ContraindicatedHypovolemia▪Gastrointestinal losses: vomiting, diarrhea, and bleeding▪Skin losses: burns and excessive sweating▪Third spacing: acute pancreatitis and small bowel obstruction▪Renal losses: diuretic use, aldosterone deficiency, cerebral salt wasting syndrome, and salt wasting nephropathiesSevere hyponatremia (presence of severe symptoms or PNa < 120 mmol/L)History of hypersensitivity reaction to vasopressin receptor antagonistsAnuriaImpaired thirst mechanismConcomitant use of drugs that increase plasma levels of vasopressin receptor antagonists (i.e., CYP3A4 inhibitors). This evidence concerns the gene CYP3A4 and acute pancreatitis.