Index of drugs

Arterial hypertension.

1 tabl sustained release contains 1.5 mg of indapamide. The preparation contains lactose.

A diuretic with hypotensive effect - a sulphonamide derivative, pharmacologically associated with thiazide diuretics. It increases the excretion of sodium and chlorides in the urine and, to a lesser extent, the excretion of potassium and Magnesium, increasing the secondary volume of urine produced. The hypotensive effect is related to the improvement of the susceptibility of the arterial walls and the decrease in the total peripheral resistance and resistance in arterioles. Indapamide inhibits left ventricular hypertrophy. The released fraction of indapamide undergoes immediate and complete absorption through the gastrointestinal tract, C_max appears after about 12 hours. The drug is approximately 79% bound to plasma proteins. The plasma elimination half-life is 14 to 24 h (average 18 h). Elimination occurs primarily through the kidneys (70% of the dose) and faeces (22%) in the form of inactive metabolites.

Hypersensitivity to Indapamide, other sulfonamides or other ingredients of the preparation. Severe renal failure. Hepatic encephalopathy or severe liver problems. Hypokalemia.

In patients with hepatic impairment indapamide may cause hepatic encephalopathy, in which case the diuretic should be stopped immediately. If a hypersensitivity reaction occurs, it is recommended to discontinue treatment; if re-use is necessary, it is recommended to protect the exposed parts of the body against sunlight and artificial UVA sources. Loss of potassium leading to hypokalemia is a major risk when using indapamide. The higher-risk group includes the elderly, malnourished and / or polypharmacy, patients with liver cirrhosis with edema and ascites, with ischemic heart disease and with heart failure. In these states, hypokalemia increases the cardiac side effects of digitalis preparations and the risk of arrhythmias. The risk group also includes patients with an extended QT segment. Hypokalemia, like bradycardia, is a predisposing factor for the development of severe cardiac arrhythmias, especially to potentially lethaltorsades de pointes. Thiazide and thiazide diuretics may reduce urinary Calcium excretion by causing a slight and transient increase in plasma calcium. Significant hypercracia may occur in the case of previously unrecognized hyperparathyroidism; treatment should be discontinued until the parathyroid function is clear. Monitoring blood Glucose is especially important in patients with diabetes, especially with concomitant hypokalaemia. Patients with hyperuricaemia may be more prone to gout attacks. The drug may exacerbate already existing kidney failure. Indapamide is not recommended for use in children and adolescents due to lack of data on efficacy and safety in this age group. Due to the lactose content, the preparation should not be used in patients with galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.

Avoid using the product in pregnant women (diuretics can cause fetal-placental ischemia that may cause fetal growth disorders) and should never be used to treat physiological pregnancy edema. The use is not recommended during breastfeeding (indapamide is excreted in breast milk).

Hypokalemia (blood potassium <3.4 mmol / l) observed in 10% of patients; in 4% of patients potassium levels were <3.2 mmol / l after 4-6 weeks of treatment. After 12 weeks of treatment, the mean drop in potassium was 0.23 mmol / l. In addition, it can occur: often - maculopapular rash. Uncommon: vomiting, purpura. Rarely: dizziness, fatigue, headache, paresthesia; nausea, constipation, dry mouth.Very rare: thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, haemolytic anemia; arrhythmia, hypotension; pancreatitis, renal failure, liver dysfunction, angioneurotic edema, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome, hypercalcemia. Not known: risk of developing hepatic encephalopathy in the case of coexistence of liver failure; the possibility of exacerbating the course of previously occurring systemic lupus erythematosus; hypersensitivity to light; potassium deficiency with hypokalemia, particularly severe in selected high-risk groups; Hyponatraemia with hypovolaemia leading to dehydration and orthostatic hypotension, concomitant loss of chloride ions can lead to secondary compensatory metabolic alkalosis (the incidence and severity of this effect are small); increase in uric acid and plasma glucose - the indications for the use of these diuretics should be carefully considered in patients with gout and diabetes.

Orally. Adults: 1 tabl. daily, preferably in the morning. Swallow whole with a glass of water. Tablets should not be crushed or crushed. Elderly patients may be treated with the preparation only if their renal function is normal or only slightly affected.