Background and aims: Tolvaptan at the current licensed dose of 15 mg is highly efficious in the treatment of hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone (SIADH), but there is a significant risk of over-correcting and therefore the possibility of osmotic demyelination syndrome (ODS). We aimed to investigate the efficacy and safety of both initial and subsequent doses of sub-15 mg, and review the effects on quality of life, length of stay and also side effects.
