Other Names/Brands

Bioprexum Plus, Natexam, Natrilix SR, Triplixam, Aldapres

Mechanism of Action

Indapamide is a diuretic that works by increasing sodium and water excretion through the kidneys. This drug belongs to the thiazide-like diuretic class, inhibiting the reabsorption of sodium and chloride ions in the distal tubule of the nephron.

By reducing fluid volume in the blood vessels, indapamide helps lower blood pressure. Indapamide also has a direct vasodilatory effect on blood vessels, which helps improve vessel elasticity and reduce peripheral resistance, thus allowing for more effective blood pressure control.

Indications

Indapamide is indicated for the treatment of hypertension (high blood pressure) and edema (fluid buildup) associated with congestive heart failure.

As a diuretic with potent antihypertensive effects, this medication helps lower blood pressure by reducing body fluid volume and dilating blood vessels. Indapamide can be used as monotherapy or in combination with other antihypertensive medications, depending on the patient's needs and the doctor's recommendation.

Contraindications

Indapamide is contraindicated in patients with hypersensitivity to indapamide, sulfonamides, or any other component of the drug. This drug should also not be used in patients with severe kidney impairment, severe liver failure, hepatic encephalopathy, or very low blood potassium levels (severe hypokalemia).

Indapamide should be avoided in pregnant and breastfeeding women unless absolutely necessary, as it may affect the electrolyte balance and kidney function of the fetus or infant.

Side Effects

Side effects of indapamide can include electrolyte imbalances such as hypokalemia (low potassium levels), hyponatremia (low sodium levels), and dehydration due to increased urine output.

Some patients may also experience headache, dizziness, fatigue, nausea, muscle cramps, or digestive problems. In rare cases, allergic skin reactions, increased uric acid levels, or liver dysfunction may occur.

Preparations

Indapamide is available in tablet form, generally for oral administration. Doses vary depending on the brand and therapeutic needs, but the most common are 1.25 mg and 2.5 mg tablets. Some preparations are also available in sustained-release forms to maintain stable blood levels and facilitate administration.

Dosage

The dosage of indapamide is generally adjusted based on the therapeutic goal and the patient's condition. For the treatment of hypertension, the usual starting dose is 1.25 mg once daily, which can be increased to 2.5 mg daily if needed.

For cases of edema associated with heart failure, the dose is usually 2.5 mg once daily. Indapamide is taken in the morning so that its diuretic effect does not interfere with sleep. Dose adjustments should be made carefully, especially in elderly patients or those with impaired kidney or liver function.

Safety of Drugs

Indapamide is classified as a pregnancy safety category C by the FDA, meaning animal studies have shown an adverse effect on the fetus, but there are no adequate, controlled studies in humans.

Its use during pregnancy is only permitted if the expected benefit outweighs the potential risk to the fetus. Furthermore, because indapamide is excreted in breast milk, its use in nursing mothers should be avoided.

Drug Interactions

Indapamide can interact with various other medications that affect blood pressure, electrolyte balance, or kidney function. Concomitant use with other antihypertensive medications, such as ACE inhibitors or beta-blockers, may enhance the blood pressure-lowering effects.

Combination with medications that cause potassium loss, such as other diuretics or corticosteroids, may increase the risk of hypokalemia. Indapamide can potentiate the toxic effects on the heart when potassium levels are low and may decrease the effectiveness of antidiabetic medications.

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