Indapamide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Hypertension As conventional tab: 1.25-2.5 mg once daily. As modified release tab: 1.5 mg once daily. Oedema Initial: 2.5 mg once daily. May increase to 5 mg daily after 1 week if necessary.
Dosage Details
Oral
Hypertension
Adult: As conventional tab: 1.25-2.5 mg once daily. As modified release tab: 1.5 mg once daily.

Oral
Oedema
Adult: Initially, 2.5 mg once daily. May increase to 5 mg daily after 1 week if necessary.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity to sulfonamide-derived drugs. Anuria; severe renal failure, hepatic encephalopathy, severe impairment of liver function, hypokalaemia.
Special Precautions
Patient with electrolyte or fluid disturbances, gout, diabetes mellitus, Addison’s disease, SLE. Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Photosensitivity, hypersensitivity reactions, electrolyte imbalance (e.g. hyponatraemia, hypokalaemia, hypochloremic alkalosis, hypomagnesaemia, hypercalcaemia).
Cardiac disorders: Arrhythmia, chest pain, palpitations.
Eye disorders: Blurred vision, conjunctivitis.
Gastrointestinal disorders: Constipation, diarrhoea, dyspepsia, abdominal pain, dry mouth, nausea, vomiting.
General disorders and administration site conditions: Fatigue, lethargy, malaise.
Investigations: Increased blood glucose, increased blood uric acid, elevated liver enzyme levels.
Musculoskeletal and connective tissue disorders: Muscle cramps, muscle spasms, back pain.
Nervous system disorders: Dizziness, headache, paresthesia, vertigo.
Psychiatric disorders: Insomnia.
Renal and urinary disorders: Nocturia, polyuria.
Respiratory, thoracic and mediastinal disorders: Rhinitis, cough, pharyngitis, rhimorrhea, sinusitis.
Skin and subcutaneous tissue disorders: Pruritus, maculopapular rash, urticaria.
Patient Counseling Information
This medicine may cause photosensitivity reactions, avoid exposure to direct sunlight and UV light. Use protective measures (e.g. applying sunscreen) when going outdoors.
MonitoringParameters
Monitor blood pressure, serum electrolytes, uric acid, renal and hepatic function. Assess weight, intake and output reports daily to determine fluid loss.
Overdosage
Symptoms: Nausea, vomiting, weakness, gastrointestinal disorders, electrolyte depletion (e.g. hyponatraemia, hypokalaemia), hypotension, cramps, vertigo, drowsiness, confusion, polyuria or oliguria leading to anuria. Management: Symptomatic and supportive treatment. May induce emesis or perform gastric lavage. Administration of activated charcoal may be done within 1-2 hours after ingestion. Correct electrolyte and fluid imbalance as necessary.
Drug Interactions
Increased risk of lithium toxicity. Increased risk of hypokalaemia and ventricular arrhythmia with drugs that induce torsades de pointes (e.g. disopyramide, amiodarone, sotalol, chlorpromazine, amisulpride, haloperidol). May enhance toxicity of cardiac glycosides (e.g. digoxin). Diminished antihypertensive effect with NSAIDs. May potentiate the action of other antihypertensive agents.
Food Interaction
Potentiated orthostatic hypotension with alcohol.
Lab Interference
May interfere with parathyroid function tests. May cause false positive result to aldosterone/renin ratio (AAR).
Action
Description: Indapamide, a diuretic with similar effects as thiazides, enhances excretion of sodium, chloride and water by interfering with the transport of sodium ions across the renal tubular epithelium.
Pharmacokinetics:
Absorption: Rapidly and completely absorbed from the gastrointestinal tract. Bioavailability: 93%. Time to peak plasma concentration: 2 hours.
Distribution: Widely distributed into the body tissues. Volume of distribution: 25 L. Plasma protein binding: 71-79%.
Metabolism: Extensively metabolised in the liver.
Excretion: Mainly via the urine (approx 70%; 7% as unchanged drug); faeces (16-23%). Elimination half-life: Approx 14 hours.
Chemical Structure

Chemical Structure Image
Indapamide

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 3702, Indapamide. https://pubchem.ncbi.nlm.nih.gov/compound/Indapamide. Accessed Sept. 24, 2020.

Storage
Store between 20-25°C.
MIMS Class
ATC Classification
C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.
References
Anon. Indapamide. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 17/07/2020.

Anon. Indapamide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 17/07/2020.

Buckingham R (ed). Indapamide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/07/2020.

Indapamide Tablet (ANI Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 17/07/2020.

Joint Formulary Committee. Indapamide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/07/2020.

Natrilix SR Film-Coated Tablets (Servier Laboratories Aust. Pty Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 17/07/2020.

Disclaimer: This information is independently developed by MIMS based on Indapamide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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