Adult Dosing

Edema associated with CHF

• Start 2.5 mg PO qam; then increase to 5 mg PO qd after 1 wk if required [Max: 5 mg/day]
• Alt: Start ETAB 1.5 mg PO qd [AU/UK]

Hypertension

• Start 1.25 mg PO qam
• Alt: Start ETAB 1.5 mg PO qd [AU/UK]
• Titrate: Increase to 2.5 mg qd after 4 wks if needed. If satisfactory response does not occur, may further increase after 4 wks to a max of 5 mg/day

Pediatric Dosing

• Safety and efficacy in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of hypertension, alone or in combination with other antihypertensive drugs
• Also indicated for the treatment of salt and fluid retention associated with CHF

• Known hypersensitivity to indapamide or to other sulfonamide-derived drugs
• Anuria
• Severe renal impairment (< 30 mL/min)

• N/A

Renal Dose Adjustment (Based on CrCl)

• Mild to moderate impairment (> 30 mL/min): No dose adjustments
• Severe impairment (< 30 mL/min): Contraindicated
• Anuria: Contraindicated

Hepatic Dose Adjustment

• Hepatic impairment/Progressive liver disease: Caution advised; dose adjustments not defined

See Supplemental Patient Information

• Hypokalemia, hypochloremic alkalosis, dilutional hyponatremia and hyponatremia can occour
• 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
• Discontinue if electrolyte disorders develop rapidly
• Tendency to gout attacks may be increased in hyperuricaemic patients
• Discontinue prior to parathyroid function testing

Cautions: Use cautiously in

• Hepatic impairment/Progressive liver disease (minor alterations in fluid electrolyte balance can precipitate hepatic coma)
• Renal impairment
• Arrhythmias
• Post-sympathectomy
• Fluid and electrolyte imbalance
• Seizure disorder
• Progressive electrolyte abnormalities
• Diabetes mellitus (monitor blood glucose levels)
• SLE (may aggravate symptoms of SLE)
• Hyperurecemia and gout
• Pregnancy
• Lactation
• Elderly patients

Supplemental Patient Information

• Advise patient to consume potassium-rich foods, such as oranges, bananas, potatoes, and spinach
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness

Pregnancy Category:B

Breastfeeding: Safety unknown. Intense diuresis with large doses may decrease breast milk production. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 4 January 2011). Manufacturer advises nursing women receiving indapamide should not breast feed.

• CNS: Asthenia, nervousness, hypertonia, lightheadedness, drowsiness, vertigo, insomnia, depression
• GI: Abdominal Pain, constipation, diarrhea, dyspepsia, nausea, gastric irritation, anorexia, dry mouth, pancreatitis, interstitial nephritis
• CV: Chest pain, orthostatic hypotension, premature ventricular contractions, irregular heart beat, palpitations
• ENDO: Peripheral Edema
• GU: Frequency of urination, nocturia, polyuria, impotence/reduced libido, glycosuria
• RESP: Cough, pharyngitis, sinusitis
• EENT: Conjunctivitis, blurred vision, rhinorrhea
• HEPA: Cholestatic jaundice
• DERM: Rash, hives, pruritus, vasculitis, flushing, tingling of extremities, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis
• METABOLIC: Hyperuricemia, hyperglycemia, hyponatremia, hypochloremia, weight loss
• HEMA: Electrolyte imbalance, necrotizing angiitis, aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia
• MISC: Flu Syndrome, anaphylaxis, photosensitivity

• Diuretic, antihypertensive; increases sodium and water excretion by inhibiting sodium reabsorption in distal tubule; enhances excretion of sodium, chloride, potassium, and water. May cause arteriolar vasodilation
• Extensively metabolized in the liver; CYP450: Unknown
• Renally excreted 70% (7% unchanged); GI tract (probably biliary route): 23%
• Half life: 26 hrs

US Trade Name(s)

• Only generic available

US Availability

indapamide (generic)

• TABS: 1.25, 2.5 mg

Canadian Trade Name(s)

• Lozide

Canadian Availability

indapamide (generic)

• TABS: 1.25, 2.5 mg

Lozide

• TABS: 1.25, 2.5 mg

UK Trade Name(s)

• Ethibide XL
• Natrilix
• Natrilix-SR

UK Availability

indapamide (generic)

• TABS: 2.5 mg

Ethibide XL, Natrilix-SR

• ETABS: 1.5 mg

Natrilix

• TABS: 2.5 mg

Australian Trade Name(s)

• Dapa-Tabs
• Indahexal
• Insig
• Napamide
• Natrilix
• Natrilix-SR

Australian Availability

indapamide (generic)

• TABS: 2.5 mg

Dapa-Tabs, Indahexal, Insig, Napamide, Natrilix

• TABS: 2.5 mg

Natrilix-SR

• ETABS: 1.5 mg

[Outline]

Cardiovascular

Diuretics

Thiazide Diuretics

Pricing data from www.DrugStore.com in U.S.A.

• Indapamide 2.5 MG TABS [Bottle] (MYLAN)
  30 mg = $13.99
  90 mg = $19.97
• Indapamide 1.25 MG TABS [Bottle] (MYLAN)
  90 mg = $15.99
  180 mg = $19.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Indapamide 1.25 MG Oral Tablet (ALPHAPHARM PTY LTD)
• Indapamide 1.25 MG Oral Tablet (Actavis Elizabeth LLC)
• Indapamide 1.25 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Indapamide 1.25 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Indapamide 1.25 MG Oral Tablet (Physicians Total Care, Inc.)
• Indapamide 2.5 MG Oral Tablet (ALPHAPHARM PTY LTD)
• Indapamide 2.5 MG Oral Tablet (Actavis Elizabeth LLC)
• Indapamide 2.5 MG Oral Tablet (Caremark L.L.C.)
• Indapamide 2.5 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Indapamide 2.5 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Indapamide 2.5 MG Oral Tablet (Physicians Total Care, Inc.)
• Lozol 1.25 MG Oral Tablet (Aventis Pharmaceuticals Inc.)