Natrilix SR

Indapamide

Essential HTN.

1 tab/24 hr, preferably in the morning.

Should be taken with food: Swallow whole w/ water, do not chew.

Hypersensitivity to indapamide, or to other sulfonamides. Hypokalaemia. Recent CVA. Severe renal failure. Hepatic encephalopathy or severe impairment of liver function.

Stop treatment in case of hepatic encephalopathy, photosensitivity. Not to be taken in patients w/ hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Measure Na & K levels before & during treatment. Hyponatraemia w/ hypovolaemia may be responsible of dehydration & orthostatic hypotension. Concomitant loss of Cl ions may lead to secondary compensatory metabolic alkalosis. High risk of hypokalaemia in elderly, malnourished &/or polymedicated, cirrhotic patients w/ oedema & ascites. Patients w/ CAD, cardiac failure & long QT interval. First measurement of plasma K 1 wk after start of treatment & more frequent monitoring required. May cause muscle disorders & rhabdomyolysis. May favor the onset of Torsades de pointes, which may be fatal. Associated w/ hypomagnesaemia can be refractory to treatment unless serum Mg is corrected. Stop treatment before investigating parathyroid function. Monitor blood glucose in diabetic patients in the case of hypokalemia. Increased tendency to gout attacks. Preexisting renal insufficiency may be worsening at start of treatment due to reduction in glomerular filtration. May cause positive doping tests in athletes. Discontinue drug intake as soon as possible once choroidal effusion, acute myopia & secondary angle-closure glaucoma occur. Prompt medical or surgical treatment may need to be considered if IOP remains uncontrolled. Not recommended in childn & adolescents. Plasma creatinine must be adjusted in elderly in relation to age, wt & sex.

Hypersensitivity reactions, maculopapular rashes. Vomiting, purpura, hyponatraemia, erectile dysfunction. Vertigo, fatigue, headache, paresthesia, nausea, constipation, dry mouth, hypochloraemia, hypomagnesaemia. Thrombocytopenia, leucopenia, agranulocytosis, aplastic anaemia, haemolytic anaemia, arrhythmia, hypotension, pancreatitis, renal failure, abnormal hepatic function, angioneurotic oedema &/or urticaria, TEN, SJS, hypercalcaemia. Syncope, myopia, blurred vision, visual impairment, acute angle-closure glaucoma, choroidal effusion, rhabdomyolysis, muscle spasms, muscular weakness, myalgia, Torsades de pointes (potentially fatal), hepatic encephalopathy, hepatitis, possible worsening of pre-existing acute disseminated lupus erythematosus, photosensitivity, ECG QT prolonged, increased blood glucose & uric acid, elevated liver enzyme levels.

Not recommended: Lithium. Precautions for use: Torsades de pointes-inducing drugs, NSAIDs (systemic route) including COX-2 selective inhibitors & high dose salicylic acid (≥3 g daily) in dehydrated patients, ACE inhibitors, other compd causing hypokalaemia, baclofen, digitalis prep. Special care: Allopurinol. To be taken into consideration: K-sparing diuretics, metformin, iodinated contrast media, imipramine-like antidepressants, neuroleptics, Ca (salts), ciclosporin, tacrolimus, corticosteroids, tetracosactide (systemic route).

Diuretics

C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.

G