Tolvaptan is an ADH antagonist. We will have few indications, but in the rare true SIADH patient, this drug will have some value. I do not know the cost.
I see many hyponatremia patients, and few of them have persistent SIADH. I am glad to have this option for those rare patients.
The NEJM had a couple of important articles about tolvaptan a couple of years ago.
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What do you think of the possibility of using this in patients with CHF related hyponatremia, refractory to water-restriction and diuretics?
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