Question 1

How can I lower the cost of my tolvaptan

Accepted Answer

You can lower cost of your tolvaptan using one of the 4 following drug savings programs: Rx Advantage Card for tolvaptan, Canadian Prescription Savings for tolvaptan, tolvaptan Drug Coupons, tolvaptan Patient Assistance Programs

Question 2

What dosages is tolvaptan available in?

Accepted Answer

tolvaptan is available as a 15 mg and 30 mg oral tablet.

Question 3

What is tolvaptan used for?

Accepted Answer

tolvaptan is a vasopressin receptor antagonist and is used to treat:  Low blood sodium levels with a high blood volume (hypervolemic hyponatremia) Low blood sodium levels with a normal blood volume (euvolemic hyponatremia)

Question 4

How does tolvaptan work?

Accepted Answer

tolvaptan is a vasopressin receptor antagonist. It works by blocking a natural hormone in your body called vasopressin from attaching to the vasopressin-2 receptor in your kidneys. When this happens, your kidney doesn’t absorb as much water back into your body and you end up urinating the water out. This causes your blood sodium level to go up.

Question 5

How do I take tolvaptan?

Accepted Answer

The typical starting dose is 15 mg by mouth once per day. Your provider might slowly raise the dose to up to 60 mg once per day, depending on how your blood sodium levels respond to the medication and if you’re having side effects. The maximum duration of treatment is 30 days.

Question 6

Is it safe for me to take tolvaptan?

Accepted Answer

tolvaptan is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have any of the following:  Autosomal dominant polycystic kidney disease (ADPKD) outside of FDA-approved REMS Are unable to respond appropriately to thirst Hypovolemic hyponatremia Concomitant use of strong CYP3A inhibitors Anuria

Question 7

tolvaptan Common Side Effects

Accepted Answer

Common side effects of tolvaptan:  Feeling thirsty Dry mouth Urinating more often and more volume Lack of energy Constipation High blood sugar

Question 8

tolvaptan Serious Side Effects

Accepted Answer

Serious side effects are rare with tolvaptan. Contact your healthcare provider immediately if you experience any of the following.

Osmotic demyelination syndrome: confusion, problems swallowing, slurred speech, low energy, weakness in face, arms, or legs
Liver problems or liver failure: yellowing of your skin or the whites of your eyes, confusion, fatigue, poor appetite, nausea, stomach discomfort, vomiting
Losing too much body fluid: dry mouth, dry skin, fast heart rate, dizziness, lightheadedness, feeling tired
High blood potassium levels: tiredness, muscle weakness, tingling or numbness, irregular heartbeat, trouble breathing

Question 9

Effects of other drugs, drug classes and over-the-counter products on tolvaptan

Accepted Answer

The following medications may interact with tolvaptan: Avoid concomitant use with:

Moderate CYP3A inhibitors
Strong CYP3A inducers
V2-receptor antagonists

Monitor serum potassium during concomitant therapy with:

Angiotensin receptor blockers
Angiotensin converting enzyme inhibitors
Potassium sparing diuretics

Question 10

Who makes tolvaptan?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is tolvaptan safe in pregnancy?

Accepted Answer

tolvaptan may cause fetal harm. You should talk to your healthcare provider before taking this medication if you are pregnant.

Question 12

What is the brand name for tolvaptan?

Accepted Answer

SAMSCA

Question 13

How can NowPatient help me to lower the cost of my tolvaptan prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your tolvaptan prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient tolvaptan savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient tolvaptan savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for tolvaptan	Canadian Prescription Savings* for tolvaptan	tolvaptan Drug Coupon*	tolvaptan Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of tolvaptan?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for tolvaptan	Canadian Prescription Savings* for tolvaptan	tolvaptan Drug Coupon*	tolvaptan Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the tolvaptan savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the tolvaptan drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for tolvaptan, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the tolvaptan prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, tolvaptan is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed tolvaptan for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the tolvaptan prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the tolvaptan prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for tolvaptan

If you are having trouble paying for your tolvaptan medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for tolvaptan you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
tolvaptan is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers tolvaptan
If tolvaptan is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for tolvaptan

If you are having trouble paying for your tolvaptan medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for tolvaptan you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers tolvaptan
If tolvaptan is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for tolvaptan

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your tolvaptan treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for tolvaptan you will need to meet the following criteria:

You must be currently insured and have coverage for tolvaptan
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.