Indapamide information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
Indapamide is a non-thiazide sulphonamide diuretic drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated cardiac failure. The US trade name for indapamide is Lozol. Indapamide is marketed as Natrilix outside of the US. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.
It is described as a thiazide-like diuretic.
Pharmacodynamics
Pharmacokinetics
Indapamide enhances excretion of sodium, chloride and water by interfering with the transport of sodium ions across the renal tubular epithelium.
Absorption
Rapidly and completely absorbed from the GI tract (oral). Peak plasma levels are achieved within 2-2.5 hours.
Distribution
Widely distributed, preferentially and reversibly bound to erythrocytes.
Metabolism
Extensively metabolised in the liver.
Excretion
Via urine (60-70% as metabolites, 5-7% as unchanged), via faeces (16-23% remaining dose); 14 hours (elimination half-life).
Indapamide Indications / Indapamide Uses
Information Not Available
Indapamide Adverse Reactions / Indapamide Side Effects
Headache, dizziness, weakness, drowsiness, fatigue, agitation, nervousness, anorexia, nausea, vomiting, pain, diarrhoea, constipation, orthostatic hypotension, palpitations, hypokalaemia, hyponatraemia, metabolic alkalosis.
Precautions
Monitoring of potassium and uric acid serum levels is recommended, especially in subjects with a predisposition or a sensitivity to hypokalemia and in patients with gout.
Overdosage
Nausea, vomiting, weakness, GI disorders, electrolyte imbalance. In severe cases, hypotension and respiratory depression. Stomach emptying recommended.
Special Precautions
Pregnancy, lactation, elderly, renal impairment, fluid or electrolyte imbalance, hyperuricaemia, DM, lupus erythematosus.
Other Drug Interactions
Additive effect with other antihypertensive agents and diuretics. Increased chance of hypokalaemia with corticosteroids, corticotropin and amphotericin.
Potentially Fatal: Increased risk of lithium toxicity. Hypokalaemia enhances digitalis toxicity with cardiac gycosides.
Other Interactions
Information Not Available
Dosage
Oral
Hypertension
Adult: 1.25-2.5 mg once daily, alone or in conjunction with other antihypertensives.
Oral
Oedema
Adult: 2.5 mg once daily increased to 5 mg daily after 1 weeks if needed.
Food(before/after)
Should be taken with food.
List of Contraindications
Indapamide and Pregnancy
Caution when used during pregnancy
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
If used in pregnancy-induced hypertension:
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Indapamide and Lactation
Caution when used during lactation
Indapamide and Children
Safety and effectiveness of Indapamide in pediatric patients have not been established.
Indapamide and Geriatic
Information Not Available
Indapamide and Other Contraindications
Anuria, severe hepatic impairment
Storage
Oral
Store at 20-25°C.
Lab interference
Oral
Store at 20-25°C.
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