indapamide


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indapamide

 [in-dap´ah-mīd]
a thiazide diuretic used in treatment of edema, such as in congestive heart failure or liver disease, as well as of hypertension.

indapamide

Apo-Indapamide (CA), Dom-Indapamide (CA), Gen-Indapamide (CA), Lozide (CA), Lozol, Natrilix (UK), Nindaxa (UK), Novo-Indapamide (CA), Nu-Indapamide (CA), PHL-Indapamide (CA), PMS-Indapamide (CA), Riva-Indapamide (CA)

Pharmacologic class: Thiazide-like diuretic

Therapeutic class: Diuretic, antihypertensive

Pregnancy risk category B

Action

Increases sodium and water excretion by inhibiting sodium reabsorption in distal tubule; enhances excretion of sodium, chloride, potassium, and water. May cause arteriolar vasodilation.

Availability

Tablets: 1.25 mg, 2.5 mg

Indications and dosages

Edema caused by heart failure

Adults: 2.5 mg P.O. daily in morning. After 1 week, may increase to 5 mg/day.

Mild to moderate hypertension

Adults: 1.25 mg P.O. daily in morning. May increase q 4 weeks, up to 5 mg/day.

Contraindications

• Hypersensitivity to drug, other thiazide-like drugs, or tartrazine

• Anuria

Precautions

Use cautiously in:

• renal or severe hepatic impairment, ascites, fluid or electrolyte imbalances, gout, systemic lupus erythematosus, impaired glucose tolerance, hyperparathyroidism, bipolar disorder

• pregnant or breastfeeding patients.

Administration

• Administer with food or milk to reduce GI upset.

• Give early in day to avoid nocturia.

Adverse reactions

CNS: dizziness, light-headedness, headache, restlessness, insomnia, lethargy, fatigue, drowsiness, asthenia, depression, anxiety, nervousness, paresthesia, irritability, agitation

CV: orthostatic hypotension, palpitations, premature ventricular contractions, arrhythmias

EENT: blurred vision, rhinorrhea

GI: nausea, vomiting, diarrhea, constipation, bloating, epigastric distress, gastric irritation, abdominal pain or cramps, dry mouth, anorexia

GU: nocturia, polyuria, glycosuria, erectile dysfunction

Metabolic: dehydration, gout, hyperglycemia, hypokalemia, hypocalcemia, hypomagnesemia, hyponatremia, hypovolemia, hypophosphatemia, hyperuricemia, hypochloremic alkalosis

Musculoskeletal: muscle cramps and spasms

Skin: flushing, rash, urticaria, pruritus, photosensitivity, cutaneous vasculitis, necrotizing vasculitis

Other: weight loss

Interactions

Drug-drug. Amphotericin B, corticosteroids: additive hypokalemia

Antihypertensives, nitrates: additive hypotension

Cholestyramine, colestipol: decreased indapamide absorption

Lithium: decreased lithium excretion, increased risk of lithium toxicity

Sulfonylureas: decreased hypoglycemic efficacy

Drug-diagnostic tests. Bilirubin, blood and urine glucose (in diabetic patients), blood urea nitrogen (BUN), calcium, creatinine, uric acid: increased values Cholesterol, low-density lipoproteins, magnesium, potassium, protein-bound iodine, sodium, triglycerides, urinary calcium: decreased values

Drug-herbs. Ginkgo: decreased antihypertensive effect

Licorice, stimulant laxative herbs (aloe, cascara sagrada, senna): increased risk of hypokalemia

Drug-behaviors. Acute alcohol ingestion: additive hypotension

Sun exposure: increased risk of photosensitivity

Patient monitoring

Assess for signs and symptoms of hypokalemia, including ventricular arrhythmias, muscle weakness, and cramping.

• Monitor BUN, creatinine, and electrolyte levels.

• Assess daily weight and fluid intake and output.

• Monitor blood pressure response to drug.

• Watch for signs and symptoms of orthostatic hypotension.

Patient teaching

• Advise patient to consume potassium-rich foods, such as oranges, bananas, potatoes, and spinach.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.

• Tell patient to weigh himself daily on same scale at same time of day while wearing similar clothing. Instruct him to report gain of more than 2 lb (0.9 kg) in 1 day or 5 lb (2.2 kg) in 1 week.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

indapamide

(ĭn-dăp′ə-mīd′)
n.
A diuretic that inhibits the reabsorption of sodium and chloride by the kidneys, used to treat high blood pressure and edema.

indapamide

A diuretic drug used to treat high blood pressure (HYPERTENSION). Brand names are Natramid and Natrilix.
References in periodicals archive ?
Indapamide tablets are indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs.
Time course of potassium concentration, therapeutic attempts and blood pressure Nebivolol 5 mg qd + Therapy Previous Nebivolol indapamide therapy 5 mg qd 1.5 mg qd + furosemide 40 mg biw Potassium 3.9 6.4 5.5 (mmol/L) Blood 150/100 140/90 150/85 pressure (mm Hg) Verapamil Nebivolol 240 mg qd + Perindopril Therapy 2.5 mg qd + Moxonidine moxonidine 2 mg qd+ moxonidine 0.6 mg qd 0.4 mg qd + indapamide 0.4 mg qd indapamide 0.625 mg qd 1.5 mg qd Potassium 4.5 4.8 4.8 3.8 (mmol/L) Blood 145/85 160/80 160/80 135/80 pressure (mm Hg)
MacMahon et al., "Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial," The Lancet, vol.
The study was sponsored by Server, the company that markets a combined perindopril and indapamide formulation (Preterax).
They were randomly assigned to receive sustained-release indapamide 1.5 mg daily or placebo.
Hansson, a regional principal investigator in this landmark trial, said a PROGRESS substudy now in press showed that stroke patients randomized to perindopril plus indapamide had a significantly lower incidence of dementia than those on placebo during a mean 4 years of follow-up.
The study design specified a fixed dosage of 4 mg/day perindopril and 2.5 mg/day indapamide. Patients who remained hypertensive on this regimen could receive additional antihypertensive drugs from their physicians.
The study was sponsored by Servier, the company that markets a combined perindopril and indapamide formulation (Preterax).
During follow-up, active treatment with a fixed combination of perindopril and indapamide reduced blood pressure by 5.3/2.3 mm Hg more than did placebo in those with AF and by 5.9/2.3 mm Hg more than placebo in
Patients were randomized to receive either the diuretic indapamide (Lozol, sustained release, 1.5 mg) or a placebo.
What we do know is that there are 2 classes of sulfonamides--those with an aromatic amine (the antimicrobial sulfonamides) and those without (eg, the diuretics acetazolamide, furosemide, hydrochlorothiazide, and indapamide).