Indapamide is an affordable and effective drug for arterial hypertension. What helps the drug indapamide and instructions for its use

Many drugs with a diuretic effect are sold in pharmacy kiosks, but the most effective is Indapamide. Before you start using it, you must definitely read the annotation of the drug and find out what Indapamide is from, what are the indications for use and contraindications.

Diuretic Indapamide helps lower blood pressure

Indapamide belongs to the group of thiazide-like diuretics, which are recommended to be taken for a prolonged period of time.

Indapamide is available in tablet form, in a volume of 1.5 and 2.5 mg, as well as in the form of capsules for internal use. It is sold in a cardboard box on a blister of 10 pcs.

The composition of the tablets contains an active substance identical to the name - indapamide. Each dragee contains 2.5 mg. The tablets are covered with a special shell, which is not desirable to deform. As excipients, the tablets contain pregelatinized starch, colloidal silicon dioxide, and magnesium stearate.

pharmachologic effect

After the introduction of the drug into the body, the drug begins to affect the body after 30 minutes. The duration of a positive result is observed within 24 hours.

After the dragee enters the cavity of the digestive organs, the maximum concentration of the drug is fixed in the plasma only after 12 hours. Eating may somewhat delay the moment of absorption into the walls of the stomach, but will not significantly affect the result.

What does indapamide help with?

Indapamide lowers blood pressure by removing excess fluid from the body

Indapamide is a medication prescribed for patients who increase above the established norms (140 to 90 mm Hg). The drug is recommended for the treatment of people with chronic course.

The drug is designed to remove fluid that has stagnated in the body. Such a process is necessary when establishing pressure at high rates for a long period of time and if the patient is detected.

Indapamide is a diuretic that stimulates blood pressure to decrease by removing excess fluid from the body. At the same time, the mechanism of action of the drug is constructed in such a way that the active substance does not affect the increase in the frequency of trips to the restroom to remove urine.

When using Indapamide, a positive effect on the heart muscle is carried out, there is a significant decrease in the load on the main human organ. In addition to lowering blood pressure, arterioles are dilated.

Indapamide has a positive effect on blood vessels. During the period of drug use, a decrease in the peripheral resistance of blood capillaries is observed. The drug stimulates a decrease in hypertrophy in the heart muscle of the left ventricle.

The tool is not forbidden to use in patients with diabetes mellitus. This is due to the fact that the active substance has no effect on lipid and carbohydrate metabolism.

Contraindications

Indapamide should not be taken by children and women who are breastfeeding

Before you start taking the drug, it is recommended that you read the instructions enclosed inside the package with the drug.

If the patient has any contraindications, it is better not to use the medication as a therapeutic effect.

It is imperative to warn the attending doctor about the identified situation and ask to recommend an analogue for the original remedy.

It is forbidden to take Indapamide in the following situations:

• Childhood and adolescence to adulthood
• Individual intolerance to the active substance or other components of the drug
• Co-administration of medications that promote
• The period of bearing a child and the time of feeding a newborn with breast milk
• hypokalemia
• Lactose intolerance or deficiency
• Changes in kidney and liver function
• Pre-infarction condition in a patient
• Circulatory disorders in the brain
• Gout
• Anuria, in which there is no urine inside the bladder

The use of the drug during childbearing is highly contraindicated. Taking the drug can adversely affect the development of the baby, provoking a slowdown in the development of the child in the womb.

In addition, if the medication is prescribed during the period of breastfeeding, then it is necessary for a while to refuse to feed the child, transferring it to an artificial mixture.

If the patient, when recommended to use Indapamide, has cirrhosis of the liver, cardiovascular insufficiency, diagnosed at the chronic stage, as well as, then the medication should be taken strictly in accordance with the dosages. The latter should be prescribed by a doctor and control the process of drug administration and subsequent phenomena.

If side processes are detected, after the active substance enters the body, it is necessary not to take the next dose, but to seek additional advice from a doctor.

Medicine Indapamide: instructions for use

Indapamide should be taken at the same time

Only the attending physician can prescribe Indapamide for on the basis of the examination.

It is not worth self-medicating and making decisions on the possibility of taking this medication on your own, there may be various unforeseen circumstances.

The duration of administration, the frequency of use per day and the dosage are prescribed by the attending physician personally for each patient individually.

Typically, the standard input scheme involves the use of 1 tablet per day. It is advisable to carry out the process in the morning. Eating does not affect the absorption of the active substance.

In order for the drug to have a positive effect, it is recommended to adhere to the following rules:

1. It is recommended to initially decide how the medication will be taken - before or after breakfast. This is necessary in order to clearly know at what point it is necessary to enter the tablet. To obtain the maximum result from the administration of the drug, it is required to enter at the same time.
2. Violating the integrity of the dragee or capsule is prohibited. It is necessary to swallow the drug whole with large sips of boiled water.
3. The dosage can be increased or decreased only on the recommendation of the attending physician.
4. The daily norm for taking the drug is prescribed in the amount of 2.5 mg. If within 4 weeks there is no positive effect, then the doctor may advise the introduction of an additional medication that helps reduce pressure.

Side effects

As a side effect when using Indapamide, shortness of breath is possible.

If, after improper use, side effects are revealed, you should seek the advice of a doctor. In such situations, the following negative consequences for the patient may occur:

• Detection of allergies - redness of certain areas of the skin, itching, urticaria, acute burning sensation.
• Changes in the functioning of the heart muscle and blood vessels - an increased heart rate, during the performance, the indicators undergo changes, are detected,.
• Digestive disorders - loss of appetite, stomach pain, intestinal upset, the presence of nausea and vomiting, liver problems, the development of inflammation of the pancreas.
• Abnormal functioning of the upper respiratory tract - pharyngitis, sinusitis, rhinorrhea, cough, bronchospasm.
• Abnormal functioning of the nervous system - problems with sleep, the occurrence of insomnia, a constant feeling of fear, apathy, lethargy, loss of efficiency.

If a second hypertensive drug is prescribed, it should be checked that it does not belong, like Indapamide, to the group of diuretic drugs. Additionally, when conducting blood tests, a decrease in platelet counts, as well as leukocytes, is detected.

special instructions

Patients who constantly take glucosides to maintain the myocardium are advised to periodically take tests for blood creatinine and potassium levels.

Patients with diabetes mellitus also need to undergo additional examination. This is required to maintain the plasma level at the proper level.

In the first days of use, all patients should drink water. It is required in order not to provoke an imbalance of electrolytes in the plasma.

Do not expose the body to visual stress after using the drug. This is due to the fact that Indapamide can significantly affect the attention and concentration of a person in space.

drug interaction

Simultaneous use of Indapamide with a laxative may lead to hypokalemia.

Not every medication should be administered simultaneously with Indapamide. The following situations are distinguished, which can be provoked by the simultaneous administration of various drugs:

• When taking non-steroidal selective anti-inflammatory drugs, as well as salicyls in significant amounts, the resulting hypertensive effect can be changed.
• Simultaneous administration of preparations containing an increased level of lithium provokes an increase in the blood flow of this microelement. Therefore, the situation should be monitored by periodically undergoing tests.
• When using tetracosactides, as well as glucocorticosteroids, there is a decrease in the positive effect of taking Indapamide.
• Using a laxative along with a hypertensive drug can provoke the occurrence.
• Using ACE inhibitors increases the possibility of developing renal failure.
• Antidepressants of the tetracyclic type, on the contrary, increase the hypertensive effect when using Indapamide.
• Introducing drugs containing estrogen, there is a loss of the entire therapeutic effect.

In order not to provoke such phenomena, it is recommended to entrust the appointment of all medications only to the doctor who leads the whole disease. Incorrect medication can lead to disastrous consequences.

Analogues

Indap is an analogue of Indapamide

If a situation arises in which you have to look for substitutes for an analogue, then the doctor is recommended to use previously proven analogues.

In most cases, they contain an identical spectrum of action and lead to a similar hypertensive effect, which allows lowering blood pressure to normal levels.

There are the following substitutes for Indapamide:

• Leskoprid
• Indap
• Arifon
• Lorvas
• Arindap
• Frantel
• Indapamide Retard
• Acrylamide
• Oxodoline
• Hydrochlorothiazide
• Cyclomethiazide

Some drugs have the same spectrum of action and an identical active substance, while others are distinguished only by a similar effect. Dosage and frequency of administration should be prescribed by a doctor.

Watch a video about diuretics:

Thus, Indapamide is a drug that has a positive effect on the reduction. It must be taken for a long time, in some cases the doctor advises to adhere to a certain dosage until the end of life.

Gross formula

Pharmacological group of the substance Indapamide

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Indapamide

White or yellowish-white crystalline powder, soluble in aqueous solutions of strong alkalis. Molecular weight 365.84.

Pharmacology

Inhibits the reverse absorption of sodium ions in the cortical segment of the nephron loop, increases the urinary excretion of sodium, chlorine, calcium and magnesium ions. Reduces the sensitivity of the vascular wall to norepinephrine and angiotensin II; stimulates the synthesis of PGE 2 ; inhibits the current of calcium ions in the smooth muscle cells of the vascular wall and thus reduces OPPS. Reduces production of free and stable oxygen radicals.

Rapidly and completely absorbed when taken orally. T max - 2 hours after taking the usual dosage form (tablets, capsules), 12 hours - after taking prolonged-release tablets. In plasma, 71-79% binds to proteins. It also binds to the elastin of the smooth muscles of the vascular wall. It can be reversibly sorbed by peripheral blood erythrocytes, the blood / plasma ratio is approximately 6:1 at the time of reaching Cmax and decreases to 3.5:1 after 8 hours. Passes through histohematic barriers (including placental). Metabolized in the liver. Excretion is biphasic: T 1/2 from whole blood is about 14 hours, the final T 1/2 is 26 hours. 70% is excreted by the kidneys and 23% with feces. Indapamide is excreted unchanged (7%) and as metabolites.

It has a dose-dependent effect. At a dose of 2.5 mg, it has the maximum hypotensive effect with a slight increase in diuresis. After taking a single dose, the maximum hypotensive effect is observed after 24 hours. After repeated administration, the therapeutic effect is observed after 1-2 weeks, reaches a maximum by 8-12 weeks.

Effective for the treatment of edematous syndrome in chronic heart failure (unregistered indication).

Application of the substance Indapamide

Arterial hypertension.

Contraindications

Hypersensitivity, acute cerebrovascular accident, anuria or severe renal failure (diuretic effects decrease, azotemia may increase), severe liver failure (including hepatic encephalopathy), hypokalemia, age up to 18 years (safety and efficacy have not been determined).

Application restrictions

Diabetes mellitus in the stage of decompensation, impaired renal and / or liver function, hyponatremia and other disorders of water and electrolyte balance, hyperuricemia (especially accompanied by gout and urate nephrourolithiasis), hyperparathyroidism, ascites, coronary artery disease, prolongation of the interval QT on the ECG, simultaneous reception of drugs that lengthen the interval QT(astemizole, intravenous erythromycin, class IA antiarrhythmics - quinidine, disopyramide - and class III - amiodarone, bretylium tosylate).

Use during pregnancy and lactation

During pregnancy, it is possible if the expected benefit to the mother outweighs the potential harm to the fetus.

Side effects of the substance Indapamide

From the nervous system and sensory organs: headache, dizziness, weakness, fatigue, lethargy, lethargy, malaise, vertigo, muscle spasm, paresthesia, nervousness, tension, irritability, agitation, anxiety, insomnia, drowsiness, depression, conjunctivitis, visual impairment.

From the side of the cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, palpitations, arrhythmia, ECG changes (manifestation of hypokalemia), thrombocytopenia, leukopenia, agranulocytosis, bone marrow aplasia, hemolytic anemia.

From the respiratory system: rhinitis, cough, pharyngitis, sinusitis.

From the digestive tract: nausea, vomiting, anorexia, dry mouth, abdominal discomfort, gastralgia, constipation / diarrhea, hepatic encephalopathy (against the background of liver failure), pancreatitis.

From the genitourinary system: nocturia, polyuria, increased incidence of infections, decreased libido and/or potency.

Allergic reactions: itching, rash, urticaria, hemorrhagic vasculitis.

Others: flu-like syndrome, chest pain, back pain, sweating, weight loss, exacerbation of systemic lupus erythematosus, hypercalcemia, hyperuricemia, hypochloremia, hyponatremia, hyperglycemia, hypokalemia, increased plasma urea nitrogen, hypercreatinemia, glucosuria.

Interaction

The combined use of indapamide with astemizole, erythromycin (i.v.), pentamidine, sultopride, terfenadine, vincamine, class Ia (quinidine, disopyramide) and class III antiarrhythmic drugs (amiodarone, bretilium, sotalol) can weaken the hypotensive effect of indapamide and lead to the development of arrhythmia according to type "pirouette" due to the synergistic effect (lengthening) on ​​the duration of the interval QT.

NSAIDs, GCs, tetracosactide, adrenostimulants reduce the hypotensive effect, baclofen enhances.

Saluretics (loop, thiazide), cardiac glycosides, gluco- and mineralocorticoids, tetracosactide, laxatives, amphotericin B (iv) increase the risk of hypokalemia.

When taken simultaneously with cardiac glycosides, the likelihood of developing digitalis intoxication increases; with calcium preparations - hypercalcemia; with metformin - aggravation of lactic acidosis is possible.

The combination with potassium-sparing diuretics may be effective in some categories of patients, however, the possibility of developing hypo- or hyperkalemia is not completely excluded, especially in patients with diabetes mellitus and renal insufficiency.

ACE inhibitors increase the risk of arterial hypotension and / or acute renal failure (especially with existing renal artery stenosis).

Indapamide increases the risk of developing renal failure when using high doses of iodine-containing contrast agents with dehydration of the body. Before using iodine-containing contrast agents, patients need to restore fluid loss.

Tricyclic antidepressants and antipsychotics may enhance the antihypertensive effect of the drug and increase the risk of orthostatic hypotension.

With simultaneous use with cyclosporine, an increase in plasma creatinine levels is possible.

Reduces the effect of indirect anticoagulants (coumarin or indandione derivatives) due to an increase in the concentration of coagulation factors as a result of a decrease in circulating blood volume and an increase in their production by the liver (dose adjustment may be required).

It enhances the blockade of neuromuscular transmission, which develops under the influence of non-depolarizing muscle relaxants.

Overdose

Symptoms: nausea, vomiting, weakness, violation of water and electrolyte balance; in severe cases - a pronounced decrease in blood pressure, respiratory depression.

Treatment: gastric lavage, correction of water and electrolyte balance, symptomatic and supportive therapy. The specific antidote is unknown.

Routes of administration

inside.

Indapamide Substance Precautions

Against the background of taking indapamide, the concentration of K +, Na +, Mg 2+ in plasma should be systematically monitored (electrolyte disturbances may develop), pH, the concentration of glucose, uric acid and residual nitrogen. The most careful monitoring is indicated in patients with cirrhosis of the liver (especially with edema or ascites - the risk of developing metabolic alkalosis, which increases the manifestations of hepatic encephalopathy), ischemic heart disease, chronic heart failure, and also in the elderly. Patients with an extended interval are also at increased risk. QT on the ECG (congenital or developed against the background of any pathological process).

The first measurement of the concentration of K + in the blood should be carried out during the first week of treatment.

Hypercalcemia while taking indapamide may be due to previously undiagnosed hyperparathyroidism.

In patients with diabetes, it is extremely important to control the concentration of glucose in the blood, especially in the presence of hypokalemia.

Significant dehydration can lead to the development of acute renal failure (reduced glomerular filtration rate). Patients need to compensate for the loss of water and carefully monitor kidney function at the beginning of treatment.

Indapamide may give a positive result in a doping test.

Interactions with other active substances

Trade names

Indapamide has a mild blood pressure lowering effect, if you follow the rules for taking it, it rarely causes side effects. The drug belongs to diuretic drugs.

In the course of complex treatment of hypertension, the doctor must prescribe diuretics, since with the removal of fluid from the body, blood pressure (blood pressure) decreases faster. The pharmaceutical industry has created a lot. Most often, if there is swelling, the doctor prescribes Indapamide for pressure. However, the medicine has contraindications and features of use, so they need to coordinate the treatment with the doctor.

The drug belongs to the thiazide-like diuretics of prolonged action, has a mild lowering effect on the level of blood pressure. Indapamide is used for arterial hypertension, when the pressure begins to exceed 140/90 mm Hg. Art., and chronic heart failure, especially if the patient has swelling.

The drug is produced in the form of tablets and capsules of 1.5 and 2.5 mg. They are produced in Russia, Yugoslavia, Canada, Macedonia, Israel, Ukraine, China and Germany. The active ingredient of the drug is Indapamide.

Indapamide is a calcium-sparing drug, which is good for hypertensive patients with osteoporosis. It can be used by people who are on hemodialysis, diabetics, with hyperlipidemia. In difficult cases, it is required to control the level of glucose, potassium, and other indicators recommended by the doctor.

indapamide for hypertension

Capsules or tablets against pressure for hypertension begin to act 30 minutes after consumption. The hypotonic effect lasts 23-24 hours.

The decrease in blood pressure is due to hypotensive, diuretic and vasodilatory effects - the pressure level begins to fall due to the influence of the active substance, the removal of excess fluid from the body and the expansion of blood vessels throughout the body.

Indapamide also has a cardioprotective property - it protects myocardial cells. After treatment, the condition of the left heart ventricle noticeably improves in hypertensive patients. The drug also gently lowers resistance in peripheral vessels and arterioles. Since it moderately increases the rate of urine formation, with which excess fluid is excreted, it is appropriate to drink the medicine if there is an edematous syndrome.

How to take Indapamide for hypertension

At high pressure (more than 140/100 mm Hg), the dosage and duration of therapy are selected by the doctor on an individual basis. Usually, Indapamide should be taken once a day: 1 tablet in the morning. It is allowed to drink on an empty stomach or after a meal - food does not affect the effect of the drug.

Mandatory rules for admission:

• consumed at a clearly set time to maintain an interval of 24 hours;
• tablets or capsules are swallowed whole;
• washed down with non-carbonated water in a volume of at least 150 ml;
• only on the recommendation of a doctor, change the dosage or stop the course of treatment.

The prolonged effect of Indapamide is associated with the gradual dissolution of the drug. If tablets or capsules are crushed before taking, a large amount of the active substance will immediately enter the tissues, which will cause the pressure to drop sharply. A sudden drop in blood pressure disrupts the functioning of all body systems, which is fraught with dangerous consequences.

It is allowed to take the following drugs with Indapamide:

• and other B-blockers;
• Lorista (counteracts angiotensin receptors);
• (with heart failure);
• Lisinopril (ACE inhibitor);
• other medicines prescribed by a doctor.

Naturally, only a doctor should choose any combination of drugs, since with an independent combination, the compatibility of active substances is often not taken into account. This can result in treatment failure or drug poisoning, which in each case is life-threatening.

Interaction with other drugs

A person is often forced to take several drugs belonging to different drug groups. Their active substances can reduce or enhance the effectiveness of Indapamide. It is worth dwelling in more detail on how such “interactions” manifest themselves.

The hypotensive effect of the drug increases when used together with antidepressants, antipsychotics - this can cause a sharp drop in pressure.

When combined with Erythromycin, a person develops tachycardia, in the complex with Cyclosporine, the level of creatinine increases. Simultaneous use together with drugs, which include iodine, can provoke dehydration of the body. Potassium loss is promoted by laxatives, saluretics and cardiac glycosides.

It should be borne in mind that corticosteroids and NSAIDs (non-steroidal anti-inflammatory drugs) reduce the hypotensive effect of Indapamide - this reduces the effectiveness of the drug. To avoid such interaction with other medicines, the doctor needs to provide a list of all the medicines and herbal medicines used.

Indapamide contraindications

Hypertensive patients with concomitant diseases of the urinary, endocrine, digestive and cardiovascular systems should additionally consult a doctor. In some pathologies, this medicine has features of use or is completely contraindicated.

Indapamide should not be used by children under 18 years of age, pregnant women. If the drug is prescribed to a woman during lactation, then during treatment the baby is transferred to artificial nutrition.

The use of Indapamide is contraindicated if the following conditions are diagnosed:

• individual intolerance;
• kidney failure;
• galactosemia, lactose intolerance;
• hepatic encephalopathy;
• circulatory disorders in the brain;
• hypokalemia;
• gout;
• anuria.

Before buying a drug, it is recommended to study the manufacturer's official instructions (included in the package of the medication), since it displays complete information about the composition, features of use, contraindications, and other data.

Side effects of indapamide

With proper use of the drug in 97% of cases, the drug does not have a negative effect on the body. In people belonging to the remaining 3%, Indapamide causes side effects. The most common effect is a violation of the water and electrolyte balance: a decrease in the level of potassium and / or sodium. This leads to dehydration (lack of fluid) in the body. Very rarely, the drug can cause arrhythmia, hemolytic anemia, sinusitis and pharyngitis.

Other side effects of Indapamide:

• allergies (urticaria, anaphylaxis, angioedema, dermatosis, rash);
• Lyell's syndrome;
• dryness of the oral mucosa;
• Stevens-Johnson syndrome;
• cough;
• weakness;
• dizziness;
• nausea, vomiting;
• muscle pain;
• migraine;
• nervousness;
• liver dysfunction;
• pancreatitis;
• constipation;
• orthostatic hypotension.

Sometimes Indapamide changes the composition of the blood and urine. The analyzes can detect a deficiency of potassium, sodium, an increased amount of calcium, glucose, creatinine and urea. Less commonly, thrombocytopenia, leukopenia, anemia, agranulocytosis occur.

What can replace the drug

Instead of Indapamide, it is allowed to use Indap. This is a medicine with the same composition, but produced by a different manufacturer and may have a different dosage of the active substance. In case of a difference, the attending physician should adjust the drug intake.

The doctor will also help you choose analogues with a similar active substance or action. With an individual consultation, the doctor will tell you which medicine is better to use: Indapamide or Hypothiazid, Arifon Retard, Veroshpiron, Hydrochlorothiazide, Diuver, Acripamide, Ionic, Retapres. Perhaps the appointment of other diuretics aimed at lowering blood pressure.

Conclusion

The drug Indapamide gently reduces pressure throughout the day. With its regular and proper use, blood pressure decreases within 7 days from the start of the intake. But it is impossible to interrupt therapy at this stage, since the treatment reaches its maximum result in 2.5-3 months. For better effectiveness of the drug, you also need to follow medical recommendations: follow a diet for hypertension, adjust the duration of rest, and other prescriptions.

Many of us, having crossed the forty-year milestone, and some of us before reaching it, will learn what high blood pressure is from our own experience. The modern pharmacological industry is replete with all kinds of drugs that help fight this disease. Nobody disputes this fact. It is much more important to find out the cause that led to arterial hypertension and, if possible, eliminate it, but this cannot always be done quickly. In such a situation, the doctor selects an individually antihypertensive drug. One of the drugs that successfully helps to cope with high blood pressure is Indapamide (INDAP).

Let's take a closer look at the drug Indapamide - description, instructions, price, contraindications of the drug.

Indapamide - instructions for use

Indapamide is a drug that is used to treat hypertension due to its diuretic action. This effect is achieved due to its wagging on the kidneys and vascular tone.

"Indapamide" changes the permeability of cell membranes for calcium and reduces the contractility of the walls of blood vessels. As a result, small arteries dilate, precardiac workload decreases, and blood pressure decreases.

At the level of the kidneys, Indapamide prevents the reabsorption of sodium into the body and does not greatly affect the excretion of potassium, magnesium, and chlorine in the urine. When taking therapeutic doses of the drug, a hypotensive effect is noted without a significant increase in the amount of urine excreted per day.

Description of the drug Indapamide says that it does not change the metabolism of lipids, carbohydrates, including in patients with diabetes. Long-term use of the drug reduces left ventricular hypertrophy. Indapamide can be used even by patients on chronic hemodialysis.

After indapamide is taken orally, it is rapidly absorbed from the gastrointestinal tract. If you drink the drug with food, then the rate of absorption decreases, but does not affect the amount of the drug that has entered the body. A dosage form of Indapamide with prolonged action has been created, which allows the substance to be released evenly over 24 hours. This made it possible to prescribe the drug once a day - in the morning. The maximum concentration of Indapamide in the blood is observed 12 hours after its administration.

Indications for use and doses

The instructions say that the drug is prescribed for the treatment of arterial hypertension. It is taken orally in the morning before meals, one tablet or capsule (1.25 and 2.5 mg) without chewing, with a small amount of water. Indapamide can be prescribed alone or in combination with other antihypertensive drugs. It is not recommended to increase the dose of the drug, its ability to lower blood pressure does not increase from this, and the diuretic effect increases. Has Indapamide contraindications.

Contraindications

Severe renal dysfunction: renal insufficiency, not corrected by hemodialysis, lack of urine (anuria);
abnormal liver function, including with brain damage (hepatic encephalopathy);
allergy to Indapamide and its components;
children under 18;
pregnancy and breastfeeding;
not long ago acute cerebrovascular accident;
in combination with drugs that increase the Q-T interval on the ECG (cisapride);
low levels of potassium in the blood;

Side effects

They rarely occur, but they are listed in the instructions:

Nervous system: fatigue, headaches, vertigo (feeling that something or the patient himself is in constant motion), muscle pain, weakness;
heart and blood vessels: lowering blood pressure, cardiac arrhythmias;
blood: anemia, decreased platelet count;
a decrease in the blood of microelements below the norm and entailing pathological conditions: potassium, sodium, calcium, chlorine;
an increase in the content of uric acid in the body;
digestive system: nausea, dry mouth, constipation, impaired liver function;
allergic reactions: allergic rash, urticaria;
exacerbation of systemic lupus erythematosus;
respiratory system: cough, pharyngitis, sinusitis, frontal sinusitis;

Interaction of Indapamide with other drugs

The drug Indapamide and lithium preparations are not recommended to be used together, it is possible to increase the toxic effect of lithium on the body.
The hypotensive effect of Indapamide can be reduced by its combined use with the following drugs: adrenostimulants, glucocorticoids (prednisolone) and non-steroidal anti-inflammatory drugs.
Taking certain drugs together with Indapamide can reduce the effectiveness of the latter, as well as cause arrhythmia. These are erthromycin, pentamidine, vincamine, sultopyrpd, tarfedin, astemizole, antiarrhythmic drugs (quinidine, disopyramide, amidoran, sotalol, bretilium).
The risk of a decrease in potassium in the blood is increased if Indapamide is combined with diuretics, cardiac glycosides, laxatives, glucocorticoids, amphotericin B.
Antidepressants enhance the ability of Indapamide to lower blood pressure.

The price of Indapamide depends on the manufacturer and weight of the tablet and ranges from 13 to 90 rubles for 20 tablets from 1.5 to 2.5 mg.

Attention!

This instruction in the article is given in free form, before using Indapamide, be sure to consult with your doctor.

Indapamide-Retard is a long-acting thiazide-like diuretic available in the form of film-coated tablets and capsules. The drug should be used 1 time per day, while for 24 hours there is a hypotensive effect. Indapamide-Retard does not affect the metabolic processes in the body and, as a rule, is well tolerated by patients. It is important to remember that there are a number of contraindications to the use of this drug. Before use, read the instructions and consult a doctor.

The effect of the drug on the body

The active substance of the drug has a hypotensive prolonged effect on the patient's body. Tablets are able to block the reabsorption of chloride, hydrogen, sodium and potassium ions in the cortical segment of the distal tubule of the nephron and in the proximal tubules. The active substance of Indapamide is a sulfonylurea derivative, its structure resembles a diuretic. It is often used as part of complex therapy for arterial hypertension.

The drug gently acts on the body, gradually reducing pressure, while slightly increasing the number of urination. The drug has a positive effect on blood vessels. The active substance changes the permeability of membranes for minerals, thereby reducing the contractility of the elements of the vascular wall.

Do not change the quantitative content of lipids in blood plasma. The drug reduces the sensitivity of the vascular walls to angiotensin I and norepinephrine, increases the rate of prostaglandin synthesis. With prolonged use, it reduces the production of stable and free acid radicals. The hypotensive effect is observed after a week of daily use.

The main actions of Indapamide-Retard:

• hypotensive;
• vasodilating;
• diuretic.

The intensity of the hypotensive action depends on its ability to increase arterial compliance, reduce the total peripheral resistance of blood vessels and arterioles. The maximum effect lasts for a day after taking Indapamide at the recommended dosage of 2.5 mg. If the dosage is exceeded, the hypotensive effect does not increase, but this leads to an increase in urination and an increase in side effects.

The drug can be used in a course for 3 months, because it does not violate lipid and carbon metabolism. Indapamide is allowed to be prescribed to patients with one kidney and to patients with acute renal failure who are on hemodialysis. The drug can also be used:

1. Patients with diabetes.
2. People with elevated plasma lipid levels.
3. Patients with chronic renal failure.

The undoubted advantage of this drug are: low price, high efficiency, good tolerance.

The composition of the medicinal product

The active substance of the drug is indapamide hydrochloride. Also, the composition of the drug includes other excipients:

• lactose monohydrate;
• magnesium stearate;
• sodium lauryl sulfate;
• macrogol;
• titanium dioxide;
• food talc;
• crospovidone.

Taking the drug in safe doses helps lower blood pressure.

Distribution in the body

The drug after administration is rapidly and completely absorbed from the gastrointestinal tract. There is a high bioavailability (more than 93%). Eating significantly slows down adsorption, but ultimately does not affect the absorption of the substance. The maximum concentration of substances in the blood plasma is observed 1-2 hours after taking the drug; in the retard form, the maximum is reached after 12 hours. At the same time, 75% of indapamide and 25% of its metabolites are in plasma.

The active substance comes into contact with plasma proteins, can be sorbed by erythrocytes, and also comes into contact with the elastins of the vascular wall. Overcomes histohematic barriers, penetrates into breast milk. The drug is excreted mainly with urine (70%) and feces (no more than 22%). The half-life of the drug is about 18 hours. Metabolism takes place in the liver.

If you use the medicine in a course, there is an accumulation of its active substances in the body. Can be used to treat patients with renal insufficiency. However, in patients with hepatic insufficiency, long-term use of a diuretic may develop encephalopathy.

When and how is it applied

This drug is used for hypotension if:

1. For elderly patients.
2. With isolated hypotension (when only blood pressure is elevated).
3. Essential arterial hypertension.
4. In patients with heart failure.

Indapamide-Retard is often prescribed in advanced cases of hypertension, as part of complex therapy. The drug has a beneficial effect on the work of the cardiovascular system, prevents the development of heart attack and stroke.

The medicine should be taken every morning half an hour before meals. It is recommended to take the tablet with a sufficient amount of water.

Contraindications and side effects

Any drug has contraindications for use, which should be read before taking the medicine, otherwise it can lead to disastrous consequences. The most common side effects should be considered:

From the side of the central nervous system:

• nervousness, irritability;
• dizziness;
• headache, migraine;
• drowsiness, insomnia (depending on the individual characteristics of the organism);
• tension;
• muscle spasm;
• palpitations, tachycardia.

From the digestive system:

• nausea, vomiting;
• diarrhea, constipation;
• stomach ache.

With prolonged use, despite the appearance of side effects, the development of pancreatitis is possible. In some cases, allergic reactions are possible, for example, urticaria. Side effects when taking Indapamide occur quite rarely, but at their first manifestations, you should consult a doctor to determine the causes and replace the drug.

• pregnant and lactating mothers;
• with liver failure;
• patients with anuria;
• patients with low concentrations of potassium and magnesium in the blood;
• with individual intolerance or hypersensitivity to individual components of the drug.

The drug is not prescribed to patients under 18 years of age. Very carefully, you can use the drug for violations of the water and electrolyte balance, at the decompensated stage of diabetes mellitus. When taking cardiac glycosides and laxatives, it is necessary to regularly monitor the concentration of potassium ions and the level of creatinine.

Patients with diabetes need to regularly monitor the level of glucose in the blood, especially with hypokalemia. Frequent urination in some cases can lead to the formation of acute renal failure. In order to prevent this, it is necessary to compensate for the loss of fluid in the body. If it is necessary to undergo a long course of treatment with this drug, kidney function should be monitored.

Analogues

Diuretics are popular in the treatment of hypertension. Their action is to increase urination, reduce vascular tension, thereby reducing the volume of circulating blood. There are many drugs with the same active ingredient. They differ among themselves by manufacturing companies, price and, in some cases, excipients. It is necessary to list the main drugs, the active substance of which is indapamide:

1. Indap.
2. Acrypamide.
3. Arindap.
4. Ravel.

To a greater extent, they differ from each other only in price. Of course, you should not replace the prescribed drug with its analogues on the advice of friends or by reading information on the Internet. Before use, a doctor's consultation is necessary.