Xipamide

Oral
Oedema

Oral
Hypertension

Severe: Contraindicated.

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.

Patient with severe coronary or cerebral arteriosclerosis, diabetes mellitus, non-symptomatic hyperuricaemia, prostatic hypertrophy. Hepatic and mild to moderate renal impairment.

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.

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.

Monitor blood pressure (standing, sitting, supine), electrolytes, renal function, uric acid. Assess weight; input and output to determine fluid loss.

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.

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.

Alcohol may enhance the antihypertensive effect of this medicine.

May cause false-negative aldosterone/renin ration (ARR).

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.

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.

Diuretics

C03BA10 - xipamide ; Belongs to the class of low-ceiling sulfonamide diuretics.

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.