Indapamide composition. Indapamide is an affordable and effective medicine for arterial hypertension

Indapamide is a diuretic medicinal product, which has a moderate diuretic effect and is widely used in the treatment arterial hypertension. The medicine is characterized by high safety. Despite this, compliance with all requirements for use contained in the instructions for use is required. Current prices, reviews from specialists and their patients, as well as possible analogues Indapamide in Russia will allow you to choose the most suitable treatment option for each patient.

Compound

The medicinal product contains the active Chemical substance Indapamide ( international name Indapamid). Quantity active component is 2.5 mg per dose, regardless of the manufacturer of the drug, and 1.5 mg in Indapamide modified-release tablets (MV, retard).

As additional components, domestic and foreign manufacturers include the following substances in the composition of the drug:

• povidones;
• starch;
• Magnesium salts;
• lactose;
• dye.

Release form

The drug is produced by different manufacturers only in the form of tablets, which are intended for oral administration. Each tablet is colored White color and covered with a shell. The package contains 30 tablets and instructions for use.

pharmachologic effect

The drug belongs to pharmacological group diuretics, indoline derivatives. The mechanisms of action consist in a predominant effect on blood vessels, due to which pressure decreases and urine excretion increases.

The main directions of pharmacological action are the following:

• obstruction of the hormone norepinephrine in the narrowing of blood vessels;
• facilitating blood flow through the vessels;
• decreased pressure in blood vessels;
• blocking calcium channels in cells;
• slight increase in urine outflow;
• decreased contractile function of the muscular layer of blood vessels;
• influence on the process of reabsorption of chlorine, sodium and water in the kidneys.

Important! Increasing the dose of the drug only enhances the diuretic effect; the antihypertensive properties of the drug do not change significantly.

Modified-release (retard) tablets contain less active substance. Due to the specific shell, Indapamide is released more slowly in the body. As a result, the duration of action of the drug is significantly extended.

Indications for use

Indications for use and prescription of the drug are: arterial hypertension different degrees and etiology.

Important! Patients with kidney disease (except very severe conditions) no dose adjustment is required, since Indapamide has a mild and mild effect on the urinary system. This allows complex therapy to be carried out without the risk of adverse reactions.

Contraindications

Indapamide is not prescribed in the following situations:

• period of bearing a child. Indapamide should not be taken during pregnancy due to the lack of sufficient reliable data on the safety of the drug for the fetus;
• period of breastfeeding. Indapamide is prohibited for use during breastfeeding (lactation);
• the drug is not prescribed in childhood(up to 18 years old);
• severe forms of renal failure accompanied by anuria (lack of urine output);
• liver encephalopathy;
• decreased level of potassium in the blood;
• malfunctions thyroid gland;
• allergy to medicine.

It is important to take into account the presence of conditions that are contraindications to the use of Indapamide in order to ensure maximum safety for the patient’s health.

Instructions for use

The prescribed dose is administered once, preferably in the morning. It is recommended to drink at least 100 ml of water. Food does not affect the effectiveness of the product.

Important! The dosage is selected individually, taking into account the patient's condition. It is forbidden to change the dose on your own without consulting your doctor. The duration of treatment is determined only by the doctor.

For Indapamide 2.5 mg, this dose is the daily dose for adults. For the prolonged form, the daily dosage is 1.5 mg (do not exceed). It is important to know that the doses of the drug that are indicated in official instructions for the standard course of treatment, it should not be changed even if it is necessary to prescribe additional drugs for the treatment of hypertension.

Overdose

A slight excess of the dose for a short time will not have serious consequences. Long-term overdose is accompanied by the following symptoms:

• dyspeptic disorders;
• digestive disorders;
• disturbed water-electrolyte balance;
• hypotension;
• dizziness;
• spasms in the bronchi;
• hepatic coma (in patients suffering from severe liver damage).

Methods of assistance:

1. Reception of sorbents.
2. Gastric lavage.
3. Taking rehydration and replenishment products salt balance(Regidron).

Important! Any cases of overdose should be reported to your doctor.

Side effects

Common side effects include the following:

• weakness;
• muscle spasms;
• headache;
• dizziness.

Consultation with a doctor is required in case of severe manifestations of these symptoms.

Rare side effects are the following:

• dyspeptic disorders;
• rash on skin, which are most clearly manifested in open areas;
• disturbances of consciousness (fainting);
• increased heart rate;
• sore throat;
• jaundice;
• tingling and pinching sensation throughout the body;
• erectile dysfunction.

In all of these cases, you should contact your doctor to make a decision on further therapy.

Interaction with other tools

Indapamide is different low level compatibility with other diuretics (according to research descriptions and manufacturers' annotations), since their combination significantly increases the likelihood of an imbalance of salts in the blood.

Indapamide leads to increased toxicity of the following drugs:

• antiarrhythmic;
• products containing Foxglove;
• Lithium preparations.

Indapamide reduces the effectiveness of Mexiletine (an antiarrhythmic drug).

The following drugs reduce the effectiveness of Indapamide:

• NSAIDs;
• glucocorticosteroids;
• sympathomimetics;
• Tetracoactide.

Increases the effectiveness of Indapamide Baclofen.

Heart rhythm disturbances can be caused by combination with the following drugs:

• Erythromycin;
• Astemizole;
• Sultopride;
• antiarrhythmics;
• Vincamine.

Important! During drug therapy, it is extremely important to consider the possible negative consequences of drug interactions.

During pregnancy and lactation

Pregnancy is a contraindication to the use of the drug. It is important to consider that there is no reliable data on the safety of Indapamide for the fetus and infant. Therefore, Indapamide is also not used during breastfeeding.

With alcohol

Despite the fact that there are no special warnings in the descriptions (annotations) of the drug manufacturers about the consequences of interactions with alcohol, you should not combine the drug with alcoholic beverages, especially strong ones. If you take Indapamide and alcohol, manifestations of low compatibility may develop, such as intoxication of the body, increased load on the liver and kidneys.

Analogues

Indapamide is produced by various pharmaceutical companies - Astrapharm, Teva, Canon, Verta, Servier, Norton, Ozon, Hemofarm, Valenta ( Russian analogue Indapamide), in the form of MV - Stada (Stada), Ratiopharm, etc. Domestic analogues(Russian) - cheaper, foreign ones are a little more expensive. Indapamide, if necessary, can be replaced with synonyms that are sold under other trade names:

• Ravel;
• Indapen;
• Vasopamide;
• Indabru;
• Indapaphone;
• Indopress;
• Indapres;
• Indap;
• Arifon;
• Lorvas;
• Ipamid;
• Arifon retard;
• Softensif;
• Ypres Long;
• Indiur;
• Hemopamide.

Indapamide differs from these substitutes only by the manufacturer. All analogues that can be replaced have proven safety and effectiveness.

It is important to consider that Indapamide is part of some combined agents used in the treatment of hypertension:

Important! All options for replacing medications should be discussed with your doctor.

Best before date

The drug is stored for two years from the date of manufacture. Do not take the medicine after the expiration date has expired.

Terms of sale and storage

To purchase the drug in pharmacies, you need a doctor's prescription (in Latin), which indicates the INN of the drug in Latin in order to avoid errors when dispensing.

It is important to store the drug in accordance with the following recommendations:

• dry place;
• ventilated room;
• no direct light;
• temperature - up to 25⁰С.

The drug should be kept away from children.

special instructions

While taking the drug, it is important to regularly monitor the electrolyte composition of the blood in order to prevent disorders.

When using the medicine, there is no need to adjust the dosage of antidiabetic drugs.

1. Pharmacological action

A decrease in blood pressure is observed only when initially increased rates a week after the first dose and reaches its maximum after 3 months of treatment.

After oral administration, the drug is quickly and completely absorbed, almost completely binding to plasma proteins and reaching its maximum concentration after 2 hours. Does not have the ability to form accumulations, is excreted through the kidneys after 36 hours in the form of breakdown products.

2. indications for use

• Long-term increase in blood pressure;
• The phenomena of stagnation of fluid and sodium ions in chronic functional heart failure.

3. Method of application

Features of application:

• During use of the drug, monitoring of the percentage of electrolytes is necessary;
• Increasing the dosage only affects the increase in the diuretic effect of Indapamide;
• Before using the drug, a number of studies should be carried out in order to identify conditions of electrolyte imbalance.

• Diabetes mellitus (use should be accompanied by constant monitoring of blood glucose levels);

4. Side effects

• Violations digestive system(stool disorders, nausea, inflammation of the pancreas, dry mouth, functional disorders of the liver);
• Nervous system disorders (headaches, general weakness, involuntary muscle contractions, muscle pain, increased fatigue, dizziness);
• Violations respiratory system(inflammation of the paranasal sinuses, inflammation of the larynx, cough);
• Disorders of the hematopoietic system ( various changes percentage shaped elements blood);
• Cardiovascular system disorders (disorders heart rate, sharp drop in blood pressure);
• Various allergic reactions(systemic lupus erythematosus, occurring in the acute stage, skin rashes, purpura);
• Violations of various clinical indicators(decreased content of potassium ions, increased content of calcium ions, decreased content of chlorine ions, increased content of uric acid, delayed orthostatic reflex (change in pressure when changing body position)).

5. Contraindications

6. During pregnancy and lactation

If necessary, the drug can be used during breastfeeding only after its complete cessation throughout the entire duration of treatment, until complete removal breakdown products from the mother's body.

7. Interaction with other drugs

• Simultaneous use with drugs that block the ACE enzyme increases the risk of developing a sharp decrease in the level of sodium ion concentration;
• Simultaneous use with hormonal drugs cortical zone of the adrenal glands and non-steroidal anti-inflammatory drugs, the therapeutic effect of Indapamide associated with a decrease in blood pressure is reduced;
• Simultaneous use with drugs containing calcium ions leads to an increased content of calcium ions in the body;
• Simultaneous use with cardiac glycosides, hormonal drugs of the adrenal cortex or any other drugs that enhance the excretion of potassium ions from the body, a decrease in the concentration of potassium ions is observed;
• Concomitant use with tricyclic antidepressants leads to increased therapeutic effect Indapamide, associated with lowering blood pressure;
• Concomitant use with Halofantrine, Terfenadine, Quinidine, Vincamine, Pentamidine, Bepridil, Astemizole, Sotalol, Sultopride, Erythromycin, Disopyramide and Amioradone leads to the development of heart rhythm disturbances;
• simultaneous use with Lithium Carbonate, development is observed side effects associated with an increased content of lithium ions in the body;
• Simultaneous use with Cyclosporine, an increase in creatinine levels is observed;
• Concomitant use with Metformin leads to the development of functional renal failure and the subsequent development of a shift in acid-base balance to the left.

8. Overdose

• Digestive system disorders (nausea, vomiting);
• Nervous system disorders (drowsiness, dizziness);
• Disorders of the urinary system (various disorders of the formation and excretion of urine).

9. Release form

10. Storage conditions

11. Composition

1 tablet:

• indapamide - 2.5 mg;
• Excipients: pregelatinized starch, microcrystalline cellulose, colloidal silicon dioxide (aerosil), magnesium stearate, hypromellose, macrogol, lactose monohydrate, titanium dioxide.

1 capsule:

• indapamide - 2.5 mg.

12. Conditions for dispensing from pharmacies

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* Instructions for medical use for the drug Indapamide has been published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, YOU MUST CONSULT WITH A SPECIALIST

The first representative of a new class of antihypertensive/diuretic drugs called indolines. It is a sulfonamide derivative with an indole ring in the structure of the molecule. At a dose of 2.5 mg/day it has pronounced and prolonged hypotensive and weak diuretic effects. When assigned to more high doses antihypertensive effect does not significantly increase, while the amount adverse reactions increases. Therefore, you should not exceed the recommended dose. At a dose of 2.5 mg/day it reduces vascular hyperreactivity to norepinephrine and peripheral vascular resistance. Reduces left ventricular hypertrophy in hypertension (arterial hypertension). The antihypertensive effect persists in case of impaired renal function. The vascular mechanism of action of indapamide is due to a decrease in the contractility of vascular smooth muscles due to the effect on transmembrane ion exchange (in particular, a decrease in intracellular calcium transport) and stimulation of the synthesis of prostaglandin E2, which has a vasodilatory and hypotensive effect. It has moderate diuretic and saluretic effects, which are associated with blockade of the reabsorption of sodium, chlorine, water and, to a lesser extent, potassium ions in the proximal and distal convoluted tubules, as well as in the area of ​​the ascending loop of Henle. Does not have a negative effect on lipid metabolism and carbohydrate metabolism.
Indapamide is quickly and completely absorbed from the digestive tract; the maximum concentration in blood plasma is achieved between the 1st and 2nd hour after oral administration. Binding to blood plasma proteins is high - 71-79%. Metabolized in the liver. 60-70% of indapamide is excreted in urine (with only 5-7% unchanged), and 20-23% in feces. The half-life is 14-18 hours.

Indications for use of the drug Indapamide

AH (arterial hypertension).

Use of the drug Indapamide

Orally, 1 tablet (2.5 mg) or 1 tablet of prolonged action (1.5 mg) 1 time per day; the drug is preferably taken in morning hours. Maximum daily dose 2.5 mg.

Contraindications to the use of the drug Indapamide

Hepatic encephalopathy, severe renal and liver failure, hypokalemia, increased sensitivity to the funds of this group.

Side effects of the drug Indapamide

Possible hypokalemia, hyponatremia, hypovolemia, orthostatic hypotension, hypericemia, hyperglycemia, extremely rarely - hypercalcemia, myelosuppression, leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, myelosuppression, encephalopathy in patients with liver failure, maculopapapulus rash, purple, exacerbation STI in the mouth, dizziness , asthenia, paresthesia, headache, pancreatitis.

Special instructions for the use of the drug Indapamide

There are no data on the safety of indapamide during pregnancy. The prescription of indapamide as a diuretic for the treatment of edema and hypertension (arterial hypertension) during pregnancy is not justified, since this can lead to fetoplacental ischemia with the risk of developing fetal malnutrition. It is recommended to stop breastfeeding during treatment with indapamide.
The use of indapamide in athletes may cause positive reaction during doping control.
During treatment with indapamide, periodic monitoring of serum potassium and sodium levels, as well as uric acid levels in patients with gout is necessary. Secondary hypovolemia following the loss of water and sodium caused by taking the diuretic at the beginning of treatment causes a decrease in glomerular filtration rate. This can lead to an increase in blood levels of urea and plasma creatinine. This transient functional renal failure does not lead to negative consequences in individuals with normal renal function, but may increase the severity of pre-existing renal failure.
By lowering blood pressure, indapamide may affect the ability to drive vehicles and working with potentially dangerous machinery.
The antihypertensive effect of indapamide may be enhanced by sympathectomy.

Drug interactions Indapamide

It is not recommended to administer simultaneously with indapamide the following means: lithium salts, sultopride, terfenadine, vincamine, astemizole, erythromycin, pentamidine, bepridil. Caution should be exercised when prescribing indapamide simultaneously with the following drugs: NSAIDs for systemic use, salicylates in high doses, metformin, iodinated contrast agents, some antiarrhythmic drugs(class Ia antiarrhythmic drugs, sotalol and amiodarone), potassium-lowering drugs (amphotericin B - intravenous), corticosteroids (gluco- and mineralocorticoids for oral administration), tetracosactide, laxatives, digitalis preparations. The simultaneous use of potassium-sparing diuretics does not exclude the possibility of developing hypokalemia. Combination with ACE inhibitors increases the risk of developing severe arterial hypotension or renal failure in patients at risk (dehydration, hyponatremia, kidney disease).

Overdose of the drug Indapamide, symptoms and treatment

Possible symptoms acute poisoning are caused by disturbances in water-electrolyte balance and are clinically manifested by nausea, vomiting, arterial hypotension, convulsions, dizziness, drowsiness, confusion, polyuria or oliguria up to anuria due to hypovolemia. First aid includes rapid elimination of the drug taken (gastric lavage, administration of activated charcoal), followed by rehydration therapy and correction of electrolyte disturbances.

List of pharmacies where you can buy Indapamide:

• Saint Petersburg

The product also stimulates the formation of vasodilators and platelet aggregation blockers: prostacyclin PgI2 and prostaglandin PgE2. As a result of the action of the product, there is a decrease in the total precardiac load, dilation of arterioles and a decrease in blood pressure. In the renal tissue at the level of the cortical layer, the product reduces the ability to reabsorb sodium, increases the excretion of magnesium, potassium and chlorine in the urine, thereby increasing the volume of excreted fluid. The effect on the release of magnesium and potassium is minor. The hypotensive effect of Indapamide is noticeable in dosages that do not cause a significant increase in diuresis. Therefore, taking the product in therapeutic doses causes only a hypotensive effect without a significant increase in the volume of urine excreted.

Has no effect on lipid metabolism(triglycerides, high and low density lipoproteins), carbohydrate metabolism, including in patients with diabetes mellitus.When taking the product, a decrease in the severity of left ventricular hypertrophy is observed. The hypotensive effect of Indapamide is detected even in patients on chronic hemodialysis.
Absorbed from the digestive tract quickly and completely. Eating at the same time as the product slows down the rate of absorption, but does not change the content of the absorbed substance. An improved release form (extended-release tablets) provides uniform release of indapamide with an active substance content of 1.5 mg, which improves the effectiveness of 24-hour blood pressure control.

The maximum plasma concentration of indapamide is determined after 12 hours. If the next dose of the product is repeated, significant changes in plasma concentrations are reduced.
The half-life is approximately 18 hours (range 14 to 24 hours). Over 79% bound by plasma proteins. The equilibrium concentration stage is determined after 7 days with regular use. Metabolized in hepatocytes, eliminated by the kidneys (in the form of inactive metabolites) - within 70% of the dose taken, 22% in feces.
With moderate renal failure, pharmacokinetic parameters do not change.

Indapamide route of administration and dosage:
Prescribed in the morning, 1 tablet every day orally. Swallow without chewing. Drink with water. Increasing the dosage of Indapamide does not increase the hypotensive effect, but increases the diuretic effect.

Indapamide contraindications:
Expressed disorders liver functions, including hepatic encephalopathy;
renal failure in the presence of anuria;
allergic reactions to indapamide and other components of the product;
gout;
age under 18 years;
pregnancy and lactation;
acute or recent disorder cerebral circulation;
combination with products that cause an increase QT interval(eg cisapride);
hypokalemia.

Indapamide side effects:
From the central and peripheral nervous system: paresthesia, fatigue, vertigo, headache, weakness, muscle pain - often.
Hematopoietic system: leukopenia, aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia - very rare.
From the cardiovascular system: hypotension, cardiac arrhythmias - very rare.
Laboratory parameters: a decrease in the concentration of potassium in the blood serum, hypokalemia especially often develops when associated factors risk; a decrease in sodium concentration, leading to dehydration of the body or hypovolemia, orthostatic reactions are possible; hypochloremia can provoke metabolic alkalosis; increase in calcium concentration (very rare); increase in uric acid content.
From the digestive system: dry mouth, nausea, constipation - not often; liver dysfunction, pancreatitis - very rare; with liver failure there is a risk of developing hepatic encephalopathy.
Immune system: allergic reactions, especially in persons with hypersensitivity to other products: purpura, maculopapular rash, exacerbation of systemic lupus erythematosus.
From the respiratory system: sinusitis, cough, pharyngitis - not often.

Pregnancy:
The use of diuretics, including Indapamide, is unjustified from a pathogenetic point of view in the treatment of edema and arterial hypertension during pregnancy. Taking Indapamide can cause insufficiency of placental-fetal blood flow with the development of fetal malnutrition. It is not recommended to prescribe the product during pregnancy. If the product must be taken during lactation, breast-feeding stop because active substance penetrates into breast milk.

Overdose:
Indapamide is toxic when taken at a dosage of 40 mg (27 times the therapeutic single dose). Signs of overdose: vomiting, nausea, hypotension, drowsiness, dizziness, oliguria or polyuria, possible anuria due to severe hypovolemia. Symptoms of overdose are caused by electrolyte and water violations(hypokalemia, hyponatremia). Indapamide can be eliminated by gastric lavage and the use of enterosorbents (activated carbon). Rehydration and restoration of electrolyte balance are effective. Further - symptomatic treatment. Treatment should be carried out in a hospital setting.

Use with other medications:
Salicylates in large doses and systemic non-steroidal anti-inflammatory drugs have a negative effect on the effectiveness of the hypotensive effect of the product. When prescribed to patients with dehydration, acute renal failure may develop (in this case, it is necessary to replenish the fluid balance).
In combination with products containing lithium salts, an increase in the concentration of lithium in the blood is observed due to a decrease in lithium excretion. This may contribute to symptoms of overdose of a lithium-containing product. If such a combination is justified, then it is necessary to monitor the level of lithium in the blood.

Influenced systemic action tetracosactide and glucocorticosteroids neutralize the hypotensive effect of Indapamide due to the retention of sodium ions and water in the body.
Mineral and glucocorticosteroids, amphotericin, laxatives with a mechanism of action due to increased intestinal motility provoke hypokalemia. If such a combination is used - for timely diagnosis Hypokalemia requires monitoring of serum potassium.
Combination with potassium-sparing diuretics (spironolactone, triamterene, amiloride) causes hyperkalemia, especially in patients with renal failure or diabetes mellitus.

In patients with signs of dehydration, the combination of Indapamide with angiotensin-converting factor inhibitors may cause renal failure (due to hyponatremia) and sudden a sharp decline blood pressure. When switching from Indapamide to angiotensin-converting factor inhibitors, the diuretic should be discontinued 3 days before the planned therapy.
When Indapamide is combined with cardiac glycosides, there is a high risk of subsequent toxic effects. For timely diagnosis of the disorder, it is necessary to monitor ECG parameters and potassium levels in the blood serum.

The combination of Indapamide with metformin can provoke the development of lactic acidosis due to the occurrence of renal failure.
It is not recommended to combine Indapamide with bepridil, astemizole, erythromycin, pentamidine, sotalol, halofantrinos, quinidine, sultopride, hydroquinidine, disopyramide, vincamine, amiodarone, terfenadine, bretylium, since torsade de points may occur. Precursors to the development of torsade de points are considered to be a prolongation of the P–Q interval, a decrease in heart rate, and hypokalemia. Torsade de points - ventricular polymorphic tachycardia in the "pirouette" variant - can provoke ventricular fibrillation.

When an X-ray contrast agent is administered while taking Indapamide, the likelihood of developing kidney failure increases. To prevent complications, hydration is necessary before administering a radiocontrast agent.
At simultaneous administration calcium salts may cause hypercalcemia. Potentiation hypotensive effect Indapamide is observed when taking antipsychotics, imipramine and other tricyclic antidepressants. This can cause orthostatic hypotension. While taking Indapamide with cyclosporine, an increase in creatinine in the blood is possible. Combination with estrogen-containing products leads to the leveling of the hypotensive effect of Indapamide due to water retention in the body.

Release form:
Extended-release tablets 1.5 mg. There are 30 tablets in a pack.

Storage conditions:
At normal conditions. The storage period is indicated on the package. Dispensed with a prescription from a doctor.

Synonyms:
Acripamide retard (Acripamide), Arifon retard (Arifon), Indap, Arindap, Indapamide retard (Indapamide), Indapamide Nycomed, Vero-Indapamide, Indapamide MV, Indapamide-Vero, Indapamide Polpharma, Indapamide-Verte, Indapsan, Indiur, Indipam, Ionic retard (Ionic), Tenzar, Ipres long, Indapamide SR, Lorvas, Lescoprid, Pamid, Retapres, Ravel SR, Frantel.

Indapamide composition:
Active substance: indapamide.
Inactive substances: copovidone, lactose monohydrate, magnesium stearate, hypromellose, colloidal anhydrous silicon dioxide.

Additionally:
Hypokalemia of 3.4 mmol or less enhances the toxic effects of cardiac glycosides and contributes to the occurrence of arrhythmia. In sick people high risk these complications ( malnutrition, heart failure, elderly age, cirrhosis of the liver, taking a large number medicinal products) it is necessary to systematically monitor the level of potassium in the blood serum and, if necessary, correct it.

Before prescribing Indapamide, a laboratory examination of the patient is carried out, especially in the presence of conditions that can provoke water and electrolyte disturbances. During the entire intake of the product, it is necessary to periodically monitor the content of electrolytes (sodium, potassium, magnesium) in the blood serum, as well as glucose levels, pH, residual nitrogen And uric acid. Particular attention is paid to patients with coronary disease heart, chronic cardiovascular failure and cirrhosis of the liver, which is accompanied by ascites or edema, since such patients have a high risk of developing hepatic encephalopathy and metabolic alkalosis.
Also included in the high-risk group are patients with prolongation of the QT interval on the ECG of any origin (acquired or congenital). The development of brady- or tachycardia can lead to severe cardiac arrhythmias and torsades de pointes with fatal.
Determination of the concentration of potassium in the blood serum must be carried out before the start of treatment, and while taking Indapamide - more than once during treatment.

While taking the product, an exacerbation of SLE (systemic lupus erythematosus) may occur.
Prescribe with caution for diabetes mellitus, renal and liver failure, hyperuricemia.
Severe dehydration can lead to the formation of acute renal failure due to a decrease in glomerular filtration. In such patients, fluid deficiency is compensated and renal function is monitored at the beginning of therapy.
At the beginning of taking the product, secondary hypovolemia may occur due to loss of sodium and water, which leads to a decrease in the level of glomerular filtration. As a result, an increase in serum urea and creatinine concentrations may occur. Typically, such transient renal failure functional nature has no negative consequences with normal renal functions, however, with existing insufficiency, the severity of the initial clinical picture may get worse.

Use of the product by athletes may cause a false positive reaction during doping control. If hypercalcemia develops while taking Indapamide, this indicates previously undiagnosed hyperfunction of the thyroid gland (hyperparathyroidism).
Before surgical treatment the patient should inform the anesthesiologist that he is taking Indapamide.
Indapamide is not prescribed to children and adolescents under 18 years of age, as there is no experience with the product in this age group yet.
The drug can cause hepatic encephalopathy with concomitant liver failure. If hepatic encephalopathy is suspected, use of the product should be discontinued immediately. Elderly patients may be highly susceptible to the product, even if they are prescribed the usual dosage.
While taking the product, caution should be exercised when engaging in potentially dangerous species activities, and management of vehicles, i.e. for work that requires intense concentration and increased speed psychomotor reactions.

Indapamide, what do these tablets help with? The medicine has a vasodilating, hypotensive and diuretic effect. The drug is prescribed for high blood pressure and heart problems.

pharmachologic effect

Indapamide, which helps with many pathologies, is a diuretic drug of the thiazide group, which has a hypotensive, vasodilator and diuretic (diuretic) effect. Indapamide reduces the force of contraction of arterial smooth muscle, reduces total peripheral vascular resistance, and also promotes involution of left ventricular hypertrophy of the heart. With a single dose, it lowers blood pressure for a long time and is used in treatment hypertension and chronic heart failure.

What does Indapamide help with?

Indapamide belongs to the class of thiazide diuretics and has the following pharmacological effects:

• Reduces blood pressure (hypotensive effect);
• Dilates blood vessels (is a vasodilator);
• Reduces total peripheral vascular resistance;
• Reduces resistance in arterioles;
• Helps reduce the degree of hypertrophy of the left ventricle of the heart;
• Has a moderate diuretic (diuretic) effect.

The hypotensive effect of Indapamide develops when taken in dosages (1.5 - 2.5 mg per day) that do not cause a diuretic effect. Therefore, the drug can be used to lower blood pressure over a long period of time. When taking Indapamide in higher dosages, the hypotensive effect does not increase, but a pronounced diuretic effect appears.

It must be remembered that a decrease in blood pressure is achieved only a week after administration, and a lasting effect develops after 3 months of use. Indapamide does not affect fat and carbohydrate metabolism, therefore it can be used by people suffering from diabetes mellitus, increased level cholesterol, etc. In addition, Indapamide is effective in lowering blood pressure in people with one kidney or on hemodialysis.

The high safety and good tolerability of Indapamide allow it to be considered the drug of choice for the treatment of hypertension in people suffering from diabetes, chronic renal failure or hyperlipidemia ( increased content cholesterol, triglycerides, low-density lipoproteins in the blood).

All types of Indapamide are indicated for use in the treatment of the following diseases:

• Arterial hypertension.
• Elimination of edema syndrome in chronic heart failure (this indication is not registered in all countries).

Contraindications

You should not take pills if you have the following diagnoses:

• Severe renal failure (in the anuric stage);
• Severe liver failure (including with encephalopathy);
• Galactosemia;
• Hypokalemia;
• Glucose/galactose malabsorption syndrome, lactose intolerance;
• Concomitant use with drugs that prolong the QT interval;
• Pregnancy and lactation;
• Age up to 18 years (safety and effectiveness of the drug for this age group patients not identified);
• Hypersensitivity to the components of the drug, as well as to other sulfonamide derivatives.

Indapamide, due to which these tablets may be dangerous, should be taken with caution by patients with functional disorders kidneys and/or liver, diabetes mellitus in the stage of decompensation, hyperuricemia (especially accompanied by urate nephrolithiasis and gout), water and electrolyte imbalance, hyperparathyroidism, with an increased QT interval on the ECG or receiving other antiarrhythmic drugs.

Medicine Indapamide: instructions for use

Tablets of regular duration of action and capsules contain 2.5 mg of active substance and are characterized by the same rules of administration. Thus, tablets and capsules must be taken orally, swallowed whole, without biting, chewing or crushing in other ways, but with a sufficient amount of still water(at least half a glass). Tablets and capsules can be taken regardless of meals, that is, at any convenient time.

It is optimal to take tablets or capsules in the morning, at approximately the same time every day, to ensure that a certain concentration of the drug in the blood is constantly maintained. Indapamide, which helps the drug with arterial hypertension, must be taken 2.5 mg (1 tablet or capsule) once a day for at least three months. In general, therapy is long-term and can last for months or years. However, it must be remembered that if after 4 to 8 weeks of taking Indapamide, blood pressure does not normalize, then you should additionally start taking some other antihypertensive drug that is not a diuretic (for example, beta-blockers, ACE inhibitors, etc.).

Increasing the dosage of Indapamide to more than 2.5 mg per day is not recommended, since this will not lead to a significant increase in the hypotensive effect, but will cause a diuretic effect. Maximum permissible daily dosage Indapamide is currently considered 5 mg (2 tablets or capsules). Indapamide can be used either alone or in combination with other antihypertensive drugs (beta-blockers, ACE inhibitors). When using the drug as part of complex therapy, its dosage, as a rule, is not reduced, leaving it at 2.5 mg per day. When combining Indapamide with beta-blockers (for example, Metoprolol, Bisoprolol, Atenolol, Timolol, etc.), both drugs can be taken simultaneously.

If Indapamide must be combined with ACE inhibitors (for example, Captopril, Enalapril, Perindopril, etc.), then in this case it is necessary to proceed as follows: 3 - 4 days before the start of administration ACE inhibitor cancel Indapamide; then, after gaining a maintenance dosage of the ACE inhibitor, Indapamide is resumed and both drugs are taken. To eliminate edema in chronic heart failure, it is recommended to take Indapamide 5–7.5 mg (2–3 tablets or capsules) per day for 1–2 weeks.

Such courses of therapy are carried out periodically, as needed. Elderly people (over 65 years of age) take Indapamide in normal dosages. For this age category The drug is allowed if kidney function is normal or slightly reduced.

Side effects

• While taking Indapamide, it is possible to develop disorders of certain body systems: The cardiovascular system: orthostatic hypotension, arrhythmia, ECG changes (hypokalemia), palpitations.
• Central nervous system: nervousness, asthenia, headache, drowsiness, dizziness, insomnia, vertigo, depression; rarely - malaise, general weakness, increased fatigue, muscle spasms, irritability, tension, anxiety.
• Digestive system: abdominal pain, nausea, dry mouth, anorexia, vomiting, gastralgia, diarrhea, constipation, possible development of hepatic encephalopathy; rarely – pancreatitis.
• Urinary system: nocturia, frequent infections, polyuria.
• Respiratory system: sinusitis, pharyngitis, cough; rarely – rhinitis.
• Hematopoietic system: very rarely - leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia and bone marrow aplasia.
• Laboratory indicators: hypercalcemia, hyperuricemia, hypokalemia, hyperglycemia, hyponatremia, hypochloremia, increased plasma urea nitrogen, glycosuria, hypercreatininemia.
• Allergic reactions: hemorrhagic vasculitis, urticaria, rash, itching; Other: exacerbation of systemic lupus erythematosus.

Patient opinions

“I can recommend indamamide, from which these tablets help me get back on my feet, to normalize blood pressure, but the question is quite serious and complex, these are still not vitamins, but the treatment of a serious disease. So it’s better not to prescribe it to yourself, especially "There are nuances about which medicine to take Indapamide with, not a diuretic. But if the doctor prescribes it, then don’t hesitate and start treatment. The drug, of course, has side effects, but this fact is always individual."

“Indapamide stada belongs specifically to the group of diuretics and is indicated for arterial hypertension. I take one capsule a day, I try to drink it in the morning, I drink it for ten days. As a rule, this course helps me and the pressure usually does not bother me for a long time.”

"I've recently been taking indapamide for high blood pressure. One tablet after lunch and great, blood pressure is normal. Its diuretic effect is almost unnoticeable and does not interfere with life. No side effects have been observed so far either. The drug is quite inexpensive, even less than 100 rubles. Of course, choosing a medicine is very individual, but it worked for me."