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Treatment of hyponatremia, especially in the clinical setting of decompensated congestive heart failure, is difficult as conventional diuretics cause neurohormonal activation and further stimulate inappropriate release of vasopressin, leading to greater free water retention and a further decrease in osmotic pressure. (Tolvaptan) is a vasopressin antagonist that blocks the binding of distal nephron V2 receptors to arginine vasopressin (AVP), thereby inducing water excretion (hydration) without concomitant electrolyte loss. So, are tolvaptan tablets effective as a diuretic?

The diuretic effect of tolvaptan tablets

In subjects with congestive heart failure (CHF), Tolvaptan tablets (Tolvaptan) are more effective than furosemide in reducing urine osmolarity. Tolvaptan increases free water clearance, whereas furosemide has no effect on this parameter. Tolvaptan does not affect urinary electrolyte excretion, whereas furosemide causes increased electrolyte excretion. Therefore, tolvaptan increases serum sodium concentrations, whereas furosemide tends to decrease serum sodium concentrations. Tolvaptan increases plasma AVP levels without clinically significant effects on the renin-angiotensin-aldosterone system. Furosemide, however, increases plasma renin activity, increases norepinephrine levels, and decreases atrial natriuretic peptide levels.

The combination of Tolvaptan tablets (Tolvaptan) and furosemide significantly increases urine output and free water clearance, and decreases urine osmotic pressure compared with furosemide alone. These results indicate that tolvaptan causes a diuretic effect, whereas furosemide causes an increase in natriuresis, and that tolvaptan exerts a diuretic effect even when coadministered with furosemide. Tolvaptan can produce diuretic effects when administered alone or in combination with furosemide, and has no activating effect on the sympathetic nervous system and the renin-angiotensin-aldosterone system.

Note: The above information comes from the Internet and is compiled and edited by Medical Companion Travel (please correct me if there are any errors or omissions). It is only to provide information on the latest drugs on the market in the world and help Chinese patients understand the latest international new drug trends. It is only for internal discussion among medical staff and does not serve as any basis for medication. For specific medication guidelines, please consult the attending physician.

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