Indapamide

Oral
Hypertension

Oral
Oedema

May be taken with or without food.

Hypersensitivity to sulfonamide-derived drugs. Anuria; severe renal failure, hepatic encephalopathy, severe impairment of liver function, hypokalaemia.

Patient with electrolyte or fluid disturbances, gout, diabetes mellitus, Addison’s disease, SLE. Renal and hepatic impairment. Pregnancy and lactation.

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.

PO: B

This medicine may cause photosensitivity reactions, avoid exposure to direct sunlight and UV light. Use protective measures (e.g. applying sunscreen) when going outdoors.

Monitor blood pressure, serum electrolytes, uric acid, renal and hepatic function. Assess weight, intake and output reports daily to determine fluid loss.

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.

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.

Potentiated orthostatic hypotension with alcohol.

May interfere with parathyroid function tests. May cause false positive result to aldosterone/renin ratio (AAR).

Description:
Mechanism of Action: 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.

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.

Store between 20-25°C.

Diuretics

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

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.