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CARDIOVASCULAR SYSTEM › DIURETICS › LOW-CEILING DIURETICS, EXCL. THIAZIDES › Sulfonamides, plain
indapamide
C03BA11
Forms & Strengths
- Oral tablet: 1.25 mg
- Oral tablet: 2.5 mg
- Oral sustained-release tablet: 1.5 mg
Adult Dosing
- Hypertension: 1.25 mg once daily in the morning; may increase to 2.5 mg once daily or 5 mg once daily (for immediate-release) if response is inadequate
- Hypertension (sustained-release): 1.5 mg once daily in the morning
- Edema associated with heart failure: 2.5 mg once daily in the morning; may increase to 5 mg once daily
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of essential hypertension (monotherapy or combination)
- Management of salt and fluid retention associated with congestive heart failure
Mechanism of Action
- Indapamide is a sulfonamide-derived thiazide-like diuretic
- Inhibits sodium reabsorption at the cortical diluting segment of the distal renal tubule
- Increases excretion of sodium, chloride, and water, while possessing direct vasodilatory properties via calcium channel blockade
Contraindications
- Known hypersensitivity to indapamide or other sulfonamide derivatives
- Anuria
- Severe hepatic impairment or hepatic coma
Adverse Reactions
- Hypokalemia, hyponatremia, hypomagnesemia, hypercalcemia
- Hyperuricemia and exacerbation of gout
- Hyperglycemia
- Orthostatic hypotension, dizziness, headache, fatigue
- Photosensitivity and rash
Drug Interactions
- Lithium: Decreased renal clearance, leading to potential lithium toxicity
- NSAIDs: May attenuate the antihypertensive and diuretic efficacy of indapamide and increase renal impairment risk
- Other antihypertensive agents: May cause additive hypotensive effects
- Coadministration with drugs that prolong the QT interval (e.g., class IA and III antiarrhythmics) increases risk of ventricular arrhythmias due to potential electrolyte disturbances (hypokalemia)
Curated Content: Needs Vetting Before Put to Clinical Use