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Jynarque is a prescription vasopressin V2 receptor antagonist containing tolvaptan. It is indicated to slow kidney function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease. Current tablets contain 15 mg, 30 mg, 45 mg, 60 mg, or 90 mg of tolvaptan.
read more about jynarque ...Tolvaptan blocks vasopressin V2 receptors in kidney collecting ducts. This reduces vasopressin-mediated cyclic adenosine monophosphate signaling, decreases water reabsorption, and increases free-water excretion. In autosomal dominant polycystic kidney disease, V2 receptor blockade is linked to slower kidney enlargement and kidney function decline.
Jynarque is used in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease. Treatment is contraindicated in patients with significant liver impairment or injury unrelated to uncomplicated polycystic liver disease, anuria, hypovolemia, uncorrected abnormal blood sodium, inability to sense or respond to thirst, uncorrected urinary outflow obstruction, or concomitant strong CYP3A inhibitor use.
Treatment starts with 45 mg on waking and 15 mg eight hours later for a total of 60 mg per day. If tolerated, the regimen is titrated at intervals of at least one week to 60 mg plus 30 mg and then 90 mg plus 30 mg daily. Patients drink enough water to avoid thirst or dehydration.
Jynarque carries a boxed warning for serious and potentially fatal liver injury. Liver tests are checked before treatment, at two and four weeks, monthly for the first 18 months, and every three months thereafter. Jynarque is distributed only through the Tolvaptan for ADPKD Shared System REMS. Other serious concerns include hypernatremia, dehydration, hypovolemia, and CYP3A drug interactions.
Jynarque slows kidney function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease.
The starting regimen is 45 mg on waking followed by 15 mg eight hours later.
Tolvaptan can cause serious and potentially fatal liver injury, so scheduled liver testing is required throughout treatment.
Yes. The boxed warning concerns serious and potentially fatal liver injury.
JYNARQUE (Tolvaptan) Prescribing Information. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3febc0a1-9e5a-4ce0-843d-210f21d862c4. Date Accessed October 7, 2026.
Search Orphan Drug Designations and Approvals: Tolvaptan. https://www.accessdata.fda.gov/scripts/opdlisting/oopd/detailedIndex.cfm?cfgridkey=347311. Date Accessed October 7, 2026.
Tolvaptan (Kidney Disease): MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a620041.html. Date Accessed October 7, 2026.
Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease. https://pubmed.ncbi.nlm.nih.gov/29105594/. Date Accessed October 7, 2026.
Tolvaptan in Patients With Autosomal Dominant Polycystic Kidney Disease. https://pubmed.ncbi.nlm.nih.gov/23121377/. Date Accessed October 7, 2026.