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Overview: Jynarque is used to slow the loss of kidney function in certain people with autosomal dominant polycystic kidney disease (ADPKD). It works by blocking a substance that helps slow the growth of the fluid-filled cysts that damage the kidneys over time. Common side effects include feeling very thirsty, peeing a lot, and waking up at night to pee. Call your health care provider right away if you have breathing problems, dizziness, confusion, unsteadiness, or your skin or the whites of your eyes turning yellowish in color.

Uses

What is Jynarque used for?

Jynarque (tolvaptan) is commonly used to slow the loss of kidney function in certain people with autosomal dominant polycystic kidney disease (ADPKD).

Learn more about Jynarque for Autosomal Dominant Polycystic Kidney Disease (ADPKD).

Jynarque may also be used for other conditions as determined by your health care provider.

Tolvaptan can also be used to treat low sodium levels (hyponatremia). See Tolvaptan for more information.

How does Jynarque work (mechanism of action)?

In autosomal dominant polycystic kidney disease (ADPKD), fluid-filled sacs (cysts) develop on the kidneys. Over time, these cysts can prevent the kidneys from working properly. Jynarque blocks a substance called vasopressin from binding to the vasopressin V2-receptor in the kidneys. In people with ADPKD, this helps to slow down the growth of these cysts, allowing the kidneys to continue working normally for longer.

How is Jynarque supplied (dosage forms)?

Brands and other names

  • Jynarque

Dosage forms and strengths

  • 15 mg, 30 mg, 45 mg, 60 mg, 90 mg oral tablets

How should I store Jynarque?

Jynarque should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Jynarque?

The most common side effects of Jynarque are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Feeling thirsty, including a constant need to drink fluids
  • Peeing a lot
  • Waking up at night to pee

There may be other side effects of Jynarque that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Jynarque?

While less common, the most serious side effects of Jynarque are described below, along with what to do if they happen.

Severe Allergic Reactions. Jynarque may cause allergic reactions, which can be serious. Stop taking Jynarque and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Dehydration and High Sodium Levels. Jynarque may cause dehydration. Dehydration may lead to high sodium levels (hypernatremia) or low blood pressure, especially when you stand up (orthostatic hypotension). It is important that you drink fluids regularly throughout the day while taking Jynarque. Call your health care provider right away if you have any of the following symptoms of dehydration or low blood pressure.

  • Dizziness or lightheadedness
  • Weakness or unusual tiredness
  • Confusion
  • Unsteadiness
  • Abnormal heart rhythm

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Jynarque. Your health care provider will monitor your liver function while you are taking this medicine. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Skin rash
  • Loss of appetite
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Warnings & Precautions

Who should not use Jynarque?

Allergies to Ingredients. People who are allergic to any of the following should not take Jynarque.

  • Jynarque
  • Tolvaptan
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Jynarque.

Drug Interactions. Jynarque should not be taken while you are using certain other medicines. Before using Jynarque, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Dehydration. People who are dehydrated or who have low levels of fluid in their bodies should not take Jynarque.

High or Low Sodium Levels. People who have high or low levels of sodium in their blood should not take Jynarque until their levels have returned to normal.

Unable to Sense or Respond to Thirst. People who cannot tell whether they are thirsty should not take Jynarque. Similarly, people who are not able to drink fluids regularly throughout the day should not take Jynarque.

Problems Peeing or Bladder Blockage. People who have problems peeing should not take Jynarque. Reasons that a person may not be able to pee include kidney disease or a blockage in the urinary tract, which can be caused by an injury, an infection, or a kidney stone.

No Urine Production. Do not take Jynarque if you are making very little to no pee. This condition is also called anuria.

Serious Liver Problems. People who have serious liver disease or who have a history of serious liver problems should not take Jynarque.

What should I know about Jynarque before using it?

Do not take Jynarque unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Jynarque with other people, even if they have the same condition as you. It may harm them.

Keep Jynarque out of the reach of children.

Jynarque can cause you to pee more often, which may increase your risk of becoming dehydrated. It is important that you drink fluids regularly throughout the day to prevent feeling thirsty or becoming dehydrated. If you do feel thirsty, it is important that you quench your thirst right away. 

Some people who take Jynarque may feel the need to pee more often at night. Make sure to take your doses at the times prescribed by your health care provider. This will help to reduce the number of times you feel the need to pee at night.

In rare cases, Jynarque can damage the liver. Because of this risk, the medicine is only available through a restricted program. As part of this program, Jynarque must come from a specific, certified pharmacy that will ship the medicine directly to you. Before you start taking Jynarque, you and your health care provider must enroll in this program, and you will have a blood test to check your liver function. To continue taking the medicine, you must get regular blood tests to monitor your liver function.

What should I tell my health care provider before using Jynarque?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Jynarque is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Any illness that causes vomiting or diarrhea
  • Dehydration
  • Liver problems
  • High or low sodium levels
  • Problems peeing or bladder blockage
  • Unable to tell when you are thirsty
  • Unable to drink fluids throughout the day

Pregnancy. It is not known if or how Jynarque could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should take Jynarque while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if Jynarque passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop taking Jynarque.

How can I get more information about Jynarque?

For more information about Jynarque, you can visit the drugmaker's website at www.jynarque.com or call them at 866-244-9446.

Interactions

Does Jynarque interact with foods or drinks?

You should not eat grapefruit or drink grapefruit juice while taking Jynarque. Grapefruit or grapefruit juice can cause a dangerous increase in the blood levels of Jynarque.

It is unknown if drinking alcohol will affect Jynarque. The risk of dehydration may be increased if you drink alcohol while taking Jynarque.

Does Jynarque interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure that you discuss any of the following before taking Jynarque.

  • Desmopressin (DDAVP), which is used to treat a condition called diabetes insipidus
  • Ketoconazole or itraconazole (Sporanox, Tolsura), which is a medicine used for fungal infections
  • Ritonavir (Norvir) or lopinavir/ritonavir (Kaletra), which is a medicine commonly used to treat HIV

Many other medicines may alter the blood levels of Jynarque. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Jynarque. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Jynarque?

If you or someone else has used too much Jynarque, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Jynarque?

If you miss a dose, skip the missed dose and take the next dose at the regularly scheduled time. Do not take double or extra doses.