Indapamide is a thiazide diuretic

Diuretic

A diuretic provides a means of forced diuresis which elevates the rate of urination. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.- Medical uses :...

 drug

Medication

A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...

 marketed by Servier, generally used in the treatment of hypertension

Hypertension

Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...

, as well as decompensated cardiac failure. The US trade name for indapamide is Lozol. Indapamide is marketed as Natrilix outside of the US, as Insig in Australia. Combination preparations with perindopril

Perindopril

Perindopril, or perindopril arginine, is a long-acting ACE inhibitor. Perindopril is used to treat high blood pressure, heart failure or stable coronary artery disease. It is also available in a generic form, perindopril erbumine...

 (an ACE inhibitor

ACE inhibitor

ACE inhibitors or angiotensin-converting enzyme inhibitors are a group of drugs used primarily for the treatment of hypertension and congestive heart failure...

 antihypertensive) are also available.

It is described as a thiazide-like diuretic

Thiazide-like diuretic

A thiazide-like diuretic is a sulfonamide diuretic that has similar physiological properties to a thiazide diuretic, but doesn't have the chemical properties of a thiazide, lacking the benzothiadiazine molecular structure....

.

Form and composition

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.

Indications

Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril

Perindopril

Perindopril, or perindopril arginine, is a long-acting ACE inhibitor. Perindopril is used to treat high blood pressure, heart failure or stable coronary artery disease. It is also available in a generic form, perindopril erbumine...

 to people over the age of 80 for the treatment of hypertension.

Dosage and administration

The adult dosage is 1.25 to 5 mg by orally once daily usually in the morning.

Contraindications

Indapamide is contraindicated in known hypersensitivity to sulfonamide

Sulfonamide (medicine)

Sulfonamide or sulphonamide is the basis of several groups of drugs. The original antibacterial sulfonamides are synthetic antimicrobial agents that contain the sulfonamide group. Some sulfonamides are also devoid of antibacterial activity, e.g., the anticonvulsant sultiame...

s, severe renal failure

Renal failure

Renal failure or kidney failure describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood...

, hepatic encephalopathy

Hepatic encephalopathy

Hepatic encephalopathy is the occurrence of confusion, altered level of consciousness and coma as a result of liver failure. In the advanced stages it is called hepatic coma or coma hepaticum...

 or severe hepatic failure

Liver failure

Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease , and indicates that the liver has sustained severe damage . The complications are hepatic encephalopathy and impaired protein synthesis...

 and hypokalemia

Hypokalemia

Hypokalemia or hypokalaemia , also hypopotassemia or hypopotassaemia , refers to the condition in which the concentration of potassium in the blood is low...

 (low blood potassium levels).

There is insufficient safety data to recommend indapamide use in pregnancy

Pregnancy

Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

 or breastfeeding

Breastfeeding

Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts rather than from a baby bottle or other container. Babies have a sucking reflex that enables them to suck and swallow milk. It is recommended that mothers breastfeed for six months or...

.

Interactions

Caution is advised in the combination of indapamide with lithium

Lithium

Lithium is a soft, silver-white metal that belongs to the alkali metal group of chemical elements. It is represented by the symbol Li, and it has the atomic number 3. Under standard conditions it is the lightest metal and the least dense solid element. Like all alkali metals, lithium is highly...

 and nonantiarrhythmic drugs causing wave burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, vincamine).

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.

Adverse effects

Commonly reported adverse event

Adverse event

An adverse event is any adverse change in health or side effect that occurs in a person who participates in a clinical trial while the patient is receiving the treatment or within a previously specified period of time after the treatment has been completed.AEs in patients participating in...

s are hypokalemia (low potassium levels), fatigue, orthostatic hypotension

Orthostatic hypotension

Orthostatic hypotension, also known as postural hypotension, orthostasis, and colloquially as head rush or dizzy spell, is a form of hypotension in which a person's blood pressure suddenly falls when the person stands up or stretches. The decrease is typically greater than 20/10 mm Hg, and may be...

(blood pressure decrease on standing up) and allergic manifestations.

Overdosage

Symptoms of overdosage would be those associated with a diuretic effect: electrolyte disturbances, hypotension, and muscular weakness. Treatment should be symptomatic, directed at correcting the electrolyte abnormalities.