Primary hypertension, alone or in combination with other antihypertensive agents.
Composition:
1 tabl powl. sustained release contains 1.5 mg of indapamide. The preparation contains lactose.
Action:
A diuretic with hypotensive effect - a sulphonamide derivative with pharmacological properties similar to thiazide diuretics. The hypotensive effect is caused by the direct, expanding effect of Indapamide on the vascular smooth muscle, which reduces the peripheral resistance. It increases the excretion of sodium and chlorides and to a lesser extent, potassium and Magnesium, thus increasing the volume of urine excreted. After oral administration, indapamide is rapidly and completely absorbed from the gastrointestinal tract, the bioavailability is 93%. About 71-79% is bound to plasma proteins. It is metabolized in the liver to inactive metabolites. 5% of the oral dose is excreted in urine unchanged, 60-70% of the dose is excreted in the urine as metabolites. About 20% of the dose is excreted in the faeces. The elimination of the drug is two-phase; the half-lives are respectively 14 h in the α phase and 25-26 h in the β phase. Full antihypertensive effect occurs after approximately 1 week of use.
Contraindications:
Hypersensitivity to Indapamide, sulfonamides or other ingredients of the preparation. Fresh ischemic stroke. Severe renal failure (GRF <10 ml / min). Severe hepatic failure with impaired water and electrolyte balance (pre-coma and hepatic coma). Hypokalemia.
Precautions:
Caution should be exercised when using preparations of Digoxin, lithium, astemizole, terfenadine, Erythromycin (administered intravenously); in patients with impaired water and electrolyte management (especially in patients treated concomitantly with digitalis glycosides or steroids with systemic effects and in patients with hepatic impairment, in these patients it is recommended to enrich the diet with products with a high potassium content or use of potassium-containing preparations, also in the case of when the potassium concentration is normal); with gout (also past) hyperuricaemia (risk of gout attack); with diabetes (risk of decreased Glucose tolerance); with hepatic impairment (if the symptoms of encephalopathy occur, the drug should be discontinued); with impaired renal function (GRF 10-50 ml / min; if renal failure worsens, discontinue the medicine); with systemic lupus erythematosus (risk of worsening of symptoms or recurrence of the disease). When using indapamide in combination with other antihypertensive agents, lower starting doses of these medicines should be given at the beginning of their use. Special care should be taken when administering ACE inhibitors (especially in the first week of combination therapy, monitoring of renal function - blood creatinine determination is recommended). In patients with hyperparathyroidism, the drug should be discontinued when hypercalcemia develops. Do not use in children (no data on efficacy and safety). Due to the lactose content, do not use the preparation in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.
Pregnancy and lactation:
Use only in case of extreme necessity. Do not use the drug during breast-feeding.
Side effects:
Common: hyponatremia, hypokalemia, erythema, urticaria, pruritus, vasculitis. Rare: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, hemolytic anemia. In addition, you may experience: nausea, vomiting, constipation, diarrhea, abdominal pain, loss of appetite, palpitations, orthostatic hypotension, premature ventricular contractions, headache and dizziness, mood disorders, paresthesia.
Dosage:
Orally. Adults: 1 tabl. once a day. The drug is usually taken in the morning, regardless of meals.
(C)
