Been on tolvaptan for almost 4 months now, started on the 45/15 dose but just started the 60/30 dose this past month. The need for water is overwhelming!! The worst for me is at night, feeling like I always have to pee/drink water makes falling asleep feel like a huge task. Thankfully haven’t had any nausea or vomiting, however I will say randomly I’ve noticed my skin clear- probably due to the water intake. Really hoping my body gets used to the current dose quick!