Adult patients w/ hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Clinically significant hypervolemic hyponatremia that has resisted correction w/ fluid restriction (serum Na <125 mEq/L or less-marked hyponatremia that is symptomatic in patients w/ heart failure).
Adult patients should be in a hospital for initiation & re-initiation of therapy to evaluate the therapeutic response. Initially 15 mg once daily, may be increased to 30 mg once daily after at least 24 hr. Max: 60 mg once daily.
View Samsca overdosage for action to be taken in the event of an overdose.
Administration
May be taken with or without food: Avoid grapefruit juice.
Contraindications
Urgent need to raise serum Na acutely; inability to sense or appropriately respond to thirst; hypovolemic hyponatremia; strong CYP3A inhibitors (eg, clarithromycin, ketoconazole, itraconazole, ritonavir, indinavir, nelfinavir, saquinavir, nefazodone & telithromycin); anuric patients.
Patients should be monitored to assess serum Na conc & neurologic status especially during initiation & after titration. Avoid fluid restriction during the 1st 24 hr of therapy. Patients receiving Samsca should be advised that they can continue ingestion of fluid in response to thirst. Discontinue or interrupt treatment if patients develop too rapid arise in serum Na; significant signs & symptoms of dehydration & hypovolemia. Monitor serum K levels during concomitant therapy. Pregnancy & lactation. Childn.
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