What helps the drug indapamide and instructions for its use. At what pressure should I take Indapamide

Arterial hypertension is a formidable disease that shortens the life of many people. Modern medicine offers many drugs to combat this disease. The main task of these drugs is to lower blood pressure in humans and prevent sudden pressure surges in humans that cause strokes and heart attacks.

Among the antihypertensive drugs is Indapamide, an effective drug with a wide spectrum of action and few negative effects, while the price of Indapamide is relatively low.

Indapamide instructions for use

In pharmacology, this medicine is referred to as diuretics, chemicals that enhance the process of urine formation and removal of excess salts with it from the body.

Action of Indapamide

This medicine changes the balance of Na and Cl in the body, from excess makes it negative. In addition to Na and Cl ions, it removes K and Mg ions somewhat less. The excretion of ions of these salts is accompanied by increased excretion of urine, which leads to a decrease in blood pressure.

This drug increases the elasticity of large arteries, reduces the resistance of the vascular system to the ejected blood flow by the human heart. It also reduces the rate of hypertension.

The maximum effect occurs after 6-7 days of administration by establishing an individual dose of the drug for each patient.

Exceeding the dose of the drug will not improve the patient's condition, but, on the contrary, increases the side effects.

Pharmacokinetics

When ingested in the form of tablets or capsules, the drug is absorbed in the gastrointestinal tract (GIT) within 2 minutes, while the bioavailability of the drug reaches 93%, 7% of the drug is removed unchanged with feces. When taking the drug during meals, bioavailability does not change, but the duration of absorption in the gastrointestinal tract increases.

Biotransformed drug in the form of inactive metabolites is removed with urine (77%) and faeces (23%).

Indapamide indications for use or what Indapamide is prescribed for

The drug is aimed at the treatment of arterial hypertension. And in complex treatment it is used to relieve edema that occurs in chronic heart failure.

Indapamide: release forms and dosage

The drug is sold in standard tablets, tablets with controlled release of the main substance and tablets of prolonged action.

Standard white hemispherical film-coated tablets. Each contains 2.5 mg of the active substance. The composition also includes excipients.

Controlled release and extended release tablets contain 1.5 mg of indapamide and excipients.

Tablets are prescribed to be taken in the morning every day, without chewing, swallowing it, drinking water.

Indapamide: side effects

With prolonged treatment with the drug, side effects may appear in the form of effects on:


Contraindications to the use of the drug


Indapamide analogs

An analogue of Indapamide is Indapamide Retard, produced in the form of prolonged-release tablets. This analog increases the duration of the drug when its dose is reduced from 2.5 mg to 1.5 mg. This is exactly the answer to the common question, which is better Indapamide or Indapamide Retard. Therefore, the price of Indapamide Retard is higher than that of Indapamide.

Other analogues of indapamide are mostly associated with the name of the drug manufacturer. For example, Indapamid-Teva is a manufacturer of Teva Israel, Indapamid MV Shtada is a manufacturer of Stada Arzneimittel Germany. This list also includes Arifon Retard, produced in France, the period of prolonged action of which remains 24 hours.

In addition to the above indapamide preparations, there are analogues under other names.

In the pharmacy network there is "Perindopril plus Indapamide", which is not a complete analogue of Indapamide, but a combination of these two drugs, which helps prevent the development of unwanted side effects (for example, increased diuresis when taking Indapamide).

Indapamide (2.5 mg), Indapamide retard and MB (1.5 mg) - indications and instructions for use (tablets, capsules), analogues, reviews and price of the drug. Reception in combination with perindopril and enalapril

Thanks

Indapamide represents diuretic group of thiazides, which has a hypotensive, vasodilating and diuretic (diuretic) effect. Indapamide reduces the force of contractions of the smooth muscles of the arteries, reduces the total peripheral vascular resistance, and also contributes to the involution of left ventricular hypertrophy of the heart. With a single dose for a long time lowers blood pressure and is used in the treatment of hypertension and chronic heart failure.

Varieties, names, composition and forms of release

Currently, various pharmaceutical companies produce the following varieties of Indapamide:
  • Indapamide;
  • Indapamide MB;
  • Indapamide MV Stada;
  • Indapamide Stada;
  • Indapamide retard;
  • Indapamide retard-OBL;
  • Indapamide retard-Teva;
  • Indapamide Sandoz;
  • Indapamide-OBL;
  • Indapamide-Verte;
  • Indapamid-Teva;
  • Indapamide Polpharma.
These varieties differ from each other almost only in names, since they all contain the same active substance in the same dosage, but are produced by different pharmaceutical companies.

The fact is that according to international standards, each pharmaceutical company must produce a drug under some original name. And since in the past Indapamide was produced in the USSR under one name, the pharmaceutical factories that became private enterprises simply added a word or abbreviation to it, meaning their modern name, thus obtaining some kind of unique name that differs from all others. Thanks to this, the main name has remained the same and is well recognizable by patients. Foreign pharmaceutical companies followed the same path, naming their drugs according to the principle "Indapamide + company name abbreviation" in order to be recognizable in the market of the CIS countries.

Thus, varieties of Indapamide can be conditionally considered the same drug, produced by various pharmaceutical companies. Of course, varieties of Indapamide may differ from each other in quality, which depends on which laboratory the active substance is purchased from. For example, the Teva and Sandoz corporations purchase active substances from Italian laboratories, while Russian manufacturers purchase from Chinese ones. Therefore, the quality of Teva and Sandoz preparations will be higher compared to domestic analogues, for the production of which raw materials of lower quality are used.

Despite these differences, all varieties of Indapamide have the same properties, indications and rules for use. Therefore, in the future text of the article, we will consider them together and use one name - Indapamide - to refer to all varieties of the drug.

Different varieties of Indapamide are currently available in three dosage forms:
1. Capsules for oral administration;
2. Tablets;
3. Prolonged action tablets.

Long-acting tablets usually have the additional word "retard" or the abbreviation "MB" in the name, which allows you to immediately distinguish them.

As active component Indapamide contains the substance of the same name indapamide in various dosages. Long-acting tablets contain 1.5 mg of indapamide, and regular-acting tablets and capsules contain 2.5 mg each.

Compound auxiliary components even the same dosage form can be different, since each pharmaceutical plant has the right to use its own manufacturing technology and formulation. Therefore, to clarify the auxiliary components of each specific drug, it is necessary to study the instructions given on the attached leaflet.

What helps Indapamide?

Indapamide belongs to the class of thiazide diuretics and has the following pharmacological effects:
  • Reduces blood pressure (hypotensive effect);
  • Dilates blood vessels (is vasodilator);
  • Reduces total peripheral vascular resistance;
  • Reduces resistance in arterioles;
  • Helps to reduce the degree of hypertrophy of the left ventricle of the heart;
  • It has a moderately diuretic (diuretic) effect.
Hypotensive action Indapamide develops when taken in dosages (1.5 - 2.5 mg per day), which 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 action. It must be remembered that a decrease in blood pressure is achieved only a week after taking Indapamide, and a lasting effect develops after 3 months of use.

Indapamide has no effect on fat and carbohydrate metabolism, therefore it can be used by people suffering from diabetes, high cholesterol, etc.

In addition, indapamide is effective in lowering blood pressure in people with one kidney or those on hemodialysis.

The high safety and good tolerability of Indapamide make it the drug of choice for the treatment of hypertension in people with diabetes mellitus, chronic renal failure or hyperlipidemia (high cholesterol, triglycerides, low-density lipoproteins in the blood).

Indications for use

All varieties of Indapamide are indicated for use in the treatment of the following diseases:
  • Arterial hypertension ;
  • Elimination of edematous syndrome in chronic heart failure (this indication is not registered in all countries).

Instructions for use

How to take Indapamide capsules and tablets

Tablets of the usual duration of action and capsules contain 2.5 mg of the active substance and are characterized by the same administration rules.

So, tablets and capsules must be taken orally, swallowed whole, not chewed, chewed or crushed in other ways, but washed down with a sufficient amount of non-carbonated water (at least half a glass). Tablets and capsules can be taken regardless of the meal, that is, at any convenient time.

It is optimal to take tablets or capsules in the morning, at about the same time every day, to ensure that a certain concentration of the drug in the blood is constantly maintained.

With arterial hypertension, Indapamide should be taken at 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.).

It is not recommended to increase the dosage of Indapamide more than 2.5 mg per day, since this will not lead to a pronounced increase in the hypotensive effect, but will cause a diuretic effect.

The maximum allowable daily dosage of Indapamide is currently considered to be 5 mg (2 tablets or capsules).

Indapamide can be used alone or in combination with other antihypertensive agents (beta-blockers, ACE inhibitors). When using the drug as part of complex therapy, its dosage, as a rule, is not reduced, leaving it equal to 2.5 mg per day. When combining Indapamide with beta-blockers (for example, Metoprolol, Bisoprolol, Atenolol, Timolol, etc.), both drugs can be started at the same time. If Indapamide needs to 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 taking the ACE inhibitor, Indapamide is canceled; then, after a set of maintenance doses of an ACE inhibitor, Indapamide is resumed and both drugs are already taken.

If the level of potassium in the blood is below 3.4 mmol / l, then taking Indapamide should be discontinued or the dosage should be halved.

In addition, against the background of the use of the drug, an increase in the concentration of urea, creatinine, uric acid and calcium in the blood is often observed. Gout needs to be treated, and urea, creatinine, and calcium levels are easy to monitor. If there is no progressive increase in the concentration of these substances, then this side effect is not dangerous and will pass on its own after completion of therapy.

If Indapamide is taken by a person suffering from diabetes, then during the entire period of therapy it is necessary to control the level of blood glucose at least once every two weeks.

Indapamide can exacerbate gout and systemic lupus erythematosus.

Athletes should be aware that the active ingredient indapamide can cause a false positive result in a doping test.

Since Indapamide can cause photosensitivity, against the background of its use, it is necessary to protect the skin from exposure to sunlight and artificial ultraviolet radiation. If photosensitivity reactions appear, then you should immediately stop taking Indapamide.

Severe dehydration while taking Indapamide can lead to acute renal failure. Therefore, during the entire period of taking the drug, you should observe the drinking regimen and replenish fluid losses.

Use during pregnancy and breastfeeding

It is recommended to stop taking Indapamide during pregnancy, since the drug can provoke fetoplacental ischemia with a slowdown in the growth and development of the fetus. Currently, in the CIS countries during pregnancy, Indapamide is allowed to be used only for health reasons.

ACE inhibitors (Captopril, Perindopril, etc.) increase the hypotensive effect of Indapamide and cause a high risk of renal failure when used in combination. Therefore, it is recommended to cancel Indapamide 3 to 4 days before taking ACE inhibitors, and start taking it again only when the maintenance dosage of the ACE inhibitor is reached.

The following drugs increase the risk of developing hypokalemia (low level of potassium in the blood) while taking the following drugs with Indapamide:

  • Amphotericin B;
  • Glucocorticoids (Dexamethasone, Betamethasone, Prednisolone, etc.);
  • Tetracosactide;
  • Laxatives that stimulate intestinal motility.
Indapamide enhances the toxic effects of cardiac glycosides (Digoxin, Celanide, etc.), therefore, against the background of the use of this combination of drugs, it is necessary to control the level of potassium in the blood, regularly do an ECG and, if necessary, adjust the dosage.

Metformin increases the risk of acidosis and renal failure when taken with Indapamide. Therefore, Metformin can be added to Indapamide only if the plasma creatinine concentration is not higher than 135 µmol/l in men and 110 µmol/l in women.

Cyclosporine and Tacrolimus lead to an increase in the level of creatinine in the blood.

Glucocorticoid hormones (Prednisolone, Betamethasone, etc.), Tetracosactide, drugs of the NSAID group (Aspirin, Paracetamol, Ibuprofen, Nimesulide, etc.), adrenostimulants, estrogens reduce the effect of Indapamide on lowering blood pressure.

Indapamide reduces the effect of indirect anticoagulants (for example, Warfarin, Coumarin, etc.), therefore, with the simultaneous use of these drugs, their dosages should be adjusted.

When indapamide is taken by patients with diabetes mellitus, it is necessary to regularly monitor the level of glucose in the blood. In some cases, it may be necessary to increase the dosage of insulin or other hypoglycemic drugs (Glibenclamide, Gliclazide, etc.).

The use of Indapamide with potassium-sparing diuretics (Amiloride, Triamterene, etc.) can lead to hyperkalemia or hypokalemia. Therefore, when taking this combination of drugs, it is necessary to control the level of potassium in the blood and the ECG.

Indapamide with calcium salts (calcium glycerophosphate, calcium gluconate, etc.) can provoke hypercalcemia (increased levels of calcium in the blood).

Indapamide side effects

Indapamide can provoke the following side effects from various organs and systems:

1. From the side of the central nervous system:

  • Lethargy;
  • tension;
  • Sleep disturbance (drowsiness, insomnia);
  • Increased fatigue;
  • Increased physical activity;
  • Dizziness;
  • Vertigo;
  • Paresthesia (numbness, coldness and a feeling of "goosebumps" in the limbs);
  • lethargy;
  • Malaise;
2. From the blood system:
  • Thrombocytopenia (the number of platelets in the blood is below normal);
  • Leukopenia (the number of white blood cells in the blood is below normal);
  • Agranulocytosis (lack of blood

There are many drugs available for the treatment of hypertension. But which one is really effective? If you bought "Indapamide", the instructions for use must be strictly observed. At what pressure is the drug recommended? At elevated. The drug has a mild effect and is available in tablet form. The main active ingredient indapamide is contained in the preparation in two dosages: 1.5 and 2.5 mg.

Operating principle

The drug belongs to the group of thiazide diuretics. It lowers blood pressure (BP), eliminates swelling. The therapeutic effect is based on the ability to remove chloride ions, excess sodium, magnesium and potassium from the body through the urinary system. Calcium channels begin to function better, the elasticity of arterial and venous walls increases, they resist pressure less.

"Indapamide": pills for pressure

After taking the pill, the maximum therapeutic effect occurs in a day. A stable improvement in pressure indicators is observed after 14 days of regular intake. Absorption of active components occurs almost immediately after entering the gastrointestinal tract, then they spread with the bloodstream. How quickly the drug is absorbed depends to a small extent on food intake. Excreted by the kidneys with urine.

Read also:

Is it possible to fly with hypertension?

"Indapamide": from what pressure?

The drug is indicated for arterial hypertension along with other medicines or as the main element of monotherapy.

Tablets "Indapamide" belong to the group of diuretics and drugs for hypertension

"Indapamide" from pressure: how to take?

It is advisable to take the medicine before meals without chewing, drinking plenty of fluids. Best taken in the morning. Usually prescribed 2.5 mg of the active ingredient per day. If a positive therapeutic effect is not observed within 1–2 months, antihypertensive drugs with other pharmacological effects are included in the treatment regimen.

An increase in the dosage of the drug does not affect the effectiveness of pressure reduction, but only enhances the diuretic effect. It is better to check with the doctor in more detail how to take "Indapamide" at high pressure. To achieve a stable therapeutic effect, the medicine must be taken daily at the same time.

special instructions

To achieve a therapeutic result without negative consequences, you must adhere to the recommendations:

  • For elderly patients, the medicine is prescribed provided that there is no pathological condition of the kidneys of a chronic nature. During the entire course of therapy, the level of creatine and potassium ions in the blood should be monitored.

The diuretic drug "Indapamide" is able to effectively reduce blood pressure

  • In the 1st trimester of pregnancy, the drug is not prescribed because of the threat to the development of the fetus. In the 2nd and 3rd trimesters, the drug is prescribed if the benefit to the mother outweighs the possible risk to the fetus.
  • The active ingredients pass into the mother's breast milk, so the drug is contraindicated in lactation.
  • Clinical studies on patients under 18 years of age have not been conducted, so the drug is not prescribed for this category of patients.
  • At the beginning of treatment, dizziness may occur. During this period, it is undesirable to drive a vehicle or perform work that requires increased concentration.
  • The drug is incompatible with alcohol due to the high likelihood of developing negative consequences - a stroke, an acute form of heart failure.

The drug effectively lowers blood pressure

Side effects

The drug has a diuretic effect, so it can provoke a number of negative consequences:

  • hives;
  • angioedema;
  • dizziness;
  • feeling of weakness;
  • headache;
  • excessive nervousness;
  • nausea;
  • constipation;
  • violation of the functioning of the liver;
  • cardiopalmus;
  • dry cough;
  • anemia;
  • hypokalemia.

Read also:

Nise raises blood pressure or lowers it? Complete instructions for use

If one of the symptoms appears, the drug should be replaced with an analogue.

With prolonged use without interruption, "Indapamide" begins to negatively affect the patient

Contraindications

"Indapamide" under pressure is contraindicated in:

  1. Anuria.
  2. chronic arrhythmias.
  3. Component intolerance.
  4. Pregnancy.
  5. Kidney dysfunction.
  6. lactation.
  7. diabetes mellitus.

A more detailed list of contraindications is contained in the instructions. "Indapamide" at low pressure is not prescribed.

Overdose

If the treatment regimen is not followed, overdose symptoms appear:

  • dry mouth;
  • thirst;
  • nausea;
  • weakness;
  • vomit.

An overdose of the drug can cause weakness in the body, drowsiness and disturbances in the digestive tract.

Drink plenty of water immediately to flush out the stomach and induce vomiting.

Combined use with other medicines

"Indapamide" - tablets for high blood pressure - can not be combined with all drugs:

  1. NPS and salicylates. Reduce the hypotensive effect.
  2. Medicines based on lithium salts. Increase the concentration of lithium in the blood.
  3. Glucocorticosteroids. Reduce the hypotensive effect.
  4. Medications with a diuretic effect. Provoke acute hyperkalemia.
  5. ACE inhibitors. Provoke acute renal failure and chronic hypotension.
  6. Cyclosparin. Increases the content of creatinine in the blood.
  7. Salts of calcium. Cause acute hypercalcemia.
  8. Tricyclic antidepressants. Strongly increase the severity of the hypotensive effect.

Read also:

Why is hypertension dangerous during pregnancy?

Therefore, only a qualified specialist can correctly draw up a treatment regimen.

"Indapamide" can be taken simultaneously with other medicines

Analogues

With the development of side effects, the doctor may decide on the advisability of replacing Indapamide with analogues. They have the same properties and therapeutic effect, but they contain a different active substance.

The most common analogues:

  1. "Indapen".
  2. "Indopress".
  3. "Ionic".
  4. "Arifon retard".

Medications based on indapamide:

  1. "Lorvas".
  2. "Indap".
  3. "Frantel".
  4. Pamid.

Analogues differ in manufacturer and form of release.

"Indapamide" from pressure: reviews

Konstantin, 55 years old: “I have been taking the drug for a year. I used to constantly suffer from high blood pressure, but now my condition has improved. And all thanks to Indapamide. You have to take pills every day, but the result is worth it.

Olga, 44 years old: “Sudden jumps in blood pressure are often disturbing. The doctor prescribed this drug. Relief comes in the first hours. For prevention, I take 1 tablet every morning.

Maxim, 48 years old:

“Hypertension manifests itself several times a year. Tablets help me a lot. But to achieve the result, you have to take the medication every day. ”

Indapamide, what do these pills help with? The drug has a vasodilatory, 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 hypotensive, vasodilating and diuretic (diuretic) effects. Indapamide reduces the force of contractions of the smooth muscles of the arteries, reduces the total peripheral vascular resistance, and also contributes to the involution of left ventricular hypertrophy of the heart. With a single dose, it lowers blood pressure for a long time and is used in the treatment of hypertension and chronic heart failure.

What helps Indapamide?

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

  • Reduces blood pressure (hypotensive effect);
  • Expands blood vessels (is a vasodilator);
  • Reduces total peripheral vascular resistance;
  • Reduces resistance in arterioles;
  • Helps to reduce the degree of hypertrophy of the left ventricle of the heart;
  • It has a moderately diuretic (diuretic) effect.

The hypotensive effect of Indapamide develops when taken in dosages (1.5 - 2.5 mg per day), which 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 has no effect on fat and carbohydrate metabolism, therefore it can be used by people suffering from diabetes, high cholesterol, etc. In addition, Indapamide effectively reduces blood pressure in people with one kidney or those on hemodialysis.

The high safety and good tolerability of Indapamide make it the drug of choice for the treatment of hypertension in people with diabetes mellitus, chronic renal failure or hyperlipidemia (high cholesterol, triglycerides, low-density lipoproteins in the blood).

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

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

Contraindications

You can not drink pills with the following diagnoses:

  • Severe renal failure (in the stage of anuria);
  • Severe liver failure (including with encephalopathy);
  • Galactosemia;
  • hypokalemia;
  • Glucose/galactose malabsorption syndrome, lactose intolerance;
  • Simultaneous administration with drugs that prolong the QT interval;
  • Pregnancy and lactation;
  • Age up to 18 years (safety and efficacy of the drug for this age group of patients have not been established);
  • Hypersensitivity to the components of the drug, as well as to other sulfonamide derivatives.

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

Medicine Indapamide: instructions for use

Tablets of the usual duration of action and capsules contain 2.5 mg of the active substance and are characterized by the same administration rules. So, tablets and capsules must be taken orally, swallowed whole, not chewed, chewed or crushed in other ways, but washed down with a sufficient amount of non-carbonated water (at least half a glass). Tablets and capsules can be taken regardless of the meal, that is, at any convenient time.

It is optimal to take tablets or capsules in the morning, at about the same time every day, to ensure that a certain concentration of the drug in the blood is constantly maintained. Indapamide, from which the drug helps with arterial hypertension, must be taken at 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.).

It is not recommended to increase the dosage of Indapamide more than 2.5 mg per day, since this will not lead to a pronounced increase in the hypotensive effect, but will cause a diuretic effect. The maximum allowable daily dosage of Indapamide is currently considered to be 5 mg (2 tablets or capsules). Indapamide can be used alone or in combination with other antihypertensive agents (beta-blockers, ACE inhibitors). When using the drug as part of complex therapy, its dosage, as a rule, is not reduced, leaving it equal to 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 needs to 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 taking the ACE inhibitor, Indapamide is canceled; then, after a set of maintenance doses of an ACE inhibitor, Indapamide is resumed and both drugs are already taken. To eliminate edema in chronic heart failure, Indapamide is recommended to be taken at 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 old) take Indapamide in the usual dosages. For this age group, the drug is allowed if the kidney function is normal or slightly reduced.

Side effects

  • While taking Indapamide, it is possible to develop disorders from some body systems: Cardiovascular system: orthostatic hypotension, arrhythmia, ECG changes (hypokalemia), palpitations.
  • Central nervous system: nervousness, asthenia, headache, drowsiness, dizziness, insomnia, vertigo, depression; rarely - malaise, general weakness, fatigue, muscle spasm, irritability, tension, anxiety.
  • Digestive system: abdominal pain, nausea, dry mouth, anorexia, vomiting, gastralgia, diarrhea, constipation, hepatic encephalopathy may develop; 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, glucosuria, hypercreatininemia.
  • Allergic reactions: hemorrhagic vasculitis, urticaria, rash, itching; Others: exacerbation of the course of systemic lupus erythematosus.

Patient opinions

“Indamamid from what these pills help me get back on my feet, I can recommend it for normalizing blood pressure, but the question is quite serious and complex, it’s still not vitamins, but the treatment of a serious disease. So it’s better not to prescribe it to yourself, especially there are nuances with which medicine to take Indapamide without a diuretic. But if the doctor prescribes, then do not hesitate and start treatment. Of course, the drug has side effects, but this fact is always individual. "

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

“Recently, I have been taking indapamide for high blood pressure. One tablet after dinner and it’s fine, the pressure is normal. The diuretic effect of it is almost imperceptible, it doesn’t interfere with life. , the choice of medicine is very individual, but it suited me."

Release form: Solid dosage forms. Tablets.



General characteristics. Compound:

Active ingredient: 0.0025 g of indapamide.

Excipients: potato starch, milk sugar (lactose), calcium phosphate, collidone 30, magnesium stearate, talc.

Shell composition: Klucel LF hydroxypropyl cellulose, VA 64 kollidon, titanium dioxide, talc.

Diuretic agent with a pronounced hypotensive effect.


Pharmacological properties:

Pharmacodynamics. An antihypertensive agent, a thiazide-like diuretic with a moderate and long-lasting effect, a benzamide derivative. Reduces the tone of the smooth muscles of the arteries, reduces the total peripheral vascular resistance.

It has moderate saluretic and diuretic effects, which are associated with blockade of the reabsorption of sodium, chlorine, hydrogen, and, to a lesser extent, potassium ions in the proximal tubules and the cortical segment of the distal tubule of the nephron. Vasodilating effects and a decrease in total peripheral vascular resistance are based on the following mechanisms: a decrease in the reactivity of the vascular wall to norepinephrine and angiotensin II; increase in the synthesis of prostaglandins with vasodilating activity; inhibition of calcium flow into vascular smooth muscle cells. Helps to shrink the heart.

In therapeutic doses, it does not affect lipid and carbohydrate metabolism (including in patients with concomitant diabetes mellitus). The antihypertensive effect develops at the end of the first / beginning of the second week with a constant intake of the drug and persists for 24 hours against the background of a single dose. Read more about how to take indapamide for high blood pressure.

Pharmacokinetics. After oral administration, it is rapidly and completely absorbed from the gastrointestinal tract. Biavailability - high (93%). Eating somewhat slows down the rate, but does not affect the completeness of absorption. The maximum concentration in the blood is reached 1-2 hours after ingestion. Equilibrium concentration is reached after 7 days of regular intake.

The drug is 70-80% bound to plasma proteins. It has a high volume of distribution, passes through histohematic (including placental), barriers, penetrates into breast milk. Metabolized in the liver. The half-life of indapamide averages 14-18 hours. It is excreted from the body by the kidneys (up to 80%) mainly in the form of metabolites, through the intestines - 20%. In patients with renal insufficiency, the pharmacokinetics do not change. Does not accumulate

Indications for use:

Arterial hypertension


Important! Get to know the treatment

Dosage and administration:

Inside, regardless of the meal, drinking plenty of fluids. Take the drug preferably in the morning. The dose is 2.5 mg (1 tablet) per day.

If after 4-8 weeks of treatment the desired therapeutic effect is not achieved, it is not recommended to increase the dose of the drug (the risk of side effects increases without increasing the antihypertensive effect). Instead, it is recommended to include another antihypertensive drug that is not a diuretic in the drug regimen.

In cases where treatment must be started with two drugs, the dose of Indapamide remains equal to 2.5 mg in the morning once a day.

Application Features:

With prolonged use or when taking Indapamide in high dosages, electrolyte disturbances, such as hypochloremic, may develop. These disorders are more often observed in patients with chronic heart failure (II-IV f.c. according to the NYHA classification), liver diseases, with vomiting and diarrhea, as well as in people who are on a salt-free diet. The simultaneous appointment of Indapamide with cardiac glycosides and corticosteroids increases the risk of hypokalemia. In addition, the excretion of magnesium in the urine may increase, which can lead to.

Perhaps the appearance of orthostatic hypotension, which can be provoked by alcohol, barbiturates, narcotic drugs and the simultaneous use of other antihypertensive drugs. In patients taking cardiac glycosides, laxatives, against the background, as well as in the elderly, careful monitoring of the content of cadium and creatinine is shown.

The most careful control is shown in patients with cirrhosis of the liver, coronary heart disease, chronic heart failure. The high-risk group also includes patients with an increased QT interval on the electrocardiogram (congenital or developed against the background of any pathological process).

The first measurement of the concentration of potassium in the blood should be carried out during the first week of treatment. against the background of taking Indapamide may be the result of a previously undiagnosed. In patients with diabetes, it is extremely important to control blood glucose levels, especially in the presence of hypokalemia. Significant dehydration can lead to development (reduced glomerular filtration rate). Patients need to compensate for fluid loss and carefully monitor renal function at the beginning of treatment. Indapamide may give a positive result during the donation control.

Patients with arterial hypertension and hyponatremia (due to taking diuretics) should stop taking diuretics 3 days before the start of taking angiotensin-converting enzyme inhibitors (if necessary, taking diuretics can be resumed a little later), or they are prescribed initial low doses of angiotensin-converting enzyme inhibitors. Sulfonamide derivatives can aggravate the course (must be borne in mind when prescribing Indapamide).

Side effects:

From the side of metabolism: hypokalemia, hyponatremia, hypochloremic alkalosis, increased plasma urea nitrogen, hypercreatininemia, glucosouria, hypercalcemia.

From the digestive system: or, nausea, dry mouth, discomfort in the abdomen,.

From the side of the central nervous system: asthenia, nervousness, asthenia, drowsiness, insomnia, fatigue, malaise, muscle spasm, tension, irritability,.

From the senses: conjunctivitis, blurred vision.

From the side of the cardiovascular system: orthostatic hypotension, ECG changes characteristic of hypokalemia, palpitations.

From the genitourinary system: the development of the frequency of infections. Allergic reactions:, hemorrhagic.

From the side of the hematopoietic organs:, bone marrow aplasia,.

Others: flu-like syndrome, chest pain, back pain, decreased libido and potency, rhinorrhea, sweating, weight loss, parestensia, exacerbation of systemic lupus erythematosus.

Interaction with other drugs:

With the simultaneous use of iidanamide with lithium preparations, an increase in the concentration of lithium in the blood plasma is possible.

Astemizole, erythromycin (when administered intravenously), pentamidine, sultopride, vincamine, antiarrhythmic drugs Ia (quinidine, disopyramide) and class III (amiodarone, bretilium, sotalol) increase the likelihood of heart rhythm disturbances according to torsades de pointes mud (ventricular tachycardia type "pirouette").

Non-steroidal anti-inflammatory drugs, glucocorticosteroids, tetracoactide, sympathomimetics reduce the hypotensive effect, baclofen increases.

Saluretics, cardiac glycosides, gluco- and mineralocorticosteroids, tetracosactide, amphotericin B (with intravenous administration), laxatives increase the risk of hypokalemia.

With simultaneous use 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- and hyperkalemia is not completely excluded, especially in patients with diabetes mellitus and renal insufficiency.

Angiotensin-converting enzyme inhibitors increase the risk of arterial hypotension and / or acute renal failure (especially with existing renal artery stenosis). Contrast iodine-containing agents in high doses increase the risk of developing kidney dysfunction (dehydration).

Before using contrast iodine-containing agents, patients need to restore fluid loss. Tricyclic antidepressants and antipsychotics increase the hypotensive effect and increase the risk of orthostatic hypotension. Cyclosporine increases the risk of developing hypercreatininemia.

Reduces the effect of indirect anticoagulants (arbitrary coumarin or indandione) 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.

Contraindications:

Hypersensitivity to indapamide, other sulfonamide derivatives or other components of the drug, decompensation of kidney function (anuria) and / or liver function (including with encephalopathy), hypokalemia, concomitant use of drugs that prolong the QT interval, pregnancy, lactation period, age up to 18 years (efficacy and safety not established)

Treatment: correction of water and electrolyte balance, symptomatic therapy. There is no specific antidote.

Storage conditions:

In a dry, dark place at a temperature not exceeding 25 ° C. In a place inaccessible to children Shelf life 2 years. Do not use after the expiry date stated on the packaging

Leave conditions:

On prescription

Package:

Film-coated tablets 2.5 mg. 10 tablets in a blister pack. 2, 3 contour packs, together with the instructions, are put into a pack of cardboard.


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