satavaptan + spironolactone

Satavaptan + spironolactone is an **experimental combination therapy** for cirrhotic patients with ascites. **Satavaptan** is a selective vasopressin V2 receptor antagonist that increases free water clearance, reducing fluid overload. **Spironolactone** is a potassium-sparing diuretic that antagonizes aldosterone at the mineralocorticoid receptor, promoting sodium and water excretion while conserving potassium. The combination aims to improve fluid management in cirrhosis patients, particularly after large volume paracentesis or in those with diuretic-resistant or recurrent ascites. Clinical trials have evaluated this combination for short-term and long-term control of ascites, finding reductions in ascites accumulation and paracentesis frequency compared to standard therapy[1][3][5][9].