Samsca® Tablets for Clinically Significant Hyponatremia

Samsca® (tolvaptan) is a selective vasopressin V2-receptor antagonist used to raise low sodium in certain adults. This page helps you compare options, see pricing, and arrange US delivery from Canada. You can review cost and availability even without insurance.

At CanadianInsulin, orders are filled by licensed Canadian pharmacies after we confirm a valid prescription with your clinic.

What Samsca® Is and How It Works

Samsca® is approved to treat clinically significant hypervolemic or euvolemic hyponatremia in adults. These are sodium problems often linked to heart failure, cirrhosis, or SIADH. The medicine blocks vasopressin’s action at the kidney’s V2 receptors. This causes aquaresis, or water loss without major electrolyte loss, which helps increase serum sodium.

Therapy must be started and, if needed, restarted in a hospital. Sodium can rise too quickly if not monitored. Your care team checks serum sodium and volume status frequently. Fluid restriction should generally be avoided during the first 24 hours of treatment. US delivery from Canada lets you access Canadian pricing once your clinician confirms the plan.

Who Samsca® Is For

Samsca is for adults with clinically significant hyponatremia that is hypervolemic or euvolemic. It can be considered when fluid restriction alone is not effective. It is not for patients who need urgent sodium correction. It is not for hypovolemic hyponatremia or for patients who cannot sense or respond to thirst.

Do not use Samsca if you are anuric or allergic to tolvaptan. Avoid it with strong CYP3A inhibitors. Patients with advanced liver disease need close monitoring. For SIADH, your prescriber will evaluate risks and benefits. You can also review our Hyponatremia category for context.

Dosage and Usage

Initial dosing is typically 15 mg by mouth once daily. If sodium response is inadequate, the dose may be increased to 30 mg once daily, then to 60 mg once daily. Increases are generally made at 24-hour intervals under hospital monitoring. The maximum recommended dose is 60 mg once daily.

Begin and reinitiate Samsca in a hospital setting to reduce the risk of overly rapid sodium correction. During the first day, avoid fluid restriction unless directed by the care team. Your clinician will order regular labs and will decide the course length. Treatment duration is limited; do not take Samsca for more than 30 days.

Strengths and Forms

Samsca comes as oral tablets in commonly available strengths:

• 15 mg tablets
• 30 mg tablets

Some doses are achieved by combining strengths. Packaging and availability can vary by supplier. Your prescription will specify the exact strength and quantity.

Missed Dose and Timing

If you miss a dose, take the next dose at the usual time. Do not double up. Maintain access to water at all times and drink to thirst. Contact your clinic if you miss more than one dose, as reinitiation should occur in a monitored setting.

Storage and Travel Basics

Store tablets at room temperature away from moisture and heat. Keep them in the original container with the label. When traveling, carry your medicine in your hand luggage. Bring a copy of your prescription for security and customs. Avoid storing tablets in a hot car. If you are arranging US delivery from Canada, plan enough supply for your planned travel dates.

Benefits

Samsca raises serum sodium in adults with hypervolemic or euvolemic hyponatremia. It promotes free water clearance while limiting electrolyte loss. Once-daily dosing simplifies use under clinical supervision. For many patients, this targeted approach can reduce symptoms linked to low sodium, such as confusion or fatigue, when guided by a clinician.

Side Effects and Safety

• Thirst and dry mouth
• Increased urination or nocturia
• Constipation
• Weakness or dizziness
• Increased blood sugar
• Nausea
• Headache

Serious risks include overly rapid sodium correction and osmotic demyelination, dehydration, low blood pressure, and potential liver injury. Contact your clinician if you develop severe thirst, confusion, difficulty speaking, weakness, or signs of liver problems such as fatigue, loss of appetite, right upper abdominal pain, or dark urine. Your care team will monitor sodium and liver tests as appropriate. Hypoglycemia is not an expected risk with tolvaptan, but dizziness and volume depletion can occur if fluid intake is inadequate.

Drug Interactions and Cautions

Avoid strong CYP3A inhibitors such as ketoconazole, clarithromycin, ritonavir, and itraconazole. These can markedly increase tolvaptan levels. Strong inducers like rifampin can reduce effectiveness. Grapefruit or grapefruit juice can raise tolvaptan exposure and should be avoided. Use caution with P-gp substrates and inhibitors, and with digoxin as levels may increase. Do not combine with desmopressin. Diuretics and other agents that reduce volume can increase the risk of dehydration and hypotension. Your prescriber will adjust your plan based on other medicines and your clinical status.

For hospital-based volume management in heart failure, your team may consider IV options such as Furosemide Injection when appropriate. Decisions about add-on therapy should be individualized.

What to Expect Over Time

Sodium usually begins to increase during the first 24 to 48 hours in a monitored setting. You will likely feel more thirsty and urinate more often. Drink to thirst so you do not become dehydrated. Your care team will titrate the dose based on sodium response and symptoms. Once the target sodium range is reached or after a defined short course, your clinician will stop therapy and continue outpatient monitoring.

Compare With Alternatives

There is no exact substitute for tolvaptan in tablet form for this use. In heart failure with fluid overload, loop diuretics can help manage congestion and may support sodium balance as part of a broader plan. Options include Lasix® and, for patients with sulfonamide allergy, Edecrin®. These agents are not indicated to directly raise sodium, and they require prescriber guidance, labs, and monitoring. Your clinician will choose the right approach based on the cause of hyponatremia, symptom severity, and comorbidities.

Pricing and Access

Check the Samsca price, compare forms, and see your total cost at checkout. Many patients see savings with Canadian pricing and US shipping. You can buy Samsca online and arrange prompt US delivery from Canada after prescription verification. If you are comparing options without insurance, you can still review per-tablet costs before placing your order. Our checkout is encrypted for your security.

Looking for seasonal offers? See current promotions at Promotions. Availability and pricing can change based on supply.

Availability and Substitutions

Strengths and pack sizes may vary by pharmacy partner. If an item is temporarily unavailable, your prescriber may recommend a suitable alternative path, such as fluid strategies or hospital-based therapies. For acute congestion in heart failure, inpatient teams may use agents like Furosemide Injection alongside careful monitoring. Only your clinician can determine if a substitution fits your condition.

Patient Suitability and Cost Saving Tips

Good candidates are adults with clinically significant euvolemic or hypervolemic hyponatremia who can access close monitoring. Samsca is not for hypovolemia, anuric states, or for those unable to sense thirst. It should not be used if urgent sodium correction is required. The course is short; do not exceed 30 days of therapy.

To save on cost, compare 15 mg and 30 mg tablet pricing and ask your clinician about the best strength for your plan. Consider ordering the full prescribed quantity to reduce per-shipment fees. If a generic tolvaptan option becomes available for your indication, your prescriber can advise whether it is appropriate. Refill reminders can help you avoid gaps when planning care transitions after discharge.

Questions to Ask Your Clinician

• Is my hyponatremia hypervolemic or euvolemic, and what is the target sodium?
• Should I avoid fluid restriction during the first day of treatment?
• How often will sodium and liver tests be checked while on therapy?
• What signs suggest sodium is correcting too quickly?
• Which medicines or foods should I avoid, including grapefruit?
• How long should I continue Samsca, and when should it stop?
• What is my plan if I miss a dose after discharge?

Authoritative Sources

FDA Label: Tolvaptan (Samsca)

DailyMed: Samsca

Health Canada DPD

Ready to proceed? Start your order for US delivery from Canada. This page is informational and does not replace professional medical advice. Always follow your clinician’s directions and the official label.