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  3. Tolwick Tablet 4's

Tolwick Tablet 4's, Pack of 4
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Written By Santoshini Reddy G , M Pharmacy
Reviewed By Dr Aneela Siddabathuni , MPharma., PhD

Tolwick Tablet 4's is used to treat low sodium levels and autosomal dominant polycystic kidney disease. It contains Tolvaptan which works by increasing the amount of water released from the body via urine. In some cases, this medicine may cause side effects such as dizziness, headache, dry mouth, fatigue, diarrhoea, thirst and increased urge to urinate. Inform the doctor if you are pregnant or breastfeeding, taking any other medication, or have any pre-existing medical conditions.

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Composition :

TOLVAPTAN-15MG

Manufacturer/Marketer :

Zenwick Pharma Pvt Ltd

Consume Type :

ORAL

Return Policy :

Not Returnable

Expires on or after :

About Tolwick Tablet 4's

Tolwick Tablet 4's is used to treat hyponatremia (low levels of sodium) in patients with heart failure, liver disease and hormonal imbalances such as Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Additionally, Tolwick Tablet 4's is also used to treat autosomal dominant polycystic kidney disease (ADPKD).

Tolwick Tablet 4's contains ‘tolvaptan’ that works by blocking the effect of vasopressin, resulting in decreased water reabsorption, a net increase in free water excretion (aquaresis) and an increase in serum sodium concentrations.

In some cases, you may experience certain common side effects such as dizziness, headache, dry mouth, fatigue, diarrhoea, thirst and increased urge to urinate. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.

You can take Tolwick Tablet 4's with food or as advised by your doctor. It should be swallowed whole with a glass of water. Do not chew, bite, or break it. You are advised to take Tolwick Tablet 4's as long as your doctor has prescribed it for you, depending on your medical condition.

Do not take Tolwick Tablet 4's if you are allergic to it or any of its components. Avoid taking Tolwick Tablet 4's if you are pregnant as it may cause foetal harm. Consult your doctor before taking Tolwick Tablet 4's if you are breastfeeding. Tolwick Tablet 4's is not recommended for children below 18 years as the efficacy and safety have not been established.

Uses of Tolwick Tablet 4's

Tolwick Tablet 4's used in the treatment of hyponatremia (low sodium levels) and autosomal dominant polycystic kidney disease (ADPKD). The detailed uses of Tolwick Tablet 4's are as follows:

  • Hyponatremia Treatment: Tolwick Tablet 4's helps the body eliminate excess water and increase sodium levels in patients with heart failure or SIADH.
  • ADPKD Treatment: Tolwick Tablet 4's slows the rate of kidney function decline in adults with rapidly progressing ADPKD, potentially delaying disease progression.

Directions for Use

  • Tolwick Tablet 4's can be taken with or without food. However, avoid taking it with grapefruit or its juice, as this may increase the effects of the medication.
  • It is usually taken once daily; however, your doctor may adjust the dosage based on your serum sodium and fluid levels.
  • Swallow Tolwick Tablet 4's as a whole with a glass of water.
  • Do not crush, break, or chew it.

Medicinal Benefits

  • Tolwick Tablet 4's belongs to a group of medicines called vasopressin V2 receptor antagonist.
  • Tolwick Tablet 4's is also used to treat autosomal dominant polycystic kidney disease (ADPKD).
  • By blocking the effect of vasopressin, Tolwick Tablet 4's slows down the development of cysts in kidneys and reduces the symptoms of the disease.
  • Tolwick Tablet 4's antagonises the effect of vasopressin; this results in an increase in free water clearance and decreases urine osmolality due to increased urinary excretion, thereby increasing serum sodium concentrations.

How Tolwick Tablet 4's Works

Tolwick Tablet 4's contains tolvaptan that works by blocking the effect of vasopressin, resulting in decreased water reabsorption, a net increase in free water excretion (aquaresis) and an increase in serum sodium concentrations. This decrease in free water is not associated with an increased excretion of sodium or potassium ions; the increase in serum sodium concentration is solely a result of increased urine production.

Storage

• Store in a cool and dry place away from sunlight.• Keep Tolwick Tablet 4's out of reach and sight of children. • Non cold chain - To be stored in cool places at 10ºC to 25ºC or below 30ºC.
Side effects of Tolwick Tablet
Here are the steps to Dry Mouth (xerostomia) caused by medication:
  • Inform your doctor about dry mouth symptoms. They may adjust your medication regimen or prescribe additional medications to manage symptoms.
  • Drink plenty of water throughout the day to help keep your mouth moist and alleviate dry mouth symptoms.
  • Chew sugar-free gum or candies to increase saliva production and keep your mouth moisturized.
  • Use saliva substitutes, such as mouthwashes or sprays, only if your doctor advises them to help moisturize your mouth and alleviate dry mouth symptoms.
  • Avoid consuming smoking, alcohol, spicy or acidic foods, and other irritants that may aggravate dry mouth symptoms.
  • Schedule regular dental check-ups to keep track of your oral health and handle any dry mouth issues as they arise.
Overcome Medication-Induced Nausea: A 9-Step Plan
  • Inform your doctor about the nausea and discuss possible alternatives to the medication or adjustments to the dosage.
  • Divide your daily food intake into smaller, more frequent meals to reduce nausea.
  • Opt for bland, easily digestible foods like crackers, toast, plain rice, bananas, and applesauce.
  • Avoid certain foods that can trigger nausea, such as fatty, greasy, spicy, and smelly foods.
  • Drink plenty of fluids, such as water, clear broth, or electrolyte-rich beverages like coconut water or sports drinks.
  • Use ginger (tea, ale, or candies) to help relieve nausea.
  • Get adequate rest and also avoid strenuous activities that can worsen nausea.
  • Talk to your doctor about taking anti-nausea medication if your nausea is severe.
  • Record when your nausea occurs, what triggers it, and what provides relief to help you identify patterns and manage your symptoms more effectively.
  • Drink six to eight glasses of water per day to be healthy.
  • Healthy urinary habits can help minimize pollakiuria (frequent urinating).
  • Avoid liquids containing caffeine, artificial sweeteners, and soda, as they might cause bladder discomfort.
  • Add bladder-friendly foods such as omega-3 fatty acids, blueberries, and cranberries.
  • Reduce fluid intake 2-3 hours prior to bedtime.
  • Limit alcohol and caffeine as they can increase urination and affect bladder health.
  • Maintain sleep hygiene.
  • Eat a low-salt and healthy diet.
  • Rest well; get enough sleep.
  • Eat a balanced diet and drink enough water.
  • Manage stress with yoga and meditation.
  • Limit alcohol and caffeine.
  • Physical activities like walking or jogging might help boost energy and make you feel less tired.
Here's a comprehensive approach to managing medication-triggered fever:
  • Inform your doctor immediately if you experience a fever after starting a new medication.
  • Your doctor may adjust your medication regimen or dosage as needed to minimize fever symptoms.
  • Monitor your body temperature to monitor fever progression.
  • Drink plenty of fluids, such as water or electrolyte-rich beverages, to help your body regulate temperature.
  • Get plenty of rest and engage in relaxation techniques, such as deep breathing or meditation, to help manage fever symptoms.
  • Under the guidance of your doctor, consider taking medication, such as acetaminophen or ibuprofen, to help reduce fever.
  • If your fever is extremely high (over 103°F), or if you experience severe symptoms such as confusion, seizures, or difficulty breathing, seek immediate medical attention.
Managing Medication-Triggered malaise (Feeling Unwell): A Step-by-Step Guide:
  • If you experience persistent or severe malaise (a general feeling of discomfort, illness, or unease) after taking medication, seek medical attention immediately.
  • Inform your doctor about the medication you're taking and the symptoms you're experiencing.
  • Your treatment plan may be modified, which may include adjusting the dosage, substituting with an alternative medication, or discontinuing the medication. Additionally, certain lifestyle changes may be recommended to help manage symptoms.
  • To manage malaise symptoms, follow your doctor's advice, such as getting plenty of rest, staying hydrated, and practicing stress-reducing techniques.
  • Track your symptoms regularly and report any changes or concerns to your healthcare provider to ensure the malaise is managed effectively.

What if I have taken an overdose of Tolwick Tablet 4's

Take Tolwick Tablet 4's only as prescribed by the physician. Avoid exceeding the recommended dose as it could lead to an overdose. Symptoms of overdose may include excessive urination, excessive thirst, dizziness, and faintness. If you experience these symptoms or suspect you have taken an overdose, seek immediate medical attention.

Drug Warnings

  • Do not take Tolwick Tablet 4's if you are allergic to any of its contents
  • Avoid taking this medicine if you have raised liver enzymes in the blood, very low blood volume, if there is no urine production, if you cannot tell that you are thirsty.
  • Inform your doctor if you have liver disease, difficulty in urination, diabetes, high levels of uric acid, advanced kidney disease or if you have to restrict fluid intake due to certain medical conditions.
  • Do not take Tolwick Tablet 4's if you are pregnant as it may cause foetal harm.
  • Consult your doctor before taking Tolwick Tablet 4's if you are breastfeeding.
  • Tolwick Tablet 4's is not recommended for children below 18 years as efficacy and safety have not been established.
  • Tolwick Tablet 4's may cause dizziness, so drive with caution. Avoid consuming alcohol as it might cause increased dizziness. 

Drug-Drug Interactions

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TolvaptanTelithromycin
Critical
TolvaptanSaquinavir
Critical

Drug-Drug Interactions

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TolvaptanTelithromycin
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet and Telithromycin are taken together, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Telithromycin, but it can be taken if prescribed by a doctor. If you notice any of these signs - like difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanSaquinavir
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet and Saquinavir are taken together, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Saquinavir, but it can be taken if prescribed by a doctor. If you notice any of these signs - like difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanMifepristone
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet is taken with Mifepristone, it may increase the levels of Tolwick Tablet, which may increase the risk of side effects.

How to manage the interaction:
Taking Tolwick Tablet and Mifepristone together is not recommended, but it can be taken if prescribed by a doctor. If you notice any of these signs -difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanPosaconazole
Critical
How does the drug interact with Tolwick Tablet:
Taking Tolwick Tablet and Posaconazole together results in an increase in the levels and effects of Tolwick Tablet.

How to manage the interaction:
Although there is an interaction between Tolwick Tablet and Posaconazole, it can be taken if prescribed by a doctor. However, consult a doctor if you experience difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, or seizures (fits). Do not stop using any medications without a doctor's advice.
TolvaptanNefazodone
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet and Nefazodone are taken together, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Nefazodone, but it can be taken if prescribed by a doctor. If you notice any of these signs - like difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanKetoconazole
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet is taken with Ketoconazole, may increase the risk of side effects.

How to manage the interaction:
Taking Tolwick Tablet with Ketoconazole is not recommended as it can lead to an interaction, it can be taken if prescribed by a doctor. However, if you notice any of these signs -difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanAmprenavir
Critical
How does the drug interact with Tolwick Tablet:
Co-administration of Amprenavir with Tolwick Tablet can increase the risk of side effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Amprenavir, but it can be taken if prescribed by a doctor. If you notice any of these signs -difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanTelaprevir
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet and Telaprevir are taken together, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Telaprevir, but it can be taken if prescribed by a doctor. If you notice any of these signs - like difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanFosamprenavir
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet is taken with Fosamprenavir, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Fosamprenavir, but it can be taken if prescribed by a doctor. If you notice any of these signs -difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.
TolvaptanIndinavir
Critical
How does the drug interact with Tolwick Tablet:
When Tolwick Tablet and Indinavir are taken together, may significantly increase the blood levels and effects of Tolwick Tablet.

How to manage the interaction:
There may be a possibility of interaction between Tolwick Tablet and Indinavir, but it can be taken if prescribed by a doctor. If you notice any of these signs -difficulty swallowing, trouble speaking, muscle weakness, trouble controlling body movements, confusion, mood changes, seizures, call a doctor right away. Do not stop using any medications without a doctor's advice.

Drug-Food Interactions

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TOLVAPTAN-15MGGrapefruit and Grapefruit Juice
Moderate

Drug-Food Interactions

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TOLVAPTAN-15MGGrapefruit and Grapefruit Juice
Moderate
Common Foods to Avoid:
Grapefruit

How to manage the interaction:
Consuming grapefruit juice while taking Tolwick Tablet can increase the effects of Tolwick Tablet. Avoid taking Tolwick Tablet with grapefruit juice.

Diet & Lifestyle Advise

  • Eat a diet rich in whole grains, vegetables, and fruits.
  • Avoid smoking and alcohol consumption.
  • Maintain a healthy weight with proper diet and exercise.
  • Manage stress with meditation, yoga, and massage.
  • Drink plenty of fluids.
  • Rehydration beverages that contain electrolytes are also helpful.

Habit Forming

No

Therapeutic Class

CARDIOVASCULAR AGENTS

Tolwick Tablet 4's Substitute

Substitutes safety advice

Product Substitutes

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Alcohol

Unsafe

Avoid consuming alcohol while taking Tolwick Tablet 4's as it may cause increased dizziness.

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Pregnancy

Unsafe

Tolwick Tablet 4's belongs to pregnancy category C. Tolwick Tablet 4's is not recommended for use in pregnant women as it may cause foetal harm. Women of childbearing age must use effective contraception while taking Tolwick Tablet 4's.

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Breast Feeding

Unsafe

Tolwick Tablet 4's is not recommended for use in breastfeeding women. Consult your doctor if you are breastfeeding; your doctor will decide whether Tolwick Tablet 4's can be taken by breastfeeding mothers or not.

bannner image

Driving

Caution

Tolwick Tablet 4's may cause dizziness, weakness and tiredness. Do not drive or operate heavy machinery if you feel dizzy.

bannner image

Liver

Caution

Tolwick Tablet 4's should be used with caution in patients with liver impairment/liver disease. Please consult your doctor if you have liver problems or any concerns regarding this.

bannner image

Kidney

Caution

Tolwick Tablet 4's should be used with caution in patients with kidney disease. Please consult your doctor if you have kidney problems or any concerns regarding this.

bannner image

Children

Unsafe

Tolwick Tablet 4's is not recommended for children below 18 years as efficacy and safety have not been established.

Have a query?

FAQs

Tolwick Tablet 4's is used to treat hyponatremia (low levels of sodium) in patients with heart failure, liver disease and hormonal imbalances such as Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Additionally, Tolwick Tablet 4's is also used to treat autosomal dominant polycystic kidney disease (ADPKD).

Tolwick Tablet 4's works by blocking the effect of vasopressin, a hormone which is involved in the formation of cysts in ADPKD patients. By blocking the effect of vasopressin, Tolwick Tablet 4's slows down the development of cysts in the kidneys, reduces the symptoms of the disease, and increases urine production. Thereby increases serum sodium concentrations.

Dry mouth could be a side-effect of Tolwick Tablet 4's. Limiting caffeine intake, avoiding smoking and mouthwashes containing alcohol, drinking water regularly and chewing sugar-free gum/candy might help in stimulating saliva and thereby prevents drying of the mouth.

Diarrhoea could be a side-effect of Tolwick Tablet 4's. Drink plenty of fluid to prevent dehydration if you experience diarrhoea. Consult your doctor if you have severe diarrhoea or if you find blood in stools.

Tolwick Tablet 4's may cause the liver to not work properly. Consult your doctor immediately if you experience nausea, vomiting, fever, loss of appetite, abdominal pain, tiredness, dark urine, jaundice, itching and flu-like symptoms.

Tolwick Tablet 4's may cause water loss due to increased urine production. This might result in side-effects such as thirst, dry mouth and kidney problems. To prevent this, drink plenty of water regularly. Drink 1-2 glasses of water before going to bed even though you are not thirsty. Special care must be taken in patients with diseases that might reduce fluid intake.

Consult your doctor before taking Tolwick Tablet 4's if you are diabetic as Tolwick Tablet 4's might increase the blood sugar levels. Regular monitoring of blood glucose levels while taking Tolwick Tablet 4's is advised.

You are advised to take Tolwick Tablet 4's for the duration prescribed by the doctor. Tolwick Tablet 4's should not be taken for more than 30 days.

Tolwick Tablet 4's might increase the blood sugar levels. Consult the doctor if you are diabetic.

Do not take Tolwick Tablet 4's if you are allergic to any of its components, if you have raised liver enzymes in the blood, very low blood volume, if there is no urine production, or if you cannot tell that you are thirsty.

Avoid consuming grapefruit or its juice while taking Tolwick Tablet 4's as it might increase the effects of the medicine in the body.

Do not exceed the prescribed dose as it might cause an overdose. Taking an excess of Tolwick Tablet 4's may cause excessive thirst, dizziness, excessive urination, or fainting. Consult the doctor if you experience these symptoms.

Tolwick Tablet 4's is not recommended for patients with severe kidney disease. It should be used with caution in patients with mild to moderate kidney problems.

If you miss a dose of Tolwick Tablet 4's take it as soon as you remember, However, if it is almost time for the scheduled dose, skip the missed dose and take the next dose at the scheduled time.

Tolwick Tablet 4's is not recommended for use during pregnancy and breastfeeding.

Common side effects are dizziness, headache, dry mouth, fatigue, diarrhoea, thirst and increased urge to urinate. Talk to your doctor if you experience these side effects persistently.

Store Tolwick Tablet 4's at room temperature, in a dry place. Keep out of sight and reach of children.

Treatment with Tolwick Tablet 4's should be started and re-started in a hospital or in the presence of a healthcare professional to monitor the sodium levels in your blood closely. Too rapid correction of hyponatremia (low sodium levels) may cause osmotic demyelination syndrome (serious nerve damage). Consult the doctor if you notice symptoms of osmotic demyelination syndrome such as difficulty speaking, feeling that food or drinks are getting stuck in your throat, difficulty swallowing, mood changes, drowsiness, confusion, body movements that are difficult to control, weakness of the arms or legs, or seizures.

Country of origin

India

Manufacturer/Marketer address

1/98B, ZERA TOWER NEAR KANNENKATT TEMPLE, , MALIANKARA P.O, ERNAKULAM, Kerala, India - 683516
Other Info - TOL0277

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Author Details

Santoshini Reddy GDoctor badge

Written By

Santoshini Reddy G

M Pharmacy

Dr Aneela SiddabathuniDoctor badge

Reviewed By

Dr Aneela Siddabathuni

MPharma., PhD

Last Updated

Aug 8, 2025 | 1:48 PM IST

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Reference

  1. https://www.medicines.org.uk/emc/files/pil.6846.pdf
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022275s007lbl.pdf
  3. https://www.ema.europa.eu/en/documents/product-information/samsca-epar-product-information_en.pdf
  4. https://www.drugs.com/mtm/tolvaptan.html
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