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Dosage/Direction for Use
Oral Hypertension Adult: As conventional tab: 1.25-2.5 mg once daily. As modified release tab: 1.5 mg once daily. Oral Oedema Adult: Initially, 2.5 mg once daily. May increase to 5 mg daily after 1 week if necessary. |
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Administration
May be taken with or without food.
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Contraindications
Hypersensitivity to sulfonamide-derived drugs. Anuria; severe renal failure, hepatic encephalopathy, severe impairment of liver function, hypokalaemia.
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Special Precautions
Patient with electrolyte or fluid disturbances, gout, diabetes mellitus, Addison's disease, SLE. Renal and hepatic impairment. Pregnancy and Lactation. Patient Counselling This medicine may cause photosensitivity reactions, avoid exposure to direct sunlight and UV light. Use protective measures (e.g. applying sunscreen) when going outdoors. Monitoring Parameters Monitor blood pressure, serum electrolytes, uric acid, renal and hepatic function. Assess weight, intake and output reports daily to determine fluid loss.
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Adverse Reactions
Significant: Photosensitivity, hypersensitivity reactions, electrolyte imbalance (e.g. hyponatraemia, hypokalaemia, hypochloremic alkalosis, hypomagnesaemia, hypercalcaemia).
Cardiac disorders: Arrhythmia, chest pain, palpitations.
Ear and labyrinth disorders: Vertigo.
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.
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.
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Overdosage
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.
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Drug Interactions
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.
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Food Interaction
Potentiated orthostatic hypotension with alcohol.
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Lab Interference
May interfere with parathyroid function tests. May cause false positive result to aldosterone/renin ratio (AAR).
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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.
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. |
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Storage
Oral: Store at 20-25°C.
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CIMS Class
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ATC Classification
C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.
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