Jynarque (Tolvaptan) Dosages: Your GoodRx Guide
Key takeaways:
Jynarque (tolvaptan) is FDA approved for adults with autosomal dominant polycystic kidney disease (ADPKD). It can help slow your kidney function from getting worse.
The starting Jynarque dosage is 45 mg taken in the morning, followed by 15 mg taken 8 hours later. The target dosage is 90 mg in the morning, followed by 30 mg taken 8 hours later. Your typical dosage may depend on how well you tolerate the medication.
You may need to take a lower Jynarque dosage if you’re combining it with certain medications. Examples include fluconazole (Diflucan), verapamil, and amiodarone (Pacerone).
Jynarque is only available through certain specialty pharmacies. If you’re eligible, you could access Jynarque for as little as $10 per month. A patient assistance program is also available.
Table of contents
Jynarque (tolvaptan) is the only FDA-approved medication for adults with autosomal dominant polycystic kidney disease (ADPKD) — the most common inherited (passed down) kidney disorder. You may be prescribed Jynarque to help slow your kidneys from getting worse if you’re living with ADPKD.
Jynarque has a specific dosage schedule to help you get the most from the medication while managing certain side effects. Here’s what you should know about Jynarque dosages, including steps to take if you miss your dose.
What’s the typical Jynarque (tolvaptan) dose?
Jynarque is an oral tablet that’s taken by mouth twice daily. A higher dose is taken soon after you wake up, followed by a lower dose taken 8 hours later. The dosing is split up this way so you don’t wake up at night to urinate. You can take Jynarque with or without food.
Your Jynarque dosage may be titrated upwards (increased) on a weekly basis until you reach the target dosage. But this can depend on how you tolerate the medication. Below is the typical Jynarque dosage schedule:
Starting dosage: 45 mg taken upon waking, 15 mg taken 8 hours later
Titration dosage: 60 mg taken upon waking, 30 mg taken 8 hours later
Target dosage: 90 mg taken upon waking, 30 mg taken 8 hours later
Jynarque tablets come in weekly blister packs. The blister pack is marked with the days of the week and time of day to help you stay on track. Each tablet is a different shape so you can tell them apart. For example, the 45 mg tablet is a square, and the 15 mg tablet is a triangle.
Are there any dosage adjustments for medical conditions or interactions?
Your liver or kidney function, your age, interactions, and other factors can sometimes influence how a medication affects you. In some cases, your dosage may need to be adjusted to reflect these circumstances.
Kidney problems
During clinical trials, Jynarque was studied in people with both normal and reduced kidney function. There are no recommended dosage adjustments if you have reduced kidney function.
Liver problems
Jynarque can cause serious liver damage. Due to this risk, it has a boxed warning (the FDA’s strictest warning), and it’s only available through a medication safety program. You shouldn’t take Jynarque if you have previous or current liver problems.
Older adults
Jynarque hasn’t been studied in many people ages 65 and older. Because of this, it’s recommended to start at the lower end of the dosage range in this group.
A guide for ADPKD: Learn all about the signs, diagnosis, and treatment for autosomal dominant polycystic kidney disease, often referred to as adult PKD.
Hereditary pattern of ADPKD: Adult PKD runs in families. Find out how to determine if you’re at risk.
Medications and kidney damage: Find out which medications may raise your risk of kidney damage.
Interactions
Jynarque has several interactions to be aware of. Certain combinations should be avoided altogether. Examples of these include phenytoin and carbamazepine. Grapefruit juice should also be avoided.
Other combinations may be OK, but you’ll need to take a lower Jynarque dosage. Examples of these include verapamil, fluconazole (Diflucan), and amiodarone (Pacerone). If you’re taking one of these medications, the recommended Jynarque dosage is as follows:
Standard dosage | Dosage adjustment |
|---|---|
45 mg upon waking, followed by 15 mg | 15 mg upon waking, followed by 15 mg |
60 mg upon waking, followed by 30 mg | 30 mg upon waking, followed by 15 mg |
90 mg upon waking, followed by 30 mg | 45 mg upon waking, followed by 15 mg |
Give your healthcare team your current medication list before starting a new medication. They can check for potential interactions and make adjustments ahead of time.
What happens if you miss a dose of Jynarque?
If you miss your scheduled Jynarque dose, skip it and take your next dose at the usual time. Don’t double up on doses.
It’s important to check the tablet shape before taking your dose to ensure it’s correct. But if you accidentally take the wrong dose (e.g., afternoon dose in the morning), contact your healthcare professional. They can give you instructions for next steps.
What should you do if you take too much Jynarque?
Jynarque can make you feel thirsty and cause you to urinate more often. So, it’s a good idea to drink enough water during treatment. Taking too much Jynarque may increase these effects, possibly making you very dehydrated. If this happens, you may feel dizzy or confused. Dark-colored urine can also be a sign of dehydration.
Higher Jynarque doses (those up to 480 mg) were well-tolerated during clinical trials. But if you think you’ve taken too much, contact your healthcare team or call Poison Control at 1-800-222-1222. If any side effects feel severe or life-threatening, go to the nearest ER.
How to save on Jynarque
Jynarque is a limited distribution drug. That means it’s only available through certain specialty pharmacies. If you’re eligible, you could pay as little as $10 per month for Jynarque. A patient assistance program is also available. Your specialty pharmacy team can help you navigate your options.
The bottom line
Jynarque is the only FDA-approved medication to treat autosomal dominant polycystic kidney disease (ADPKD) in adults. It’s typically taken twice daily. It’s recommended to take the first dose soon after waking up and the second dose 8 hours later. Depending on how you respond to Jynarque, your dosage may be increased until you reach the target tolvaptan dosage.
Tell your prescriber if you start any new medications. If they interact with Jynarque, your dosage may need to be lowered or stopped altogether. Talk to your prescriber or pharmacist if you have any questions about your Jynarque dosage.
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References
U.S. Food and Drug Administration. (2023). Drug development and drug Interactions | Table of substrates, inhibitors and inducers.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Autosomal dominant polycystic kidney disease. National Institute of Health.
Otsuka America Pharmaceutical. (2021). Starting Jynarque (tolvaptan).
Otsuka America Pharmaceutical. (2025). Jynarque - tolvaptan [package insert].
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