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Suggest Treatment For Hypertension While Having SIADH
Question: hello, my mother has is 87 and has SIADH. her serum sodium levels run between 127-130. She has had two episodes in the last three years where she had been hospitalized with a serum sodium of 121. One was from effexor she took for hot flashes and the other was last january when she had a virus and wasn't eating and just drinking water . In the hospital , the gave her NS and her sodium went up . Also they took her off lasix. Her primary care prescribed her sodium tablet pills 2 twice a day. Mt concern is that she has hypertension and a history of chf when she was eating too much chicken broth and another time after an MI.
Brief Answer:
is she not taking tolvaptan?
Detailed Answer:
Hello,
Thanks for posting in HCM.
As you told she has been diagnosed a SIADH and is being given sodium tablets (sodamint i suppose).
My question is has she been not started on tolvaptan 15mg tablets?
Because she will respond wonderfully to this medication and even can be taken off sodium tablets thus preventing worsening of hypertension problem.
Please get back to me with the above question as asked about tolvaptan and we will take ahead from there.
Waiting for your answer.
Thank you
is she not taking tolvaptan?
Detailed Answer:
Hello,
Thanks for posting in HCM.
As you told she has been diagnosed a SIADH and is being given sodium tablets (sodamint i suppose).
My question is has she been not started on tolvaptan 15mg tablets?
Because she will respond wonderfully to this medication and even can be taken off sodium tablets thus preventing worsening of hypertension problem.
Please get back to me with the above question as asked about tolvaptan and we will take ahead from there.
Waiting for your answer.
Thank you
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hi, I have never heard of that drug. I just googled it and it said that it was approved by the fda in 2009 and it shouldn't be used for longer than 30 days. I haven't seen anybody in that medication. ( I am a CRNA) I will mention it to her primary care . Have you used it or have much experience with this medication.? Thanks
Brief Answer:
yes we have used it. excellent results
Detailed Answer:
Hello,
Thanks for following up with me.
Good to know that you are CRNA. So you are known to medical field.
I am from XXXXXXX and here we do use tolvaptan for patients with hyponatremia and this drug shows excellent results. Combined with hypertonic saline infusion it shows very good results.
But as you said rightly it cannot be used more than 30 days as it can cause liver damage.
So do use it with precautions.
Another thing advisable is as there is excessive water reabsorption its a dilutional hyponatremia. So if you restrict the intake of water to 1.5 to 2 ltrs of water totally throughout the day it will also keep water level in body appropriate with sodium levels optimum.
I would recommend you to talk to her primary physician about tolvaptan wimhich we usually give 15mg OD or BD depending upon sodium levels. It can be even given TID if severe hyponatremia.
Also restrict water intake to 1.5-2 ltrs totally including water in curry or soup and juices and everything should be included.
I hope with this her sodium levels will remain in normal range and also keep her hypertension and chf in check.
Try with this treatment, if it works well and good. If it doesnt revert back with me will help you with advancement.
Hope i have answered your query well.
if you have any more query kindly write back to me will be happy to answer them.
Thank you
yes we have used it. excellent results
Detailed Answer:
Hello,
Thanks for following up with me.
Good to know that you are CRNA. So you are known to medical field.
I am from XXXXXXX and here we do use tolvaptan for patients with hyponatremia and this drug shows excellent results. Combined with hypertonic saline infusion it shows very good results.
But as you said rightly it cannot be used more than 30 days as it can cause liver damage.
So do use it with precautions.
Another thing advisable is as there is excessive water reabsorption its a dilutional hyponatremia. So if you restrict the intake of water to 1.5 to 2 ltrs of water totally throughout the day it will also keep water level in body appropriate with sodium levels optimum.
I would recommend you to talk to her primary physician about tolvaptan wimhich we usually give 15mg OD or BD depending upon sodium levels. It can be even given TID if severe hyponatremia.
Also restrict water intake to 1.5-2 ltrs totally including water in curry or soup and juices and everything should be included.
I hope with this her sodium levels will remain in normal range and also keep her hypertension and chf in check.
Try with this treatment, if it works well and good. If it doesnt revert back with me will help you with advancement.
Hope i have answered your query well.
if you have any more query kindly write back to me will be happy to answer them.
Thank you
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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