Conivaptan

VAPRISOL

What it isDual V1a and V2 vasopressin antagonist; euvolemic and hypervolemic hyponatremia.

Why this oneIntravenous aquaresis raises sodium without a fluid load.

What limits itIt must not correct sodium too fast — osmotic demyelination. IV only, and a strong CYP3A4 inhibitor.

FDA-approved for

NO BOXED WARNINGS

Principal riskToo-rapid sodium correction; a strong CYP3A4 inhibitor

Therapeutic safety burden4 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityRapid sodium correction causing osmotic demyelination; hypotension; CYP3A interactions