Indapamide
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Clinical data | |
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AHFS/Drugs.com | Monograph |
MedlinePlus | a684062 |
Pregnancy category | |
Routes of administration | Oral tablet |
ATC code | |
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Pharmacokinetic data | |
Protein binding | 71–79% |
Metabolism | Hepatic |
Elimination half-life | 14–18 hours |
Identifiers | |
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CAS Number | |
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ChEMBL | |
ECHA InfoCard |
100.043.633 |
Chemical and physical data | |
Formula | C16H16ClN3O3S |
Molar mass | 365.835 g/mol |
3D model (JSmol) | |
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Indapamide is a thiazide-like diuretic[1] drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available. The thiazide-like diuretics (indapamide and chlortalidone) are more effective than the thiazide-type diuretics (including hydrochlorothiazide) for reducing the risk of heart attack, stroke, and heart failure in persons with high blood pressure and the thiazide-like and thiazide-type diuretics have similar rates of adverse effects.[2]
Form and composition
Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.[3] It is now also available in SR (sustained release) form.
Indications
Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all-cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension.[4]
Dosage and administration
The adult dosage is 1.25 to 5 mg, orally and once daily, usually in the morning.
Contraindications
Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level.
There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.
Interactions
Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, and vincamine).
Precautions
Monitoring the serum levels of potassium and uric acid is recommended, especially in subjects with a predisposition or a sensitivity to low levels of potassium in the blood and in patients with gout.
Adverse effects
Commonly reported adverse events are low potassium levels, fatigue, orthostatic hypotension (blood pressure decrease on standing up), and allergic manifestations.
Overdose
Symptoms of overdosage would be those associated with a diuretic effect, i.e. electrolyte disturbances, low blood pressure, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.
See also
References
- ↑ Indapamide at the US National Library of Medicine Medical Subject Headings (MeSH)
- ↑ Olde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ (May 2015). "Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis". Hypertension. 65 (5): 1033–40. doi:10.1161/HYPERTENSIONAHA.114.05122. PMID 25733241.
- ↑ "Lexicomp Online Login". lexi.com.
- ↑ Beckett, NS; Peters, R; Fletcher, AE; et al. (May 2008). "HYVET Trial". N. Engl. J. Med. 358: 1887–98. doi:10.1056/NEJMoa0801369. PMID 18378519.