Preparations containing indapamide. Rules for taking Indapamide for high blood pressure. Release forms and prices

The first representative of a new class of antihypertensive/diuretic drugs called indolines. It is a sulfonamide derivative with an indole ring in the structure of the molecule. At a dose of 2.5 mg/day it has pronounced and prolonged hypotensive and weak diuretic effects. When prescribed in higher doses, the antihypertensive effect does not significantly increase, while the number of adverse reactions increases. Therefore, you should not exceed the recommended dose. At a dose of 2.5 mg/day it reduces vascular hyperreactivity to norepinephrine and peripheral vascular resistance. Reduces left ventricular hypertrophy in hypertension (arterial hypertension). The antihypertensive effect persists in case of impaired renal function. The vascular mechanism of action of indapamide is due to a decrease in the contractility of vascular smooth muscles due to the effect on the transmembrane ion exchange(in particular, a decrease in intracellular calcium transport) and stimulation of the synthesis of prostaglandin E2, which has a vasodilator and hypotensive effect. It has moderate diuretic and saluretic effects, which are associated with blockade of the reabsorption of sodium, chlorine, water and, to a lesser extent, potassium ions in the proximal and distal convoluted tubules, as well as in the area ascending department loops of Henle. Does not provide negative influence on lipid metabolism and carbohydrate metabolism.
Indapamide is quickly and completely absorbed from the digestive tract; the maximum concentration in blood plasma is achieved between the 1st and 2nd hour after it oral administration. Binding to blood plasma proteins is high - 71-79%. Metabolized in the liver. 60-70% of indapamide is excreted in urine (with only 5-7% unchanged), and 20-23% in feces. The half-life is 14-18 hours.

Indications for use of the drug Indapamide

AH (arterial hypertension).

Use of the drug Indapamide

Orally, 1 tablet (2.5 mg) or 1 tablet of prolonged action (1.5 mg) 1 time per day; It is preferable to take the drug in the morning. Maximum daily dose 2.5 mg.

Contraindications to the use of the drug Indapamide

Hepatic encephalopathy, severe renal and liver failure, hypokalemia, hypersensitivity to drugs in this group.

Side effects of the drug Indapamide

Possible hypokalemia, hyponatremia, hypovolemia, orthostatic hypotension, hyperuricemia, hyperglycemia, extremely rarely - hypercalcemia, myelosuppression, leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, myelosuppression, encephalopathy in patients with liver failure, maculopapular rash, purpura, exacerbation of systemic lupus erythematosus, nausea, constipation, dry mouth, dizziness, asthenia, paresthesia, headache, pancreatitis.

Special instructions for the use of the drug Indapamide

There are no data on the safety of indapamide during pregnancy. The prescription of indapamide as a diuretic for the treatment of edema and hypertension (arterial hypertension) during pregnancy is not justified, since this can lead to fetoplacental ischemia with the risk of developing fetal malnutrition. It is recommended to stop breastfeeding during treatment with indapamide.
The use of indapamide in athletes may cause positive reaction during doping control.
During treatment with indapamide, periodic monitoring of serum potassium and sodium levels, as well as uric acid levels in patients with gout is necessary. Secondary hypovolemia following the loss of water and sodium caused by taking the diuretic at the beginning of treatment causes a decrease in glomerular filtration rate. This can lead to an increase in blood levels of urea and plasma creatinine. This transient functional renal failure does not lead to negative consequences in persons with normal renal function, but may increase the severity of pre-existing renal failure.
By lowering blood pressure, indapamide may affect the ability to drive vehicles and working with potentially dangerous machinery.
The antihypertensive effect of indapamide may be enhanced by sympathectomy.

Drug interactions Indapamide

It is not recommended to administer simultaneously with indapamide the following means: lithium salts, sultopride, terfenadine, vincamine, astemizole, erythromycin, pentamidine, bepridil. Caution should be exercised when prescribing indapamide simultaneously with the following drugs: NSAIDs for systemic use, salicylates in high doses, metformin, iodinated contrast agents, some antiarrhythmic drugs(class Ia antiarrhythmic drugs, sotalol and amiodarone), potassium-lowering drugs (amphotericin B - IV), corticosteroids (gluco- and mineralocorticoids for oral administration), tetracosactide, laxatives, digitalis preparations. Simultaneous use potassium-sparing diuretics does not exclude the possibility of developing hypokalemia. Combination with ACE inhibitors increases the risk of developing severe arterial hypotension or renal failure in patients at risk (dehydration, hyponatremia, kidney disease).

Overdose of the drug Indapamide, symptoms and treatment

Possible symptoms acute poisoning are caused by disturbances in the water-electrolyte balance and are clinically manifested by nausea, vomiting, arterial hypotension, convulsions, dizziness, drowsiness, confusion, polyuria or oliguria up to anuria due to hypovolemia. First aid includes rapid elimination of the drug taken (gastric lavage, administration activated carbon) followed by rehydration therapy and correction of electrolyte disturbances.

List of pharmacies where you can buy Indapamide:

• Saint Petersburg

Hypertension is a common disease in humans of different ages, which is characterized by an increase blood pressure. High blood pressure can be defined as an indicator exceeding 140/90 mmHg. Art. People suffering from this disease should remember that a careless attitude towards high blood pressure can result in a stroke or myocardial infarction.

Unfortunately, it is impossible to completely cure hypertension. But, with all this, you can keep the indicator normal using special drugs. One of these is Indapamide, the contraindications to which are described in detail in this article.

• 1 pharmachologic effect and indications for use
• 2 Dosage
• 3 Side effects
• 4 Contraindications for use
• 5 Indapamide and alcohol
• 6 Pregnancy and breastfeeding
• 7 Benefits and harms of Indapamide
• 8 Videos on the topic

Pharmacological action and indications for use

Indapamide can reduce smooth muscle tone and vascular resistance.

Its positive effects on the body also include a decrease in hypertrophy of the left ventricle of the heart muscle.

On this moment it was noted that a drug called Indapamide has no effect on fat and carbohydrate metabolism. This suggests that it is allowed to be taken by people suffering from relevant disorders.

At constant reception With this drug, you can notice the first improvements in your health after just two weeks. In this case, the effect lasts throughout the day. As mentioned earlier, Indapamide is indicated for use in high blood pressure.

Dosage

In order to improve general state health and reduce blood pressure to normal levels, you need to take the drug orally, preferably in the first half of the day. The intake does not depend on nutrition in any way, so the medicine can be taken both before and after meals.

Indapamide tablets

To stabilize high blood pressure, you need to take one tablet per day at a dosage of 2.5 mg, washing it down big amount water . Do not use tea, juices or other drinks for this.

After two months have passed since the start of treatment with this drug, it is recommended to pay attention to your general health. If the desired result is not achieved, then the dose should not be increased, since the risk of side effects without improving health status increases significantly.

To protect the body from negative impact increasing the dose this drug, you need to start taking a similar medication with the same indication for use.

But there is one requirement here - it should not be a diuretic.

IN in some cases When treatment should be started with two drugs, the dose of Indapamide should remain equal to the original dose of 2.5 mg once a day.

To avoid unexpected side effects, you should strictly adhere to the recommendations of your doctor, not exceeding the strictly indicated dose to lower blood pressure.

Side effects

Detailed description of all unwanted effects:

• metabolism. At self-increase doses of the drug can cause hypokalemia, hyponatremia, alkalosis associated with the loss of chlorine anions, increased concentration of nitrogen in the blood, high content creatinine in the blood and hyperglycemia;
• nervous system. When the dose of this drug is increased, the human central nervous system also suffers. The most common unwanted side effects after taking Indapamide are dizziness, nervousness, unbearable headaches, drowsiness, aggression, fast fatiguability, weakness and sleep disturbance. Depressive moods, tension, irritability, persistent feelings of anxiety and fear, lethargy, lethargy, as well as discomfort tingling in the limbs;
• organs gastrointestinal tract . Side effects of the drug include excessive dryness of the mucous membrane oral cavity, vomiting, appetite disturbances, painful sensations in the pelvic area, pancreatitis, constipation, diarrhea, as well as hepatic encephalopathy;
• sense organs. Sometimes noted serious violations vision and even conjunctivitis;
• respiratory system. Rhinitis is often observed, coughing, pharyngitis and sinusitis;
• heart and blood vessels. From the outside of cardio-vascular system Indapamide has the following side effects: arrhythmia, dramatic changes in the electrocardiogram and hypotension;
• excretory system. Nocturia, polyuria and various dangerous infections urinary tract;
• allergic reactions. There are frequent cases of occurrence skin rash, urticaria, itching and hemorrhagic vasculitis.

To avoid side effects, you must be careful when taking this drug. It is important to remember that taking Indapamide without a prescription from your doctor is strictly prohibited.

Other undesirable side effects that occur when taking the drug in an increased dosage include flu-like syndrome, unbearable pain in the chest, general malaise, muscle spasms and pain in the spine.

Such phenomena as decreased sexual desire for opposite sex, lack of erection in men, increased sweating, sudden and rapid weight loss, as well as exacerbation of lupus.

Contraindications for use

There is a list of conditions and diseases for which the use of the drug is strictly prohibited. These include:

• serious problems with the liver;
• disruption of blood supply to the brain;
• irregularities in work excretory system, in particular the kidneys;
• stopping the flow of urine into the bladder;
• allergy to active substance;
• gout;
• not recommended for children under eighteen years of age;
• pregnancy and lactation;
• reduced concentration of potassium ions in the blood;
• The drug is not recommended to be taken with medications that can increase the Q-T interval.

It is very important to undergo all necessary tests before prescribing a medicine. This is especially true if there is a suspicion that the drug may provoke water-salt changes.

It should be noted that the tablet shell consists of lactose, so this should be taken into account by those patients who are intolerant to this substance. It is also strictly forbidden to take the drug for those people who have hypersensitivity to the active substance.

Since Indapamide has serious contraindications and side effects, its use should be treated with extreme caution. This point should be especially observed by patients with diabetes mellitus in the so-called stage of decompensation.

Indapamide and alcohol

It is important to remember that Indapamide and alcohol have zero compatibility.

If you ignore this statement, you may encounter severe poisoning of the body.

Pregnancy and breastfeeding

If a woman is in interesting position, then she should not take the diuretic Indapamide.

IN otherwise you can get fetoplacental ischemia with the risk of developing chronic disorder fetal nutrition.

Side effects of Indapamide apply not only to the mother taking the drug, but also to the child who receives breast milk. To protect your baby from the unwanted effects of individual components of the drug, you need to stop taking it during breastfeeding.

It is important to note that only in some cases, doctors prescribe medicinal product pregnant women. This is justified only when the benefit outweighs the likely risk.

Benefits and harms of Indapamide

As you know, Indapamide has many side effects that occur if its dosage is increased.

When taken correctly and prescribed by a doctor, you can note an excellent effect on the general condition of the body.

The blood pressure stabilizes and your health improves. Long-term treatment This remedy can normalize high blood pressure.

In addition, one tablet per day is enough to ensure that it does not increase throughout the day. If you neglect the dosage prescribed by your doctor, you may end up with irreparable health problems.

Reducing the dose will not only have no effect on the body, but will also not have any positive impact. But an increase in the prescribed amount of the drug can cause various unwanted effects, which can cause serious harm to the health of a person suffering from hypertension.

Before starting treatment with the drug, you should consult with your doctor, who will rule out serious pathologies, during which the use of Indapamide is strictly prohibited.

Video on the topic

About the use of Indapamide for high blood pressure in the video:

Since this drug is known for its effectiveness, many patients prefer to start taking it without contacting a specialist. This is incorrect, because in this way you can apply irreparable harm own health.

Before starting your appointment, you need to contact a specialist who will refer you for examination and take all necessary tests. This will allow you to find out whether a particular patient can be treated with Indapamide for high blood pressure.

In any case, taking this drug is strictly prohibited without prescription by your doctor, especially during pregnancy and breastfeeding. It is also worth noting that the duration of treatment should be determined only by the specialist who is monitoring the patient.

The information on the website is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment.

Patients with hypertension Doctors prescribe diuretics. They help remove excess fluid from the body.

A common drug is Indapamide. It is worth studying the instructions for use before taking the drug.

In what cases is Indapamide prescribed?

Purpose of Indapamide - therapy arterial hypertension. The drug is prescribed for persistent high blood pressure, which causes swelling and retains fluid in the body.

When excess fluid is removed, blood pressure normalizes (decreases).Blood pressure tablets Indapamide are a component in the treatment of hypertension. In addition to it, doctors prescribe other drugs intended to treat arterial hypertension.

What blood pressure does Indapamide help with? The drug is prescribed for high blood pressure, which leads to the development of full-fledged arterial hypertension. A harbinger of arterial hypertension is blood pressure readings of 142/105.

Indapamide is a diuretic, the main task is to remove excess fluid from the body. This drug is considered a diuretic.

If you take the medicine in large doses, it does not enhance hypotensive effect other medications.At the same time, the diuretic properties are enhanced. Because of this, doctors do not recommend increasing the dosage on your own.

The price of Indapamide averages from 25 to 55 rubles.

Instructions for use and dosage

Indapamide should be taken without chewing and washed down with plenty of water. Basically, doctors prescribe one tablet per day. One tablet - 2.5 mg. If after a course of treatment, which lasted 1 to 2 months, the patient does not have a result, then treatment continues.

Increasing the dosage may lead to unpleasant consequences and complications. In this case, it is worth replacing Indapamide with another drug.

In the treatment complex, Indapamide is replaced with a drug that is not included in the group of diuretics and has an antihypertensive effect.

When the course of treatment consists of Indapamide Retard, the dosage of the former remains unchanged, that is, one tablet once a day. Retard – one tablet (1.5 mg) is taken once a day and washed down with plenty of water. If after two months there is no result, then Indapamide Retard is replaced with another drug, with the same conditions as in the first situation.

When a patient is prescribed treatment with two drugs, the initial dosage of Indapamide is 1.5 times a day in the morning.

Elderly patients taking Indapamide Retard are under the supervision of their attending physician. Once a month, the patient must be tested to determine plasma creatinine concentration. The patient's body weight, age and gender are taken into account. The drug is prescribed to elderly patients whose kidneys function normally.

Medicine Indapamide for hypertension

This medicine is a common way to combat high blood pressure and has a number of benefits. It easily lowers blood pressure and is harmless to the human body.

Indapamide is prescribed to all patients suffering from diabetes mellitus and vascular lesions. The drug does not affect the metabolic process, blood glucose and uric acid do not increase. These advantages allow us to consider the drug Indapamide in demand for hypertension.

Indapamide is not considered an emergency treatment for high blood pressure or hypertensive crisis.

Important! Despite the advantages of this drug, it is prescribed exclusively by the attending physician.

The first result of Indapamide appears after 7-14 days with daily use. It has a smooth effect on blood pressure. There are drugs that can quickly lower blood pressure levels than Indapamide. But such drugs have many negative consequences.

Based on the results of numerous studies, experts have determined that Indapamide is more effective if taken in combination with medications. To maintain blood pressure within 120-130/85 millimeters of mercury, doctors prescribe Indapamide with angiotensin-acting drugs.

Based on research results, it was determined that Indapamide helps reduce the risk of heart attacks, strokes and other consequences caused by hypertension.

It is easier for each patient to take one tablet a day than to swallow several of them. Preparations containing two or three active ingredients are in great demand.

If you have high blood pressure, your doctor will prescribe a combination medicine. The drug is prescribed to patients diagnosed with hypertension of the first or second degree, accompanied by edema. Edema occurs due to heart failure.

Indapamide is taken once a day, one tablet. The tablet is taken whole and washed down with water. If the patient does not have the desired result, then Indapamide is replaced with another drug. Otherwise, irreversible side effects may occur.The doctor may cancel it or prescribe another drug in addition to Indapamide.

When should you not take Indapamide?

Indapamide should not be taken by patients with:

• impaired liver functions;
• anuria (complete cessation of urine flow into the bladder);
• allergic reaction to the active ingredients of this drug;
• metabolic diseases;
• impaired cerebral circulation;
• reduced concentration of potassium ions in the blood;

Doctors do not recommend taking the drug to pregnant women or during breastfeeding. The active substance of the drug has a negative effect on intrauterine development and can cause fetal malnutrition.

If, according to indications, a woman needs to take the drug during breastfeeding, then the baby is temporarily transferred to artificial feeding.

Before prescribing Indapamide to a patient, the doctor must send him for certain tests. This is especially true when the patient has a tendency to water-salt changes.

If the doctor prescribes the drug, the patient donates blood once every two weeks so that the doctor can monitor sodium, potassium and magnesium levels in the blood plasma. The level of nitrogen residue, uric acid and glucose is controlled.

When the drug is prescribed to patients diagnosed with chronic cardiovascular failure, coronary heart disease, cirrhosis of the liver, the patient is under strict control. The patient has an increased risk of developing metabolic alkalosis and hepatic encephalopathy.

How long does the treatment last?

When are medications prescribed to patients with hypertension? hypotensive effect, then the course of treatment is several weeks. After your blood pressure normalizes, you can stop taking it.

The attending physician can resolve the issue. To prevent a rebound increase in blood pressure, the patient must follow proper nutrition and all instructions from the attending physician.

The duration of the course is determined by the doctor. Treatment may last differently for each patient. It all depends on individual characteristics body and the degree of hypertension.

Side effect

If you follow all the rules for using Indapamide, you can avoid side effects. Otherwise, non-compliance with the rules may result in:

• dizziness, headaches, insomnia, asthenic syndrome and other disorders of the central nervous system;
• hypotension ( a sharp decline blood pressure below 85 millimeters of mercury), cardiac arrhythmia;
• severe cough, pharyngitis ( infection larynx), sinusitis (inflammation of the mucous membrane in the nasal sinus);
• various violations by circulatory system, changes in normal blood levels;
• all kinds of allergic reactions, rashes on skin and urticaria.

The above side effects are considered the most common, but if you follow all the rules, they can be avoided.

special instructions

If, in addition to Indapamide, the patient takes drugs to combat heart failure, a laxative, then once every two weeks it is necessary to take tests that monitor the content of potassium ion and creatinine in the blood. The doctor systematically monitors potassium, magnesium and sodium levels in the blood plasma.

Patients diagnosed with liver cirrhosis, coronary heart disease, metabolic alkalosis, chronic heart failure, as well as elderly patients are under strict medical supervision.

Patients who have an increased Q-T interval are at risk. It is determined using an electrocardiogram. This interval may be increased at birth, or may be caused by pathological processes.

The first time the doctor prescribes a test for potassium concentration in the blood a few days after treatment.

In order for the patient to remove excess liquid from the body and the blood pressure indicator had normal indicators, then Indapamide is taken throughout life. But, if the patient does not experience side effects.

Elevated blood calcium levels are caused by previously undiagnosed hyperparathyroidism.In patients diagnosed with diabetes, doctors monitor glucose levels.

Against the background of dehydration, renal failure develops and glomerular filtration decreases. To do this, patients compensate for the lack of fluid in the body with drugs.

To achieve the effect, patients undergo doping control. Patients with arterial hypertension, before starting treatment, should stop treatment with diuretics. If you cannot do without diuretics, you can resume taking them later. In such situations, doctors prescribe the lowest dose inhibitors. L the drug reduces alertness and reaction, so you should not drive a car or engage in dangerous activities during the treatment period.

Interaction of Indapamide with drugs

1. Impaired hypotensive action is observed when simultaneous administration Indapamide with salicylates high dosage and a systemic non-steroidal anti-inflammatory drug.
2. When a patient suffers from dehydration, Indapamide causes kidney failure. In these cases, you need to replenish the fluid.
3. The level of lithium in the blood may increase if you take drugs containing lithium salt with Indapamide. This occurs due to decreased excretion of elements. If the patient needs to take a complex of medications, then tests must be taken.
4. Glucocorticosteroid and tetracosactide drugs can neutralize the hypotensive effect. This occurs due to the retention of sodium and water ions in the body.
5. Drugs with laxative effects can cause hyperkalemia. If the doctor prescribes these drugs in combination, then you have to monitor the level of potassium in the blood serum to avoid the disease.
6. Hyperkalemia can develop due to the combination of diuretics with a diuretic drug, which conserves potassium in the body.
7. If Indapamide is used together with angiotensin-converting enzyme inhibitors, acute renal failure and arterial hypertension may develop.
8. The level of creatinine in the blood plasma may increase due to the combination of Indapamide with cyclosporine.
9. The use of radiocontrast agents leads to renal failure.

If you take the drug for a month and it does not give the desired results, do not increase the dose under any circumstances, otherwise serious side effects may occur.

Talk to your doctor and he will prescribe a different treatment.Indapamide is taken in combination with medications, the effect becomes pronounced.

The course of treatment with Indapamide is considered one of the long ones. You can notice results in 10-14 days, and the maximum effect is in three months. The active substance begins to act a few hours after taking the tablet.

If during treatment you notice adverse reactions, then consult your doctor. There are two options to get rid of them:

• The doctor stops this drug.
• The dosage is reduced.

Doctors often use the first option, since Indapamide’s side effects are serious.

Indapamide-Retard is a long-acting thiazide-like diuretic, available in the form of film-coated tablets and capsules. The drug should be taken once a day, and a hypotensive effect is observed for 24 hours. Indapamide-Retard has no effect on metabolic processes in the body and is generally well tolerated by patients. It is important to remember that there are a number of contraindications to the use of this medicine. Before use, you should read the instructions and consult a doctor.

The effect of the drug on the body

The active ingredient of the drug has a prolonged hypotensive effect on the patient's body. The tablets are capable of blocking the reabsorption of chlorine, hydrogen, sodium and potassium ions in the cortical segment of the distal tubule of the nephron and in the proximal tubules. The active substance Indapamide is a sulfonylurea derivative, its structure resembles a diuretic. It is often used in the composition complex therapy with arterial hypertension.

The drug has a gentle effect on the body, gradually reducing blood pressure, while slightly increasing the number of urinations. The drug has positive influence on the vessels. The active substance changes the permeability of membranes for minerals, due to this, the contractility of the elements is reduced vascular wall.

Will not change the quantitative content of lipids in the blood plasma. The drug reduces the sensitivity of vascular walls to angiotensin I and norepinephrine, increases the rate of prostaglandin synthesis. At long-term use reduces the production of stable and free acid radicals. The hypotensive effect is observed after a week of daily use.

Main actions of Indapamide-Retard:

• hypotensive;
• vasodilating;
• diuretic.

The intensity of the hypotensive effect depends on its ability to increase arterial compliance and reduce the total peripheral resistance of blood vessels and arterioles. The maximum effect lasts for 24 hours after taking Indapamide at the recommended dosage of 2.5 mg. If the dosage is exceeded, the hypotensive effect does not increase, but this leads to increased urination and increased side effects.

The drug can be used in a course for 3 months, because it does not disrupt lipid and carbon metabolism. Indapamide is approved for use in patients with one kidney and in patients with acute renal failure undergoing hemodialysis. The medicine can also be used:

1. Patients with diabetes.
2. People with increased level lipids in blood plasma.
3. Patients with chronic renal failure.

The undoubted advantages of this drug are: low price, high efficiency, good tolerance.

Composition of the medicinal product

The active ingredient of the drug is indapamide hydrochloride. The drug also contains other excipients:

• lactose monohydrate;
• magnesium stearate;
• sodium lauryl sulfate;
• macrogol;
• titanium dioxide;
• food talc;
• crospovidone.

Taking medication in safe doses helps reduce blood pressure.

Distribution in the body

After administration, the drug is quickly and completely absorbed from the gastrointestinal tract. High bioavailability is noted (more than 93%). Eating significantly slows down adsorption, but ultimately does not affect the absorption of the substance. The maximum concentration of substances in the blood plasma is observed 1-2 hours after taking the medicine; in the retard form, the maximum is reached after 12 hours. At the same time, 75% of indapamide and 25% of its metabolites are found in plasma.

The active substance comes into contact with plasma proteins, can be sorbed by red blood cells, and also comes into contact with the elastins of the vascular wall. Overcomes histohematic barriers and penetrates into breast milk. The drug is excreted primarily in urine (70%) and feces (no more than 22%). The half-life of the drug is approximately 18 hours. Metabolism occurs in the liver.

If you take a medicine in a course, its active substances accumulate in the body. Can be used to treat patients with renal failure. However, in patients with liver failure with long-term use diuretics, encephalopathy may develop.

When and how to use

This drug is prescribed for hypotension in the following cases:

1. For elderly patients.
2. With isolated hypotension (when only blood pressure is increased).
3. Essential arterial hypertension.
4. In patients with heart failure.

Indapamide-Retard is often prescribed in advanced cases of hypertension, as part of complex therapy. The drug has a beneficial effect on the functioning of the cardiovascular system, preventing the development of heart attack and stroke.

The medicine should be taken every morning half an hour before meals. It is recommended to take the tablet with a sufficient amount of water.

Contraindications and side effects

Any drug has contraindications for use, which should be read before taking the medicine, otherwise it may lead to disastrous consequences. The most common side effects to consider are:

From the central nervous system:

• nervousness, irritability;
• dizziness;
• headache, migraine;
• drowsiness, insomnia (depending on the individual characteristics of the body);
• tension;
• muscle spasm;
• rapid heartbeat, tachycardia.

From the outside digestive system:

• nausea, vomiting;
• diarrhea, constipation;
• stomach ache.

With long-term use, despite the appearance of side effects, pancreatitis may develop. In some cases, allergic reactions, such as urticaria, are possible. Side effects When taking Indapamide, they occur quite rarely, but at their first manifestations you should consult a doctor to determine the causes and replace the drug.

• pregnant and nursing mothers;
• at liver failure;
• patients with anuria;
• patients with low concentrations of potassium and magnesium in the blood;
• in case of individual intolerance or hypersensitivity to individual components of the drug.

The medicine is not prescribed to patients under 18 years of age. The drug can be used very carefully in cases of water-electrolyte imbalance, or in the decompensated stage of diabetes mellitus. When taking cardiac glycosides and laxatives, it is necessary to regularly monitor the concentration of potassium ions and creatinine levels.

In patients with diabetes mellitus, blood glucose levels should be regularly monitored, especially if there is hypokalemia. Frequent urination in some cases can lead to acute renal failure. In order to prevent this, it is necessary to compensate for the loss of fluid in the body. If it is necessary to undergo a long course of treatment with this drug, renal function should be monitored.

Analogs

Diuretics are popular in the treatment of hypertension. Their effect is to increase urination, reduce vascular tension, thereby reducing the volume of circulating blood. There are many drugs with the same active ingredient. They differ from each other by manufacturer, price and in some cases excipients. The main drugs whose active ingredient is indapamide should be listed:

1. Indap.
2. Acripamide.
3. Arindap.
4. Ravel.

To a large extent, they differ from each other only in price. Of course, you should not replace the prescribed drug with its analogues on the advice of friends or by reading information on the Internet. Before use, consult a doctor.

The product also stimulates the formation of vasodilators and platelet aggregation blockers: prostacyclin PgI2 and prostaglandin PgE2. As a result of the action of the product, there is a decrease in the total precardiac load, dilation of arterioles and a decrease in blood pressure. IN renal tissue at the level of the cortical layer, the product reduces the ability to reabsorb sodium, increases the excretion of magnesium, potassium and chlorine in the urine, thereby increasing the volume of excreted fluid. The effect on the release of magnesium and potassium is minor. The hypotensive effect of Indapamide is noticeable in dosages that do not cause a significant increase in diuresis. Therefore, taking the product in therapeutic doses causes only a hypotensive effect without a significant increase in the volume of urine excreted.

Has no effect on lipid metabolism(triglycerides, high and low density lipoproteins), carbohydrate metabolism, including in patients with diabetes. When taking the product, a decrease in the severity of left ventricular hypertrophy is observed. The hypotensive effect of Indapamide is detected even in patients on chronic hemodialysis.
Absorbed from digestive tract quickly and completely. Eating at the same time as the product slows down the rate of absorption, but does not change the content of the absorbed substance. An improved release form (extended-release tablets) ensures uniform release of indapamide when contained active substance 1.5 mg, which improves the effectiveness of 24-hour blood pressure control.

The maximum plasma concentration of indapamide is determined after 12 hours. In case of repeated admission next dose product, significant changes in plasma concentrations are reduced.
The half-life is approximately 18 hours (range 14 to 24 hours). Over 79% bound by plasma proteins. The stage of equilibrium concentration is determined after 7 days at regular use. Metabolized in hepatocytes, eliminated by the kidneys (in the form of inactive metabolites) - within 70% of dose taken, 22% - with feces.
With moderate renal failure, pharmacokinetic parameters do not change.

Indapamide route of administration and dosage:
Prescribed in the morning, 1 tablet every day orally. Swallow without chewing. Drink with water. Increasing the dosage of Indapamide does not increase the hypotensive effect, but increases diuretic effect.

Indapamide contraindications:
Severe hepatic dysfunction, including hepatic encephalopathy;
renal failure in the presence of anuria;
allergic reactions to indapamide and other components of the product;
gout;
age under 18 years;
pregnancy and lactation;
acute or recent disorder cerebral circulation;
combination with products that cause an increase QT interval(eg cisapride);
hypokalemia.

Indapamide side effects:
From the central and peripheral nervous system: paresthesia, fatigue, vertigo, headache, weakness, muscle pain - often.
Hematopoietic system: leukopenia, aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia - very rare.
From the cardiovascular system: hypotension, cardiac arrhythmias - very rare.
Laboratory parameters: decrease in potassium concentration in the blood serum, especially often hypokalemia develops with accompanying risk factors; a decrease in sodium concentration, leading to dehydration of the body or hypovolemia, orthostatic reactions are possible; hypochloremia can provoke metabolic alkalosis; increase in calcium concentration (very rare); increase in uric acid content.
From the digestive system: dry mouth, nausea, constipation - not often; liver dysfunction, pancreatitis - very rare; with liver failure there is a risk of developing hepatic encephalopathy.
Immune system: allergic reactions, especially in persons with hypersensitivity to other products: purpura, maculopapular rash, exacerbation of systemic lupus erythematosus.
From the outside respiratory system: sinusitis, cough, pharyngitis - not often.

Pregnancy:
The use of diuretics, including Indapamide, is unjustified from a pathogenetic point of view in the treatment of edema and arterial hypertension during pregnancy. Taking Indapamide can cause insufficiency of placental-fetal blood flow with the development of fetal malnutrition. It is not recommended to prescribe the product during pregnancy. If the product must be taken during lactation, breast-feeding stop because the active substance passes into breast milk.

Overdose:
Indapamide is toxic when taken at a dosage of 40 mg (27 times the therapeutic single dose). Signs of overdose: vomiting, nausea, hypotension, drowsiness, dizziness, oliguria or polyuria, possible anuria due to severe hypovolemia. Symptoms of overdose are caused by electrolyte and water violations(hypokalemia, hyponatremia). Indapamide can be eliminated by gastric lavage and the use of enterosorbents (activated carbon). Rehydration and restoration of electrolyte balance are effective. Further - symptomatic treatment. Treatment should be carried out in a hospital setting.

Use with other medications:
Salicylates in large doses and systemic non-steroidal anti-inflammatory drugs have a negative effect on the effectiveness of the hypotensive effect of the product. When prescribed to patients with dehydration, acute renal failure may develop (in this case, it is necessary to replenish the fluid balance).
In combination with products containing lithium salts, an increase in the concentration of lithium in the blood is observed due to a decrease in lithium excretion. This may contribute to symptoms of overdose of a lithium-containing product. If such a combination is justified, then it is necessary to monitor the level of lithium in the blood.

Influenced systemic action tetracosactide and glucocorticosteroids neutralize the hypotensive effect of Indapamide due to the retention of sodium ions and water in the body.
Mineral and glucocorticosteroids, amphotericin, laxatives with a mechanism of action due to increased intestinal motility provoke hypokalemia. If such a combination is used - for timely diagnosis Hypokalemia requires monitoring of serum potassium.
Combination with potassium-sparing diuretics (spironolactone, triamterene, amiloride) causes hyperkalemia, especially in patients with renal failure or diabetes mellitus.

In patients with signs of dehydration, the combination of Indapamide with angiotensin-converting factor inhibitors can cause renal failure (due to hyponatremia) and a sudden sharp decrease in blood pressure. When switching from Indapamide to angiotensin-converting factor inhibitors, the diuretic should be discontinued 3 days before the planned therapy.
When Indapamide is combined with cardiac glycosides, there is a high risk of subsequent toxic effects. For timely diagnosis of the disorder, it is necessary to monitor ECG parameters and potassium levels in the blood serum.

The combination of Indapamide with metformin can provoke the development lactic acidosis due to renal failure.
It is not recommended to combine Indapamide with bepridil, astemizole, erythromycin, pentamidine, sotalol, halofantrinos, quinidine, sultopride, hydroquinidine, disopyramide, vincamine, amiodarone, terfenadine, bretylium, since torsade de points may occur. Precursors to the development of torsade de points are considered to be a prolongation of the P–Q interval, a decrease in heart rate, and hypokalemia. Torsade de points - ventricular polymorphic tachycardia in the "pirouette" variant - can provoke ventricular fibrillation.

When an X-ray contrast agent is administered while taking Indapamide, the likelihood of developing kidney failure increases. To prevent complications, hydration is necessary before administering a radiocontrast agent.
When taking calcium salts simultaneously, hypercalcemia is possible. Potentiation of the hypotensive effect of Indapamide is observed when taking antipsychotics, imipramine and other tricyclic antidepressants. This can cause orthostatic hypotension. While taking Indapamide with cyclosporine, an increase in creatinine in the blood is possible. Combination with estrogen-containing products leads to the leveling of the hypotensive effect of Indapamide due to water retention in the body.

Release form:
Extended-release tablets 1.5 mg. There are 30 tablets in a pack.

Storage conditions:
Under normal conditions. The storage period is indicated on the package. Dispensed with a prescription from a doctor.

Synonyms:
Acripamide retard (Acripamide), Arifon retard (Arifon), Indap, Arindap, Indapamide retard (Indapamide), Indapamide Nycomed, Vero-Indapamide, Indapamide MV, Indapamide-Vero, Indapamide Polpharma, Indapamide-Verte, Indapsan, Indiur, Indipam, Ionic retard (Ionic), Tenzar, Ipres long, Indapamide SR, Lorvas, Lescoprid, Pamid, Retapres, Ravel SR, Frantel.

Indapamide composition:
Active substance: indapamide.
Inactive substances: copovidone, lactose monohydrate, magnesium stearate, hypromellose, colloidal anhydrous silicon dioxide.

Additionally:
Hypokalemia of 3.4 mmol or less enhances the toxic effects of cardiac glycosides and contributes to the occurrence of arrhythmia. In sick people high risk these complications (malnutrition, heart failure, elderly age, cirrhosis of the liver, reception large number medicinal products) it is necessary to systematically monitor the level of potassium in the blood serum and, if necessary, correct it.

Before prescribing Indapamide, carry out laboratory examination patient, especially in the presence of conditions that can provoke water and electrolyte disturbances. During the entire intake of the product, it is necessary to periodically monitor the content of electrolytes (sodium, potassium, magnesium) in the blood serum, as well as glucose levels, pH, residual nitrogen And uric acid. Special attention given to patients with coronary disease heart, chronic cardiovascular failure and cirrhosis of the liver, which is accompanied by ascites or edema, since such patients have a high risk of developing hepatic encephalopathy and metabolic alkalosis.
Also included in the high-risk group are patients with prolongation of the QT interval on the ECG of any origin (acquired or congenital). The development of bradycardia or tachycardia can lead to severe disorders heart rate and torsades de pointes with fatal.
Determination of the concentration of potassium in the blood serum must be carried out before the start of treatment, and while taking Indapamide - more than once during treatment.

While taking the product, an exacerbation of SLE (systemic lupus erythematosus) may occur.
Prescribe with caution when diabetes mellitus, renal and liver failure, hyperuricemia.
Severe dehydration can lead to the formation of acute renal failure due to a decrease in glomerular filtration. In such patients, fluid deficiency is compensated and renal function is monitored at the beginning of therapy.
At the beginning of taking the product, secondary hypovolemia may occur due to loss of sodium and water, which leads to a decrease in the level of glomerular filtration. As a result, an increase in serum urea and creatinine concentrations may occur. As a rule, such transient renal failure of a functional nature does not have negative consequences with normal renal functions, however, with existing failure, the severity of the initial clinical picture may get worse.

Use of the product by athletes may cause a false positive reaction during doping control. If hypercalcemia develops while taking Indapamide, this indicates previously undiagnosed hyperfunction thyroid gland(hyperparathyroidism).
Before surgical treatment the patient should inform the anesthesiologist that he is taking Indapamide.
Indapamide is not prescribed to children and adolescents under 18 years of age, as experience with the use of the product in this age group not yet available.
The drug can cause hepatic encephalopathy with concomitant liver failure. If hepatic encephalopathy is suspected, use of the product should be discontinued immediately. Elderly patients may be highly susceptible to the product, even if they are prescribed the usual dosage.
While taking the product, caution should be exercised when engaging in potentially dangerous species activities, and management of vehicles, i.e. for work that requires intense concentration and increased speed psychomotor reactions.