name. I did not write a brand name as all brands are not available everywhere. So in such cases, writing generic names are more useful for patients. You can consult your doctor and get a prescription for these medicines.

Hope this helps.

Kindly revert in case of further queries.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Arpit Varshney
Dr. Arpit Varshney

General Medicine

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