Xipamide


Generic Medicine Info
Indications and Dosage
Oral
Oedema
Adult: Initially, 40 mg once daily, doses may be reduced to 20 mg once daily according to response. In resistant cases, 80 mg daily may be given.

Oral
Hypertension
Adult: As monotherapy or in combination with other antihypertensive agents. 20 mg once daily in the morning.
Renal Impairment
Severe: Contraindicated.
Contraindications
Severe electrolyte deficiency, hypercalcaemia; pre-comatose states associated with liver cirrhosis, untreated Addison’s disease, pre-existing hypovolaemia, symptomatic hyperuricaemia. Severe renal impairment. Pregnancy and lactation.
Special Precautions
Patient with severe coronary or cerebral arteriosclerosis, diabetes mellitus, non-symptomatic hyperuricaemia, prostatic hypertrophy. Hepatic and mild to moderate renal impairment.
Adverse Reactions
Significant: Electrolyte imbalance (e.g. hypokalaemia, hyponatraemia, hypercalcaemia), hypovolaemia, hepatic encephalopathy, choroidal effusion with visual field defect, transient myopia, acute angle-closure glaucoma, photosensitisation, acute gouty arthritis.
Cardiac disorders: Palpitations.
Gastrointestinal disorders: Dry mouth, diarrhoea, constipation, upper abdominal pain, abdominal cramps.
Investigations: Hypomagnesaemia, hypochloraemic alkalosis, hyperuricaemia.
Musculoskeletal and connective tissue disorders: Muscle cramps.
Nervous system disorders: Headache, dizziness, dry mouth, fatigue, sweating.
Psychiatric disorders: Lethargy, anxiety, agitation.
Vascular disorders: Orthostatic hypotension.
Patient Counseling Information
This drug may cause dizziness, if affected, do not drive or operate machinery. Avoid exposure to direct sunlight and UV light. Use protective measures (e.g. applying sunscreen) when going outdoors.
Monitoring Parameters
Monitor blood pressure (standing, sitting, supine), electrolytes, renal function, uric acid. Assess weight; input and output to determine fluid loss.
Overdosage
Symptoms: hypotension, nausea, vomiting, dizziness, convulsions, confusional state, somnolence, polyuria, oliguria, anuria, hypokalaemia, hyponatraemia. Management: Symptomatic and supportive treatment. Administer activated charcoal. Perform gastric lavage or induce emesis to prevent further absorption. Correct electrolytes, fluids, and blood volume as necessary.
Drug Interactions
Enhanced antihypertensive effect with nitrates, vasodilators, barbiturates, phenothiazines, and TCAs. Increased risk of electrolyte imbalance with loop diuretics. Increased risk of hypo- or hyper- kalaemia with K-sparing diuretics. May decrease the therapeutic efficacy of antidiabetic agents, uricosurics, noradrenaline, and adrenaline. Increased risk of cardiotoxic and neurotoxic effects with lithium. Increased risk of ventricular arrhythmias (e.g. torsade de pointes) with sultopride. Diminished antihypertensive effect with NSAIDs. Enhanced antihypertensive effect with baclofen. Increased risk of ototoxicity and nephrotoxicity with aminoglycosides. Decreased diuretic effect with phenytoin. Increased risk of lactic acidosis with metformin.
Food Interaction
Alcohol may enhance the antihypertensive effect of this medicine.
Lab Interference
May cause false-negative aldosterone/renin ration (ARR).
Action
Description: Xipamide is an antihypertensive diuretic. Its activity takes effect at the distal section of the nephron.
Onset: Diuresis: 3-4.5 hours.
Duration: Up to 24 hours.
Pharmacokinetics:
Absorption: Well absorbed from the gastrointestinal track. Bioavailability: 73%. Time to peak plasma concentration: 1-2 hours.
Distribution: Volume of distribution: 10 L. Plasma protein binding: 99%.
Excretion: Via urine (90%; 50% as unchanged drug, 30% as glucuronide metabolite). Elimination half-life: Approx 5-8 hours.
Chemical Structure

Chemical Structure Image
Xipamide

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 26618, Xipamide. https://pubchem.ncbi.nlm.nih.gov/compound/Xipamide. Accessed Apr. 26, 2021.

MIMS Class
Diuretics
ATC Classification
C03BA10 - xipamide ; Belongs to the class of low-ceiling sulfonamide diuretics.
References
Anon. Xipamide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/04/2021.

Buckingham R (ed). Xipamide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/04/2021.

Diurexan Tablets (Mylan Products Ltd.). European Medicines Agency [online]. Accessed 15/04/2021.

Disclaimer: This information is independently developed by MIMS based on Xipamide 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 © 2021 MIMS. All rights reserved. Powered by MIMS.com
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