Drug & supplement interaction

Sodium + Tolvaptan

Tolvaptan brand names: Samsca, Jynarque.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Sodium has a moderate interaction with Tolvaptan. Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sodium and Tolvaptan

Here is the interaction we found between these two, with the evidence behind it.

Moderate

TOLVAPTAN (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.
Severity Moderate Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here is the simple version: tolvaptan (Samsca, Jynarque) works by helping your body get rid of extra water through your urine. Because it removes water but holds onto sodium, your blood sodium level naturally rises while you're on it. That is actually the point when it's used to treat low sodium. So if you add more sodium on top of that, whether from sodium chloride tablets or concentrated salt supplements, you can push your sodium too high. That's called hypernatremia, and it can show up as intense thirst, confusion, weakness, or restlessness.

This concern is largely theoretical and based on how the drug works, not a flood of case reports, so don't panic. Normal salt in your food is a different story than deliberately taking sodium supplements. Before adding any sodium product, please check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Sodium Also Interacts With Other Medications

Sodium has 204 moderate known drug interactions in our database — the Tolvaptan one above is one of them. If you take anything else, check it against the full list below.

Moderate 204 No known interaction 2,626 (incl. Tolvaptan)
Taking anything else?

Check Another of Your Medications Against Sodium

Covers the 2,830 medications we’ve checked against Sodium. Pick one to open its full report.

From our Q&A

Questions About Sodium or Tolvaptan

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sodium or Tolvaptan, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Tolvaptan

This page covers Sodium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tolvaptan page lists 145 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 104 moderate · 38 minor.

From our pharmacist’s overview on the Tolvaptan page

“People taking tolvaptan (Samsca, Jynarque) for polycystic kidney disease or low blood sodium are on a drug whose blood level depends heavily on one liver enzyme, CYP3A4, and that is exactly where most of these 145 supplements interfere. Grapefruit can drive tolvaptan levels up, St.”

Reviewed by 2 · Jul 18, 2026

Open the Tolvaptan interaction page

One more smart check

Taking Sodium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 26,145 real supplement products containing Sodium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sodium. Your product may carry other ingredients that interact with Tolvaptan too, on top of Sodium — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sodium and Tolvaptan Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Sodium
Top 10

#6 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tolvaptan
Top half

#1,040 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Sodium

What is Sodium?

  • Replacing fluids and electrolytes
  • Preventing dehydration during exercise or illness
  • Treating low blood sodium (under medical care)
  • Seasoning and food preservation
  • Antacid (as sodium bicarbonate)

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets get more than enough—often too much—from food, so supplements are rarely needed except for specific medical reasons like dehydration or low blood sodium. Talk to your doctor or pharmacist before deliberately adding sodium, especially if you have high blood pressure, heart, or kidney problems.

Read the full Sodium monograph & all interactions
Medication

About Tolvaptan (kidney disease)

What Is Tolvaptan (kidney disease) Used For?

Brand names: Samsca, Jynarque

Tolvaptan (brand name Jynarque) is used to slow the decline of kidney function in adults who have autosomal dominant polycystic kidney disease (ADPKD) — a genetic condition where fluid-filled cysts grow in the kidneys over time, gradually damaging them. It is specifically for people whose disease is at risk of progressing quickly.

It does not cure ADPKD, but it works to slow down how fast the kidneys deteriorate, helping preserve kidney function for longer.

See full Tolvaptan (kidney disease) drug information
Keep checking

Other Drugs & Sodium

Browse every other medication we’ve checked against Sodium — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
204Moderate
0Minor
2,625No known interaction
204 Moderate 2,625 No interaction
Moderate

204 interactions

Showing 60 of 204 moderate interactions — see all 204 on the Sodium page.

No interaction 2,625 drugs checked — show the list

We also checked Sodium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,625 medications checked with no known interaction — see the full Sodium list.

See the full Sodium interactions page
See every supplement checked against Tolvaptan, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Sodium monograph › Uses, safety, and every drug interaction in one place Tolvaptan supplement interactions › Every supplement checked against Tolvaptan, ranked by severity Tolvaptan (kidney disease) drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Sodium and Tolvaptan Together: Common Questions

Can you take Sodium with Tolvaptan?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Sodium and Tolvaptan interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tolvaptan and Sodium?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.