Indapamide

Indapamide
Systematic (IUPAC) name
4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)-3-sulfamoyl-benzamide
Clinical data
AHFS/Drugs.com monograph
MedlinePlus a684062
  • B(US), C (Aus)
  • POMt
Oral tablet
Pharmacokinetic data
Protein binding 71–79%
Metabolism Hepatic
Half-life 14–18 hours
Identifiers
26807-65-8 Yes
C03BA11
PubChem CID 3702
DrugBank DB00808 Yes
ChemSpider 3574 Yes
UNII F089I0511L Yes
KEGG D00345 Yes
ChEMBL CHEMBL406 Yes
Chemical data
Formula C16H16ClN3O3S
365.835 g/mol
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Indapamide is a thiazide-like diuretic[1] drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.

Form and composition

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.[2] It is now also available in SR (sustained release) form.

Indications

Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension.[3]

Dosage and administration

The adult dosage is 1.25 to 5 mg, orally and once daily, usually in the morning.

Contraindications

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level.

There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.

Interactions

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, vincamine).

Precautions

Monitoring of potassium and uric acid serum levels is recommended, especially in subjects with a predisposition or a sensitivity to hypokalemia and in patients with gout.

Adverse effects

Commonly reported adverse events are hypokalemia (low potassium levels), fatigue, orthostatic hypotension (blood pressure decrease on standing up) and allergic manifestations.

Overdosage

Symptoms of overdosage would be those associated with a diuretic effect, i.e. electrolyte disturbances, hypotension, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.

References

  1. ↑ Indapamide at the US National Library of Medicine Medical Subject Headings (MeSH)
  2. ↑ http://online.lexi.com/crlsql/servlet/crlonline
  3. ↑ "HYVET Trial".