Indapamide


Indapamide is a thiazide-like diuretic drug generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril are also available. Thiazide-like diuretic appears more effective than the thiazide-type diuretics in reducing risk of major cardiovascular events and heart failure in persons with high blood pressure. In terms of risk of stroke, both thiazide-type and thiazide-like diuretic are effective in reducing it. Both drug classes also appears to have similar rates of adverse effects when compared to other classes of anti-hypertensives.
It was patented in 1968 and approved for medical use in 1977.

Medical uses

Hypertension and edema due to congestive heart failure. Indapamide has been shown to reduce stroke occurrences in people over the age of 52. When used in combination with perindopril, evidence from multiple studies show that a greater reduction in stroke occurrences may be obtained. In the HYVET study, indapamide has been demonstrated to reduce all-cause mortality in octogenarians regardless of the addition of perindopril.

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.

Adverse effects

Commonly reported adverse events are low potassium levels, fatigue, orthostatic hypotension, and allergic manifestations.
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.

Interactions

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia.

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.

Dosage and administration

The adult dosage is 1.25 to 5 mg, orally and once daily, usually in the morning.
Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets. It is also available in SR form.