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Jynarque Coupon - Jynarque 56 tablets of 45mg/15mg carton

Jynarque

tolvaptan
Used for Kidney Disease
Used for Kidney Disease

Jynarque (tolvaptan) is a vasopressin-2 (V2) receptor antagonist that helps protect kidney function in adults with autosomal dominant polycystic kidney disease (ADPKD) who are at risk of their condition worsening quickly. It comes as a tablet that's taken by mouth twice a day, with doses spaced 8 hours apart. Treatment starts with a low dose and is slowly raised based on how you respond. Common side effects include feeling thirsty and needing to urinate often. Because this medication can cause serious liver damage, it's only available through a Risk Evaluation and Mitigation Strategy (REMS) program to make sure it's used safely.

Last reviewed on February 21, 2025
basics-icon

What is Jynarque (tolvaptan)?

What is Jynarque (tolvaptan) used for?

How Jynarque (tolvaptan) works

Jynarque (tolvaptan) is a vasopressin-2 (V2) receptor antagonist. It blocks vasopressin, a hormone in the body, from attaching to the V2 receptor. This helps prevent cysts from growing on the kidneys in people with ADPKD, which protects kidney function by slowing kidney damage.

Are you looking for information on tolvaptan (Samsca) instead?
When does Jynarque (tolvaptan) start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
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YEARS
Full effect

Drug Facts

Common BrandsJynarque
Drug ClassVasopressin receptor antagonist, V2
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Jynarque (tolvaptan)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Frequent urination (70%)
  • Feeling very thirsty (64%)
  • Dry mouth (16%)
  • Tiredness (14%)
  • Diarrhea (13%)
  • Dizziness (11%)
  • Indigestion (8%)
  • Poor appetite (7%)
  • Feeling bloated (5%)
  • Dry skin (5%)

Other Side Effects

  • Rash
  • High uric acid levels
  • Palpitations

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Liver damage: tiredness, loss of appetite, nausea, stomach pain, vomiting, fever, rash, itching, yellowing of the skin or eyes, dark urine

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Blurred vision

dry mouth

flushed, dry skin

frequent urination

fruit-like breath odor

increased hunger

increased thirst

increased urination

increased volume of pale, dilute urine

nausea

stomach pain

sweating

thirst

troubled breathing

unexplained weight loss

unusual tiredness or weakness

vomiting

Less common

Anxiety

blood in the urine

bloody stools

blue lips, fingernails, or skin

bruising

chest pain

confusion

cough

coughing or vomiting blood

dark urine

dizziness or lightheadedness

fainting

fast, slow, irregular, or shallow heartbeat

fever

irregular, fast or slow, or shallow breathing

loss of consciousness

muscle cramp, spasm, pain, or stiffness

pain, redness, or swelling in the arm or leg

persistent bleeding or oozing from puncture sites, mouth, or nose

pink or red urine

rash

rectal bleeding

stomach tenderness

troubled breathing

sweating

vaginal bleeding

Incidence not known

Difficulty swallowing

general feeling of tiredness or weakness

headache

high blood pressure

hives, itching, skin rash

irritability

light-colored stools

muscle twitching

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

restlessness

seizures

stomach pain, continuing

swelling of the feet or lower legs

tightness in the chest

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Difficulty having a bowel movement

lack or loss of strength

Less common

Loss of appetite

weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Jynarque (tolvaptan)

thumbs-up

Pros

The only FDA-approved ADPKD treatment option to slow kidney function decline

Comes as a tablet that's taken by mouth

Can be taken with or without food

thumbs-down

Cons

Must be taken twice a day

Can make you urinate more often

Need to get blood work done regularly to check your liver

pharmacist-tips

Pharmacist tips for Jynarque (tolvaptan)

pharmacist
  • Check the shape of your Jynarque (tolvaptan) tablet before taking it to make sure you have the right dose. The 15 mg tablet is triangle-shaped, 30 mg tablet is round, 45 mg tablet is square, 60 mg tablet is rectangular, and 90 mg tablet is shaped like a pentagons (five sides).

    • You can take Jynarque (tolvaptan) with or without food. If it upsets your stomach, try taking it with food to help ease discomfort.

      • If you miss your dose of Jynarque (tolvaptan), take your next dose at the usual time. Don't double up to make up for the missed dose.

        • Avoid grapefruit or grapefruit juice while taking Jynarque (tolvaptan) because they interact. Taking them together can cause your body to absorb more medication which can raise your risk for side effects.

          • Jynarque (tolvaptan) will make you thirsty and urinate more. Keep a water bottle nearby and drink water regularly to avoid dehydration. If you feel lightheaded, dizzy, or faint, rehydrate quickly. If these symptoms don't go away, get medical attention right away.

            • You'll need regular blood tests while taking Jynarque (tolvaptan), such as liver tests and electrolyte levels. Mark your test dates on your calendar so you don’t miss them.

              • Jynarque (tolvaptan) interacts with many prescription and over-the-counter medications. Tell your care team about all medications you're taking before starting Jynarque (tolvaptan). Don't start any new medications without checking with your prescriber first.

                • The safety of Jynarque (tolvaptan) during pregnancy isn’t fully known. Studies in animals found no harm at normal doses, but higher doses led to fetal loss and development problems. Let your prescriber or OB-GYN provider know right away if you're pregnant or thinking of becoming pregnant while you're taking this medication.

                  • It's not recommended to breastfeed while you're taking Jynarque (tolvaptan) because it has the potential to cause serious side effects. Speak with your prescriber if you have questions about the risks and benefits of taking this medication while breastfeeding.

                    faqs

                    Frequently asked questions about Jynarque (tolvaptan)

                    How quickly does Jynarque (tolvaptan) work?
                    It's not exactly known how long it takes for Jynarque (tolvaptan) to work, since it helps prevent ADPKD from getting worse. But studies show it takes several years to slow the growth of kidney cysts. Talk to your prescriber if you have concerns about how quickly this medication works.
                    How long can Jynarque (tolvaptan) be given?
                    There's no set time for how long you need to take Jynarque (tolvaptan) for. Your prescriber will have you continue taking the medication as long as it's helping prevent worsening of your ADPKD and you're not having any serious side effects. The medication was studied in people who took it for 5 years, with the most benefit seen in the first year. Talk to your prescriber if you have questions about how long you should take this medication.
                    Can you drink alcohol while taking Jynarque (tolvaptan)?
                    Talk to your prescriber if it's safe to drink alcohol while taking Jynarque (tolvaptan). This medication can cause dehydration, and alcohol can make it worse. Drinking alcohol can also damage your kidney and liver.
                    Is Jynarque (tolvaptan) a diuretic?
                    No. Jynarque (tolvaptan) isn't a diuretic. But like diuretics, it works in the kidneys to prevent water from being absorbed back into your body, which causes you to urinate more. Unlike commonly-used diuretics, such as furosemide (Lasix) and hydrochlorothiazide, Jynarque (tolvaptan) isn't approved for high blood pressure or swelling.
                    Does Jynarque (tolvaptan) make you tired?
                    Yes, tiredness can happen with Jynarque (tolvaptan) and might also be a sign of dehydration from the medication. If you're feeling overly tired and it's affecting your ability to go about your day, speak to your prescriber.
                    Does Jynarque (tolvaptan) cause weight loss?
                    Jynarque (tolvaptan) isn't a weight-loss medication. But because it works in the kidney to make you urinate more, it's possible to experience weight loss from fluid loss, or dehydration. If you notice weight loss along with headache, low blood pressure, or feeling faint, rehydrate quickly by drinking fluids. If your symptoms don't improve, get medical help right away.
                    Can Jynarque (tolvaptan) be cut in half?
                    Don't cut Jynarque (tolvaptan) in half unless your healthcare team says it's safe to do so. The pills don't have a score line (line in the middle of the tablet to cut), making them hard to split evenly. This could lead to taking the wrong dose. If you have trouble swallowing the tablets whole, talk to your prescriber.
                    What's the difference between Jynarque and Samsca?
                    While both Jynarque and Samsca contain tolvaptan as the active ingredient, they are used for different conditions. Jynarque is taken twice a day for ADPKD and is only available through a REMS program. Samsca is taken once a day for low sodium levels and doesn't require a REMS program, but treatment must be started in a hospital for closer monitoring. One brand should never be taken in the place of the other due to important differences in how they are prescribed and monitored. Speak to your prescriber if you have questions comparing these two medications.
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                    What are the risks and warnings for Jynarque (tolvaptan)?

                    Jynarque (tolvaptan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                    risk-warning

                    Liver damage

                    Jynarque (tolvaptan) can cause serious liver problems that can lead to liver failure or death. Because of this risk, Jynarque (tolvaptan) is available only through the Jynarque REMS program. You'll need to get regular blood tests done to make sure your liver is working properly. Make sure you keep track of your lab appointments. Get medical attention right away if you notice tiredness, loss of appetite, nausea, stomach pain, vomiting, fever, rash, itching, yellowing of the skin or eyes, dark urine. If this happens, you might need to stop using the medication to prevent further liver damage.

                    risk-warning

                    High sodium levels, dehydration, and low blood volume

                    Jynarque (tolvaptan) makes you urinate more, which can put you at risk for dehydration, low blood volume, and high sodium levels. To help prevent this, stay hydrated by drinking fluids regularly, especially when you feel thirsty. Before starting Jynarque (tolvaptan), your prescriber will check your sodium level to make sure you have enough body fluids. Your fluid level must stay in the normal range to continue taking this medication. If you experience dry mouth, weight loss, high heart rate, or low blood pressure (feeling dizzy, lightheaded, or faint), rehydrate quickly and contact your prescriber because these could be signs of dehydration.

                    risk-warning

                    Interactions with other medications

                    Some medications, such as itraconazole, Kaletra (lopinavir/ritonavir), ritonavir (Norvir), can raise Jynarque (tolvaptan) levels in your body. This can put you at higher risk for serious side effects, such as liver problems. If you're taking a medication that affects Jynarque (tolvaptan) levels, your prescriber might need to make changes to one or both of your medications. Before starting Jynarque (tolvaptan), tell your care team about all prescription and over-the-counter medications you're taking. Don't start any new medications without checking with your prescriber to make sure they're safe to take together.

                    dosage

                    Jynarque (tolvaptan) dosage forms

                    Typical dosing for Jynarque (tolvaptan)

                    The typical starting dose is 45 mg by mouth when you wake up and 15 mg about 8 hours later. Your prescriber might raise your dose based on how you respond. The maximum recommended dose is 90 mg in the morning and 30 mg 8 hours later.

                    Your dose might differ if you're taking certain medications that interact with Jynarque (tolvaptan).

                    More on Jynarque (tolvaptan) dosage forms

                    interactions

                    Interactions between Jynarque (tolvaptan) and other drugs

                    Jynarque (tolvaptan) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Jynarque (tolvaptan). Please note that only the generic name of each medication is listed below.

                    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    contraindications-icon

                    Jynarque (tolvaptan) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Jynarque (tolvaptan) will not be safe for you to take.
                    • History or signs or symptoms of severe liver problems (except for uncomplicated polycystic liver disease)

                    • Taking certain medications that interact with Jynarque (tolvaptan) (strong CYP3A inhibitors)

                    • Uncorrected abnormal blood sodium levels

                    • Unable to sense or respond to thirst

                    • Low blood volume

                    • Lack of urination due to blockage

                    • Inability to make urine

                    images

                    Jynarque (tolvaptan) images

                    Blue Square Otsuka 45 - JYNARQUE 45mg-15mg Tablet
                    This medicine is Blue, Square Carton Imprinted With "Otsuka 45".Blue Square Otsuka 45 - JYNARQUE 45mg-15mg Tablet

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                    References

                    Best studies we found

                    Cuzzo, B., et al. (2023). Physiology, vasopressin. StatPearls.

                    National Organization for Rare Disorders. (2023). Polycystic liver disease.

                    Otsuka America Pharmaceutical, Inc. (2023). Tips for managing the most common side effects of Jynarque® (tolvaptan).

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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