Meds and you

27 September 2013

Indapamide

Indapamide is a diuretic. Diuretics are drugs that increase the production of urine, thereby reducing excess water from the body.

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Indapamide is the active ingredient of Catexan Tablets (Nappi Code: 700820-005), Dapamax Tablets (Nappi Code: 819417-008/017), Hydro-less Tablets (Nappi Code: 822825-007/015), Indalix Tablets (Nappi Code: 839531-001/028), Lixamide Tablets (Nappi Code: 891531-003/011), Merck-Indapamide Tablets (Nappi Code: 703329-001), Natrilix Tablets (Nappi Code: 746002-009) and Sandoz Indapamide 2,5 Tablets (Nappi Code: 831026-006).

It is also one of the active ingredients found in Bipreterax Tablets (Nappi Code: 704928-001), Coversyl Plus Tablets (Nappi Code: 877549-001), Preterax Tablets (Nappi Code: 700512-001) and Prexum Plus Tablets (Nappi Code: 704929-001).

General information
Indapamide is a diuretic. Diuretics are drugs that increase the production of urine, thereby reducing excess water from the body.

In South Africa indapamide is registered for the treatment of mild to moderately high blood pressure. It is also indicated for the treatment of oedema - an accumulation of excessive amounts of fluid in body tissue resulting in swelling - that results from chronic heart failure.

Indapamide is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective you must take it regularly. High blood pressure declines slowly and it may take a few weeks for indapamide to reach its full effect. Keep taking this medicine during this period, even if you are feeling better or fail to notice any improvement.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to be resting when starting treatment and to lie down for 2 hours afterwards.

The diuretic should best be taken in the morning to prevent additional night-time visits to the toilet. It is possible that you may produce a larger volume of urine at the start of treatment with indapamide. Be aware of where your nearest ablution facilities are if you are away from home!

Indapamide enhances the excretion of potassium from your body and may warrant a potassium-rich diet (foods such as bananas or tomatoes), or even the use of a potassium supplement.

A low sodium diet is furthermore advised, as this may diminish potassium loss, and also lower the dosage requirements for this drug.

How does indapamide work?
A diuretic such as indapamide reduces the overall fluid volume in the body, thereby reducing pressure within blood vessels. It also has a direct action on blood vessels, causing them to widen.

Fast facts

Drug schedule: schedule 3
Available as: indapamide is available as tablets
What does it do? Indapamide lowers blood pressure and reduces fluid volume in the body.
Overdose risk: low
Dependence risk: low
Is Indapamide available as a generic? yes
Is Indapamide available on prescription only? yes

User information

Onset of effect: within 2 hours
Duration of action: up to 18 hours
Dietary advice: indapamide enhances the excretion of potassium from your body and may warrant a potassium-rich diet containing foods such as bananas or tomatoes.
Stopping this medicine: it may be dangerous to discontinue this drug abruptly as symptoms of the condition being treated may recur. Don't discontinue this drug without speaking to your doctor.
Prolonged use: prolonged use may result in an electrolyte disturbance. Kidney function may also need to be evaluated periodically.

Special precautions
Consult your doctor before using this drug if:

  • you have kidney or liver disease

  • you have known low blood levels of potassium or high blood levels of calcium

  • you have gout

  • you have diabetes

  • you have heart disease

  • you are pregnant

  • you have been diagnosed with porphyria

  • you have been diagnosed with lupus erythematosus

  • you are taking other medication

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
Infants and children: this medication is not intended for use in children.
The elderly: caution is advised in the elderly as adverse effects may be more likely.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness and light-headedness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
muscle cramps or pain
X

X

palpitations

X

X
weakness

X

X
dizziness

X
X

thirst/dry mouth
X

X

constipation

X
X

loss of appetite

X
X

gout

X
X

increased blood sugar

X
X

skin rash/itch

X

X
sore throat

X

X
pins and needles sensation

X

X
yellow tinge of skin/eyes

X

X

Interactions

Drug interactions

amiodarone increased risk of cardiac toxicity of amiodarone
disopyramide increased risk of cardiac toxicity of disopyramide
flecainide increased risk of cardiac toxicity of flecainide
quinidine increased risk of cardiac toxicity of quinidine
drugs for the treatment of diabetes control of diabetes may be destabilised
carbamazepine risk of low sodium levels in the body
terfenadine increased risk of heart rhythm disturbance in case of electrolyte imbalance
lithium increased risk of lithium toxicity
hydrochlorothiazide increased blood pressure lowering effect
beta blocking drugs increased blood pressure lowering effect
nifedipine, amlodipine, felodipine, nimodipine increased blood pressure lowering effect

Disease interactions
Consult your doctor before using this drug if you have kidney or liver disease, gout, diabetes, Addison’s disease or if you have been diagnosed with arteriosclerosis.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults: oral, 1.5-2.5 mg/day

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.
 
 

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