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Description

Arginine vasopressin is intimately involved in volume homeostasis, and elevated levels of arginine vasopressin are responsible for the pathogenesis and progression of diseases with an imbalance of sodium and water, particularly congestive heart failure. To restore homeostasis, antagonism of vasopressin receptors is a practical solution. As such, conivaptan has been developed and launched as a dual V1a and V2 vasopressin receptor antagonist. As a competitive, reversible inhibitor of both subtypes, conivaptan can modulate systemic vascular resistance through the V1a receptor (Ki ? 0.48 nM) distributed in vascular smooth muscle cells, cardiomyocytes, hepatocytes, and platelets and blocks the renal V2 receptor (Ki ? 3.04 nM) resulting in enhanced diuresis, thereby increasing serum sodium concentration and reducing total body volume. Currently, the drug is approved for the management of refractory hyponatremia and potentially lifethreatening sodium and water imbalance, but it has shown promise as a potential treatment option for other diseases, such as congestive heart failure, syndrome of antidiuretic hormone, diabetes insipidus, and liver cirrhosis.