Indapamide

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Indapamide
Indapamide.svg
Clinical data
AHFS/Drugs.comMonograph
MedlinePlusa684062
Pregnancy
category
  • AU: C
  • US: B (No risk in non-human studies)
Routes of
administration
Oral tablet
ATC code
Legal status
Legal status
  • UK: POM (Prescription only)
Pharmacokinetic data
Protein binding71–79%
MetabolismHepatic
Elimination half-life14–18 hours
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
ECHA InfoCard100.043.633 Edit this at Wikidata
Chemical and physical data
FormulaC16H16ClN3O3S
Molar mass365.835 g/mol
3D model (JSmol)
  (verify)

Indapamide is a thiazide-like diuretic[1] drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available. The thiazide-like diuretics (indapamide and chlortalidone) are more effective than the thiazide-type diuretics (including hydrochlorothiazide) for reducing the risk of heart attack, stroke, and heart failure in persons with high blood pressure and the thiazide-like and thiazide-type diuretics have similar rates of adverse effects.[2]

Form and composition[edit]

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.[3] It is now also available in SR (sustained release) form.

Indications[edit]

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 to people over the age of 80 for the treatment of hypertension.[4][non-primary source needed]

Dosage and administration[edit]

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

Contraindications[edit]

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level.

There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.

Interactions[edit]

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, and vincamine).

Precautions[edit]

Monitoring the serum levels of potassium and uric acid is recommended, especially in subjects with a predisposition or a sensitivity to low levels of potassium in the blood and in patients with gout.

Adverse effects[edit]

Commonly reported adverse events are low potassium levels, fatigue, orthostatic hypotension (blood pressure decrease on standing up), and allergic manifestations.

Overdose[edit]

Symptoms of overdosage would be those associated with a diuretic effect, i.e. electrolyte disturbances, low blood pressure, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.

See also[edit]

References[edit]

  1. ^ Indapamide at the US National Library of Medicine Medical Subject Headings (MeSH)
  2. ^ Olde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ (May 2015). "Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis". Hypertension. 65 (5): 1033–40. doi:10.1161/HYPERTENSIONAHA.114.05122. PMID 25733241.
  3. ^ "Lexicomp Online Login". lexi.com.
  4. ^ Beckett, NS; Peters, R; Fletcher, AE; et al. (May 2008). "HYVET Trial". N. Engl. J. Med. 358: 1887–98. doi:10.1056/NEJMoa0801369. PMID 18378519.