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Indications and Dosage
Oral
Hypertension Adult: As conventional tab: 1.25-2.5 mg once daily. As sustained-release tab: 1.5 mg once daily. Oral Oedema Adult: For the treatment of salt and fluid retention associated with CHF: As conventional tab: Initially, 2.5 mg once daily; may increase the dose to 5 mg once daily after 1 week if necessary. Dosage and treatment recommendations may vary among individual products and between countries (refer to specific product guidelines).
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What are the brands available for Indapamide in Malaysia?
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Other Known Brands
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Renal Impairment
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Hepatic Impairment
Severe: Contraindicated.
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Administration
Indapamide May be taken with or without food.
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Contraindications
Hypersensitivity to indapamide or other sulfonamide-derived drugs. Anuria, hypokalaemia; hepatic encephalopathy. Severe hepatic impairment and severe renal failure (CrCl <30 mL/min).
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Special Precautions
Patient with prediabetes or diabetes mellitus, Addison's disease, long QT interval; history of gout, familial predisposition to gout; moderate or high cholesterol concentrations. Mild to moderate renal and hepatic impairment. Elderly. Pregnancy and lactation.
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Adverse Reactions
Significant: Electrolyte disturbances (e.g. hyponatraemia, hypokalaemia, hypomagnesaemia, hypercalcaemia, hypochloraemic alkalosis); acute angle-closure glaucoma and increased IOP with or without a noticeable acute myopic shift and/or choroidal effusions; gout, hyperuricaemia; new-onset or exacerbation of SLE; photosensitivity reactions.
Eye disorders: Visual impairment. Gastrointestinal disorders: Vomiting. Investigations: Increased blood glucose, elevated liver enzymes. Reproductive system and breast disorders: Erectile dysfunction. Skin and subcutaneous tissue disorders: Rash, purpura. Potentially Fatal: Torsades de pointes. |
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Monitoring Parameters
Monitor blood pressure, serum electrolytes, kidney function, uric acid; fluid intake and output. Assess for signs and symptoms of visual changes.
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Overdosage
Symptoms: Water or electrolyte imbalances (e.g. hyponatraemia, hypokalaemia); nausea, vomiting, hypotension, cramps, vertigo, drowsiness, confusion, polyuria, oliguria and anuria. Management: Employ gastric wash-out and/or give activated charcoal, then restore water or electrolyte balance.
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Drug Interactions
Increases plasma concentrations of lithium. Increased risk of torsades de pointes with class Ia antiarrhythmic drugs (e.g. quinidine, disopyramide), class III antiarrhythmic drugs (e.g. amiodarone, bretylium tosilate, sotalol, ibutilide), phenothiazines (e.g. chlorpromazine, thioridazine), benzamides (e.g. amisulpride, sulpiride), butyrophenones (e.g. droperidol, haloperidol), pimozide, bepridil, cisapride, moxifloxacin, methadone, astemizole and terfenadine. Concomitant use with NSAIDs (including COX-2 inhibitors) and high-dose salicylic acid may cause a decrease in antihypertensive effect. Increased risk of hypokalaemia with IV amphotericin B, glucocorticoids, mineralocorticoids, tetracosactide, diuretics and stimulant laxatives. Increased hypertensive effect with baclofen. May increase the risk of hypersensitivity reactions to allopurinol. Increased risk of lactic acidosis with metformin. Increased risk of orthostatic hypotension with TCAs and neuroleptics.
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Lab Interference
May interfere with parathyroid function tests and may reduce serum iodine (protein-bound) without signs of thyroid disturbance. May cause a false-negative aldosterone/renin ratio (ARR). May cause a positive reaction in doping tests.
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Action
Description:
Mechanism of Action: Indapamide, a non-thiazide sulfonamide with an indole ring, is a diuretic. It acts at the proximal segment of the distal tubule of the nephron and interferes with the transport of sodium ions across the renal tubular epithelium which results in enhanced sodium, chloride and water excretion. Pharmacokinetics: Absorption: Rapidly and completely absorbed from the gastrointestinal tract. Bioavailability: 93%. Time to peak plasma concentration: 2 hours. Distribution: Crosses the placenta. Volume of distribution: 25 L. Plasma protein binding: 71-79%. Metabolism: Extensively metabolised in the liver. Excretion: Via urine (approx 70%; 7% as unchanged drug); faeces (23%). Elimination half-life: Biphasic: 14 and 25 hours. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 3702, Indapamide. https://pubchem.ncbi.nlm.nih.gov/compound/Indapamide. Accessed Mar. 26, 2025. |
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Storage
Store between 20-25°C.
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MIMS Class
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ATC Classification
C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.
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References
Brayfield A, Cadart C (eds). Indapamide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/11/2024. Indapamide 2.5 mg Tablets (Special Concept Development [UK] Limited T/A RxFarma). MHRA. https://products.mhra.gov.uk. Accessed 11/11/2024. Indapamide Tablet, Film Coated (Actavis Pharma, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 11/11/2024. Indapamide. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 11/11/2024. Joint Formulary Committee. Indapamide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 11/11/2024. Natrilix SR 1.5 mg, Sustained-release Film-coated Tablets (Servier Malaysia Sdn Bhd). MIMS Malaysia. http://www.mims.com/malaysia. Accessed 11/11/2024. Viatris Ltd. DAPA-TABS 2.5 mg Tablets data sheet 07 July 2022. Medsafe. http://www.medsafe.govt.nz. Accessed 11/11/2024.
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