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Why it's used

Indapamide is used to treat high blood pressure, alone or in combination with other blood pressure lowering drugs. Indapamide is also used to treat salt and fluid retention associated with heart failure. Indapamide reduces the contraction of blood vessels by altering the electrolyte levels, mainly calcium. This medicine also dilates blood vessels by activating some hormones.
Indapamide may also be used together with other medicines to treat certain conditions as recommended by the doctor. It is used in combination with Anti-Hypertensive to treat high blood pressure.
When not to use
Indapamide will not work to prevent the development of the dangerous pregnancy complication characterized by high blood pressure (toxemia of pregnancy).
Diuretics
Indapamide is a prescription medicine that belongs to a class of medicines called Diuretics. Diuretics increase the production of urine in the body. This helps removal of water from the body.

How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Indapamide. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
You should keep track of your blood pressure regularly. Share your results with the doctor and discuss if your blood pressure measurements are too low or too high. Your treatment plan may need changes.
Indapamide is eaten with or without food. The doctor may add low salt or low sodium diet, potassium supplements, and potassium-rich diets such as raisins, bananas, prunes, and orange juice in the food of the patients. Indapamide is eaten usually in the morning.
The typical dose of Indapamide is 1.25 mg/day as a single dose in the morning (not more than 5 mg daily).
This medicine is to be used for longer periods of time. Indapamide may be given for long-term use for treatment of high blood pressure. You should continue to use this medicine as directed by the doctor even if you feel well.
Talk to your doctor if you develop new symptoms. Tell your doctor if swelling of the lower layer of the skin, hives, shortness of breath, difficulty in swallowing, severe skin reactions, intense skin rashes, skin redness, severe itching, blisters on the skin, skin peeling, swelling of the skin, Stevens-Johnson Syndrome, irregular heartbeat, inflammation of the pancreas, loss of brain function due to liver disease (hepatic encephalopathy), and inflammation of the liver (hepatitis).
Your doctor may recommend a lower initial dose of this medicine to see the impact of this medicine on the body. Please follow your doctor's directions. Taking a higher dose of this medicine may increase the risk of side-effects. A lower dose of this medicine may be recommended to reduce the risk of side-effects. Older patients may see an increase in the incidence of side-effects with this medicine. As a result, a lower dose may be recommended for older patients.
The safety and effectiveness of using Indapamide in children has not been established. The safety and effectiveness data of this medicine has not been studied yet in children.
Your doctor may request that specific lab tests be performed before you start using Indapamide. You may need to have Sodium test. This medicine may cause low sodium levels in the blood. While using Indapamide, the monitoring of blood sodium level is essential.
You should store Indapamide at 20 to 25°C (68 to 77°F). Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Indapamide for conditions for which it was not prescribed. Do not give Indapamide to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Indapamide

Your dose and how often you take Indapamide will depend on the following factors:

Indapamide Dosage

Dosage for high blood pressure

Adult
  • Recommended: 2.5 mg once daily after four weeks of starting dose based on the patient's response and can be increased up to 5 mg once daily after four weeks based on the patient's response
  • Initial: 1.25 mg daily as a single dose in the morning

Dosage for heart failure

Adult
  • Recommended: 5.0 mg once daily after one week of starting dose based on the patient's response
  • Initial: 2.5 mg daily as a single dose in the morning

Forms

Tablet
Strength: 1.25 mg and 2.5 mg
Film-coated tablet
Strength: 1.25 mg and 2.5 mg

Missed Dose

Take the missed dose as soon as you remember. Skip the missed one if it's time for next dose. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Indapamide?
There is no specific antidote for the overdose of Indapamide. If such symptoms appear, supportive measures for adequate respiration and blood circulation in the heart should be provided. Stomach emptying should be performed by inducing vomiting or cleaning out the contents of the stomach. The use of charcoal, a form of carbon which absorbs the harmful content from the stomach is also recommended. After this, the water and electrolyte balance should be carefully monitored and maintained.
Symptoms of an overdose of Indapamide
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • confusion
  • cramps
  • drowsiness
  • inadequate breathing (depressed respiration)
  • increased or reduced urination
  • low blood pressure
  • low levels of sodium in the blood
  • low potassium levels in the blood
  • nausea
  • non-passage of urine (anuria) due to decreased blood volume (hypovolaemia)
  • stomach and intestinal disorders
  • vertigo
  • vomiting
  • water or electrolyte disturbance
  • weakness
If you think you have overdosed on Indapamide, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Indapamide

Before you use Indapamide, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: sulphonamide derivatives.
Before you use Indapamide, tell your doctor of your medical and health history including the following: liver problems, kidney problems, heart rhythm problems, diabetes, build up of a natural chemical called as porphyrin (porphyria), swelling and pain in joints (gout), thyroid, parathyroid disease, low potassium levels in the blood, photosensitivity reactions, or low sodium levels in the blood.
The use of this medicine may change protein-bound iodine (PBI) level. This medicine may decrease blood PBI levels without any symptoms of thyroid disturbance.
The use of this medicine may change uric acid level. This medicine increases the uric acid level. It is advised to monitor your uric acid level periodically during treatment with this medicine.
The use of Indapamide may change potassium level. This medicine may cause low potassium levels in the blood. It is essential to monitor the potassium levels by means of blood tests.
The use of this medicine may change sodium level. This medicine may cause a low blood sodium level. When using Indapamide, the monitoring of blood sodium level is essential.
The use of Indapamide may change glucose level. This medicine may cause an increase in glucose level in the blood. Blood glucose level should be monitored routinely, during the use of this medicine.
Indapamide can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Indapamide can worsen the sleepiness.
The use of Indapamide during pregnancy should only be when required. There are no well-controlled studies in the pregnant women. Indapamide may cross the placenta and can cause harm to the baby. Use of this medicine may further lead to jaundice, low level of platelets and other side effects in the newborn baby. The use of Indapamide is not safe for use in women who are breastfeeding. If you are breastfeeding a baby, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. Indapamide may pass into the breast milk. Consult with your doctor on the use of Indapamide, if you are trying to conceive.
This medicine may increase your sensitivity to sunlight. If this happens, use a sunscreen and cover your skin when you are outdoors. Limit your time in the sun. If you get a sunburn on your skin, consult with your doctor.
Indapamide may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of low potassium levels in the blood, and low sodium levels in the blood.
The long term treatment of this medicine may cause high blood calcium level (hypercalcemia) and low potassium level in the blood (hypophosphatemia).

What precautions should be taken during Pregnancy and Nursing, and administering Indapamide to Children or the Older Adults?

Pregnant Women

Only When Necessary
Warning: As no well-controlled safety studies in the pregnant women are available with Indapamide, so this medicine can only be used if required.

Breastfeeding

Contraindication
Warning: As Indapamide may pass into the breast milk, so it is inadvisable to use Indapamide while breastfeeding infants.

Younger Adults Population

No Known Risk
Warning: The safety and effectiveness of this medicine have not been established in children.

Older Adults Population

Precaution
Warning: A low dose of this medicine should be recommended while starting treatment in elderly patients.

Indapamide Side-effects

The following side-effects may commonly occur when using Indapamide. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
  • flat and raised bumps on the skin (maculopapular rash)
  • low potassium level
  • skin allergic reactions
Rarely, the use of Indapamide may cause the following side-effects:
The following severe side-effects may also occur when using Indapamide:
  • Symptoms: nervousness, tension, anxiety, agitation depression
  • stomach and intestine disorders
    Symptoms: constipation, diarrhea, vomiting inflammation of the pancreas (pancreatitis)
  • blood and lymphatic system disorders
    Symptoms: low white blood cells level (leukopenia), low level of platelets decreased production of red blood cells (aplastic anemia)
  • liver disorders
    Symptoms: yellowing of the whites of the eyes and skin (jaundice), inflammation of the liver (hepatitis), loss of brain function due to liver disease (hepatic encephalopathy) increased liver enzymes levels
  • allergic reactions
    Symptoms: severe skin reactions, swelling of the outer skin or face, swelling of the lips or tongue, swelling around the eyes, hands or feet, swelling of the mucous membranes of the throat or airways, shortness of breath, difficulty in swallowing, skin rash, reddening, peeling, blistering, and swelling of the skin, worsening of an autoimmune disease (existing acute disseminated lupus erythematosus), swelling of the limbs, blisters on the skin (bullous eruptions) increased skin sensitivity to sunlight (photosensitivity)
  • heart and blood vessels disorders (can be possibly fatal)
    Symptoms: irregular heart beat (arrhythmia), low blood pressure, prolonged heartbeat (Torsade de pointes), fall in blood pressure while standing up from lying position, extra heartbeats (premature ventricular contractions), abnormal electrocardiography (ECG) heart trace, inflammation of blood vessels (vasculitis/necrotizing angiitis) decreased blood volume (hypovolaemia)
  • metabolism and nutrition disorders
    Symptoms: low potassium level, increased level of calcium (hypercalcaemia ), low sodium level, increased level of uric acid in the blood (hyperuricemia), high blood sugar level (hyperglycemia) increased blood pH/alkalosis (secondary compensatory metabolic alkalosis)
  • kidney disorders
    Symptoms: kidney failure
  • respiratory tract disorders
    Symptoms: inflammation of the throat (pharyngitis), inflammation of cavities around the nasal passages (sinusitis), inflammation of the lungs (pneumonitis) build-up of fluid in the lungs (respiratory distress)
Your doctor has prescribed this Indapamide because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Indapamide.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Indapamide by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:
  • hypokalemia
  • maculopapular rash
  • skin allergic reactions

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Older Adults

Following are the side-effects of this medicine in elderly patients:

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:
  • hives
  • inflammation of the blood vessels (vasculitis)
  • itching of the skin
  • swelling around the hands, eyes, or feet
  • swelling of the lips or tongue
  • swelling of the outer skin or face
If such symptoms appear, stop using this medicine and contact the doctor immediately.

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If any of these symptoms appear, stop using this medicine and contact the doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Athletes who are exposed to doping tests

Athletes are at increased risk when using this medicine. An active ingredient of this medicine may give a positive reaction in the results of doping tests, which is used to check the consumption of banned drugs.

Increased levels of blood urea and creatinine in the blood

Elderly patients with disturbed functioning of kidney are at increased risk when using this medicine. These patients may have increased level of blood urea and waste products in blood (creatinine). This medicine can also worsen the existing kidney insufficiency.

High uric acid levels

Patients with high uric acid level (hyperuricemic) are at increased risk when using this medicine. The chances for the occurrence of severe attacks of pain, redness, swelling, and tenderness in the joints (gout attacks) are higher in these patients. It is advised to monitor your uric acid level periodically during treatment with this medicine.

High blood calcium level

Patients who use thiazides and thiazide related diuretics are at increased risk. In these patients, blood calcium level increases due to the decreased excretion of calcium in the urine. Furthermore, it may also be associated with an unrecognized increased level of parathyroid hormone (hyperparathyroidism). This medicine can reduce the level of parathyroid hormone. The treatment with this medicine should be stopped before investigating parathyroid function.

Increased sensitivity to sunlight

Patients who are using thiazides and thiazide related diuretics are at increased risk. These patients may see an increased risk of sensitivity to sunlight. If this happens, stop using Indapamide. If treatment with a diuretic is necessary, then it is advised to protect the exposed areas to the sunlight and artificial ultraviolet light.

Genetic problems

Patients with genetic diseases including Lapp lactose deficiency, decreased absorption of glucose-galactose, fructose or galactose intolerance, and sucrase-isomaltase insufficiency is at increased risk when using this medicinal product due to its other components. These patients should not use this medicinal product.

Liver function disturbance

Patients developing electrolyte imbalance and kidney insufficiency with the use of this medicine are at increased risk. These patients may suffer from loss of brain function due to the damaged liver (hepatic encephalopathy). If this happens, stop using diuretics immediately.

Decreased sodium and potassium levels in the body

Elderly females and patients with a liver problem (cirrhotic patients) are at increased risk when using this medicine. Also, the patients with an irregular heartbeat, heart disease (coronary artery disease) and patients using cardiac glycosides are at risk of developing low blood potassium level. Low levels of sodium may increase the risk of irregular heartbeat. A low starting dose should be used in these patients. When using this medicine, the monitoring of sodium and potassium levels is essential. In the presence of low potassium level in the blood, the control of blood glucose is also necessary for people with diabetes.

Interactions with Indapamide

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Indapamide may interact with lithium, which is used to treat mental disorders. The use of Indapamide with lithium may cause the removal of Indapamide through kidneys and add a high risk due to the increased amount of lithium in the blood. The patients should read the leaflet or prescribing information before using these medicines together.
There may be an interaction of Indapamide with norepinephrine, which is used to treat low blood pressure. When Indapamide is used in combination with norepinephrine, may decrease the responsiveness of norepinephrine to blood vessels.
Indapamide interacts with antiarrhythmic drugs, which are used to treat irregular heartbeat. Class Ia antiarrhythmic drugs (disopyramide, quinidine, hydroquinidine) and class III antiarrhythmic drugs (bretylium, amiodarone, sotalol dofetilide, ibutilide) can cause prolonged heartbeat (Torsade de pointes) in patients with higher risk for the condition of low potassium levels in the blood. If necessary, check low blood potassium level and correct it before using this combination. Blood electrolytes and electrocardiography (ECG) monitoring is also advised. Use such drugs that are not associated with the effect of heartbeat prolongation.
Special instructions need to be followed while taking this medicine along with antipsychotics, which are used to treat mental disorders. The use of Indapamide with antipsychotics such as butyrophenones (haloperidol, droperidol), phenothiazines (cyamemazine, thioridazine, chlorpromazine, levomepromazine, trifluoperazine) and benzamides (sulpiride, amisulpride, tiapride) may cause prolonged heartbeat (Torsade de pointes) in the patients. Low blood potassium is a risk factor. The combined use of these medicines may also increase the blood pressure lowering effect and thus the risk of sudden fall in the blood pressure increases. The patients should be monitored for changes in blood potassium levels, electrolyte level, electrocardiogram before using these medicines together. If low potassium levels are diagnosed, provide treatment and use alternative medicines which do not cause prolongation of the heartbeat.
Your doctor's guidelines may need to be followed while taking this medicine along with angiotensin converting enzyme inhibitors, which are used to treat high blood pressure. The patients with narrow kidney arteries or low sodium level may suffer from a sudden fall in blood pressure or kidney failure while using Indapamide with angiotensin converting enzyme inhibitors. The functioning of kidneys should be monitored during the first few weeks of treatment with an A.C.E inhibitor. In patients with high blood pressure and low sodium level, stop using Indapamide three days before starting treatment with an A.C.E inhibitor. If necessary, then a low initial dose of Indapamide with gradual increase afterward is recommended. In patients with heart failure, a low starting dose of Indapamide may be prescribed.
Indapamide may interact with non-steroidal anti-inflammatory drugs (systemic route), which are used to treat fever, pain and inflammation. These drugs can reduce the blood pressure lowering effect of Indapamide. There are also the risk of acute kidney failure in dehydrated patients. While starting the treatment with Indapamide, hydrate the patient and monitor the functioning of the kidneys.
There may be an interaction of Indapamide with medicines lowering potassium level in the blood. The use of Indapamide with drugs lowering the potassium level in the blood such as stimulant laxatives, an injection of amphotericin B in the vein, tetracosactide, gluco-and mineralocorticoid injection, and digitalis may cause an excessive lowering of potassium level in the patients. The monitoring and suitable treatment for reduction in potassium level is advised. When using Indapamide together with digitalis preparations, monitor electrocardiogram and provide adequate treatment accordingly. The non-stimulant laxatives should be used as an alternate for stimulant laxatives.
Indapamide interacts with baclofen, which is used to treat muscle spasms. When Indapamide is used with baclofen, may increase the blood pressure lowering effect of Indapamide. Such patients should remain hydrated, and the functioning of kidneys should be monitored at start of the treatment.
Special instructions need to be followed while taking this medicine along with potassium-sparing diuretics (amiloride, spironolactone, triamterene), which are used to treat high blood pressure. The blood potassium level may be increased or decreased in patients with diabetes and kidney failure by using these drugs with Indapamide. In such cases, blood potassium level or electrocardiography (ECG) should be monitored. If required, treatment must be reviewed.
Your doctor's guidelines may need to be followed while taking this medicine along with metformin, which is used to treat diabetes. The use of Indapamide with metformin may result in the build-up of acids in the body (lactic acidosis) due to the possibility of kidney failure. The use of metformin in patients with kidney dysfunction (creatinine clearance of more than 15 mg/liter in men and 12 mg/liter in women) is not recommended.
Indapamide may interact with iodinated contrast media, which is used in diagnostic imaging tests. During the treatment with large doses of iodinated contrast media, the risk of acute kidney failure is increased in dehydrated patients. Rehydrate the patients before using iodinated compounds.
There may be an interaction of Indapamide with antidepressants, which are used to treat depression. The use of Indapamide with imipramine like antidepressants (tricyclics), may enhance the blood pressure lowering effect and thus the risk of a sudden fall in the blood pressure also increases.
Indapamide interacts with calcium salts, which are used as dietary supplements. The use of Indapamide with calcium salts may cause an increase in the calcium level (hypercalcemia) resulting from a decrease in the removal of calcium by urine.
Special instructions need to be followed while taking this medicine along with immunosuppressive drugs such as cyclosporine or tacrolimus. The combined use of Indapamide with immunosuppressive drugs such as cyclosporine or tacrolimus may increase the creatinine levels in the blood.
Your doctor's guidelines may need to be followed while taking this medicine along with corticosteroids, which is used to treat inflammation. The combined use of Indapamide with corticosteroids may cause a decrease in the blood pressure lowering effect of Indapamide due to water/ or sodium retention.
This page does not contain all the possible interactions of Indapamide. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Indapamide by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Indapamide be not used?

Patients suffering from diminished urine production (anuria)

The use of this medicine is not recommended in patients suffering from diminished urine production (anuria).

Severe allergy

This medicine should not be used in patients who are severely allergic to Indapamide or other sulfonamide-derived drugs.

Patients with severe kidney failure

The use of this medicine is not recommended in patients with severe kidney failure.

Patients with severe liver dysfunction or loss of brain function due to liver disease (hepatic encephalopathy)

This medicine should not be used in patients with severe liver dysfunction or loss of brain function due to liver disease (hepatic encephalopathy).

Low levels of potassium in the blood

The use of this medicine is not recommended in patients having low potassium levels in the blood.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Indapamide is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Indapamide .
High Blood Pressure
Heart Failure
Heart Diseases
Heart Attack

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