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In SIADH due to malignancy, do you prefer to use free water restriction or salt tablets?

Or other therapy - e.g., tolvaptan? Free water restriction may hinder QOL. Salt tablets may raise levels more quickly but have risks of edema and hypertension, and dosing is not standard.
1 Answer
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Endocrinology · Johns Hopkins Endocrinology and Pituitary Center
Answered on

Fluid restriction is usually the first line measure in chronic SIADH. Salt tablets only work at high doses, as SIADH is a water, not a salt problem, and you improve sodium only minimally. Tolvaptan is a very powerful drug, but, as per the package insert, must be started in an inpatient setting. Addi...

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