Table 2.

Characteristics and clinical indications for the combined V1a/V2 receptor blocker conivaptan and the selective V2 receptor blockers tolvaptan, lixivaptan, and satavaptana

    receptor antagonismV1a and V2V2
    route of administrationIntravenouscOral
    urine osmolarityDecreasedDecreased
    free water clearanceIncreasedIncreased
    Na+ excretion/24 hUnchangedUnchanged
Recommendations for use
    euvolemic hyponatremia (SIADH)dYeseYes, once available
    hypervolemic hyponatremia (CHF)dYeseYes, once available
    hypervolemic hyponatremia (cirrhosis)dNo, safety data lackingYes, once available
    hypervolemic hyponatremiadNeverNever
    acute symptomatic hyponatremiaNot yet, insufficient dataNot yet, insufficient data
    ADPKDNo dataPhase III trial ongoing
    CHFNo, no dataSelected patients with severe congestive symptoms
  • a ADPKD, autosomal dominant polycystic kidney disease; CHF, congestive heart failure; SIADH, syndrome of inappropriate antidiuretic hormone secretion.

  • b Like tolvaptan, lixivaptan and satavaptan are selective V2RA with similar characteristics and anticipated indications.

  • c Conivaptan is effective when administered orally, but only the parenteral formulation is approved by the Food and Drug Administration.

  • d Refers to chronic and non–life-threatening hyponatremia.

  • e Food and Drug Administration–approved indication.