indapamide

Action and Spectrum

Actions and Spectrum 

indapamide reduces the amount of extra fluid in the body by increasing the volume of urine the kidneys generate. This is accomplished by preventing the reabsorption of sodium and chloride ions in the kidneys distal convoluted tubules. It helps in lowering blood pressure and reducing edema brought on by fluid retention by encouraging greater urine production. 

The spectrum of indapamide’s utilisation and efficiency relates to the assortment of ailments for which it is utilised. indapamide is recommended as the initial treatment for hypertension. By lowering fluid retention and relaxing blood arteries, which improves blood flow, it lowers blood pressure. 

Drug Interaction

Adverse Reaction

Frequency defined  

<1% 

Glycosuria 

Pancreatitis 

Cutaneous vasculitis 

1-10% 

Light headedness 

Restlessness 

Rhinnorhea 

Rash 

Drowsiness 

Flushing 

Dizziness 

Nocturia 

Blurred vision 

Electrolyte abnormalities 

Pruritus 

Vertigo 

Fatigue 

Polyuria 

Lethargy 

Headache 

Weakness 

Malaise 

Anorexia 

Nausea 

Hypotension 

Palpation 

Post marketing reports 

Eye Disorders: Choroidal effusion, angle-closure glaucoma and acute myopia 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• People who are known to be allergic or hypersensitive to indapamide or any of its ingredients should not use indapamide.  
• Patients with significant renal impairment should not use indapamide. This is since indapamide is mostly removed through the kidneys, and its usage in people with severe renal impairment can worsen kidney function. 

Caution: 

• indapamide can raise blood uric acid levels, which could lead to gout attacks or exacerbate pre-existing gout.  
• Diabetes patients should use indapamide with caution because it has the potential to influence blood glucose levels.  
• Use of indapamide during pregnancy and breast-feeding should be avoided. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: B 

Lactation: Excretion into human milk is unknown  

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category
 

Pharmacology

Pharmacology 

indapamide predominantly affects the kidneys distal convoluted tubules, where it blocks the reabsorption of sodium and chloride ions. By reducing the reabsorption of these electrolytes, this action causes an increase in urine production and a consequent diuresis. indapamide lowers bodily fluid content by increasing diuresis, which lowers blood pressure and lessens edema. 

Pharmacodynamics 

The main cause of indapamide’s ability to lower blood pressure is its diuretic impact. It lowers blood pressure by decreasing the volume of fluid circulating in the blood vessels and increasing urine production. By lowering peripheral resistance and enhancing blood flow, this enhances its antihypertensive action. 

The body’s electrolyte balance can be impacted by indapamide. It primarily encourages salt and chloride ion excretion, which aids in lowering fluid retention. 

Pharmacokinetics 

Absorption   

indapamide is well absorbed from the gastrointestinal tract. Within 1 to 2 hours of use, the drug’s plasma concentrations reach their peak. 

Distribution 

The moderate volume of distribution of indapamide suggests that it is dispersed among all bodily tissues. The medication partially binds to plasma proteins. 

Metabolism 

indapamide is extensively metabolized in the liver, mostly by cytochrome P450 (CYP) enzymes. The primary metabolites produced are inert and do not significantly contribute to the pharmacological effects of the medication. 

Elimination and excretion 

indapamide has an elimination half-life of 14 to 24 hours. The urine is where most of the medication and its metabolites are eliminated. indapamide elimination is mostly dependent on renal clearance. The medication is also partially excreted in the feces. 

Adminstartion

Administration:  

indapamide is normally used orally and is available in tablet form. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: indapamide 

Why do we use indapamide? 

indapamide is a drug that is primarily used to treat edema (fluid retention) and hypertension (high blood pressure) that are linked to diseases including congestive heart failure.