CEV_5997_Conivaptan: evidence supporting its therapeutic use

Correspondence: Joseph G Verbalis Professor of Medicine and Endocrinology, and Chief, Endocrinology and Metabolism, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Building D, Suite 232, 4000 reservoir road Nw, washington, DC 20007, USA Email [email protected] Introduction: The available treatment options for euvolemic and hypervolemic hyponatremia are limited, and consist mainly of fluid restriction, diuresis, or hypertonic solutions. Most of these therapies are neither well tolerated nor totally effective, and many are associated with significant adverse effects. Vasopressin receptor antagonists, also known as vaptans, are a new class of agents that now offer an additional treatment option for hyponatremic patients. Conivaptan hydrochloride, a competitive antagonist of vasopressin V1a and V2 receptors, is the first agent in this class to be approved for treatment of euvolemic and hypervolemic hyponatremia in hospitalized patients. Aims: This review critically assesses the evidence that support the use of conivaptan for the treatment of patients with euvolemic and hypervolemic hyponatremia. Evidence review conclusion: Conivaptan is effective in raising serum sodium levels in a predictable and safe fashion in euvolemic and hypervolemic hyponatremic patients. Conivaptan provides the first molecularly targeted approach for correcting hyponatremia in hospitalized patients.