Indapamide

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Indapamide
Systematic (IUPAC) name
4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)- 3-sulfamoyl-benzamide
Clinical data
AHFS/Drugs.commonograph
MedlinePlusa684062
Pregnancy cat.B(US), C (Aus)
Legal statusPOMt
RoutesOral tablet
Pharmacokinetic data
Protein binding71-79%
MetabolismHepatic
Half-life14-18 hours
Identifiers
CAS number26807-65-8 YesY
ATC codeC03BA11
PubChemCID 3702
DrugBankDB00808
ChemSpider3574 YesY
UNIIF089I0511L YesY
KEGGD00345 YesY
ChEMBLCHEMBL406 YesY
Chemical data
FormulaC16H16ClN3O3S 
Mol. mass365.835 g/mol
 YesY (what is this?)  (verify)
 
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Indapamide
Systematic (IUPAC) name
4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)- 3-sulfamoyl-benzamide
Clinical data
AHFS/Drugs.commonograph
MedlinePlusa684062
Pregnancy cat.B(US), C (Aus)
Legal statusPOMt
RoutesOral tablet
Pharmacokinetic data
Protein binding71-79%
MetabolismHepatic
Half-life14-18 hours
Identifiers
CAS number26807-65-8 YesY
ATC codeC03BA11
PubChemCID 3702
DrugBankDB00808
ChemSpider3574 YesY
UNIIF089I0511L YesY
KEGGD00345 YesY
ChEMBLCHEMBL406 YesY
Chemical data
FormulaC16H16ClN3O3S 
Mol. mass365.835 g/mol
 YesY (what is this?)  (verify)

Indapamide is a thiazide-like diuretic drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated cardiac failure. The US trade name for indapamide is Lozol.[1] Indapamide is marketed as Natrilix outside the US, and as Insig in Australia. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.

It is described as a thiazide-like diuretic.[2]

Form and composition[edit]

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.[3]

Indications[edit]

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.[4]

Dosage and administration[edit]

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

Contraindications[edit]

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe renal failure, hepatic encephalopathy or severe hepatic failure and hypokalemia (low blood potassium levels).

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

Interactions[edit]

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[edit]

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[edit]

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

Overdosage[edit]

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[edit]