VASOPRESSIN ANTAGONISTS
A group of nonpeptide
antagonists of vasopressin receptors is being investigated for use in patients
with hyponatremia or acute heart failure, which is often associated with
elevated concentra-tions of vasopressin. Conivaptan
has high affinity for both V1a and V2 receptors. Tolvaptan
has a 30-fold higher affinity for V2 than for V1 receptors. In several clinical trials, both
agents relieved symptoms and reduced objective signs of hyponatremia and heart
failure. Conivaptan and tolvaptan are approved by the FDA for intravenous
administration in hyponatremia. Several other nonse-lective nonpeptide vasopressin
receptor antagonists are being investigated for these conditions .
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