indapamide

Therapeutic Classification: antihypertensives, diuretics

Pharmacologic Classification: thiazide like diuretics

REMS

Mild to moderate hypertension.
Edema associated with HF and other causes.

Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule.
Promotes excretion of chloride, potassium, magnesium, and bicarbonate.
May produce arteriolar dilation.

Therapeutic effects:

Lowering of BP in hypertensive patients and diuresis with subsequent mobilization of edema.

Absorption: Well absorbed from the GI tract after oral administration.

Distribution: Widely distributed.

Metabolism/Excretion: Mostly metabolized by the liver. Small amounts (7%) excreted unchanged by the kidneys.

Half-Life: 14–18 hr.

(antihypertensive effect)

ROUTE	ONSET	PEAK	DURATION
PO (single dose)	unknown	24 hr	unknown
PO (multiple dose)	1–2 wk	8–12 wk	up to 8 wk

Contraindicated in:

Hypersensitivity;
Cross-sensitivity with sulfonamides may occur;
Anuria.

Use Cautiously in:

Renal or severe hepatic impairment;
Lactation: May be taken while breastfeeding although higher doses followed by significant diuresis may milk production;
Pedi: Safety not established;
Geri: sensitivity to drug effects.

CV: arrhythmias, hypotension

Derm: photosensitivity, rashes

Endo: hyperglycemia

F and E: hypokalemia, dehydration, hypochloremic alkalosis, hyponatremia, hypovolemia

GI: anorexia, cramping, nausea, vomiting

Metab: hyperuricemia

MS: muscle cramps

Neuro: dizziness, drowsiness, lethargy

Drug-drug:

Additive hypotension with other antihypertensives, nitrates, or acute ingestion of alcohol.
Additive hypokalemia with corticosteroids, amphotericin B, piperacillin, or ticarcillin.
↓excretion of lithium; may cause toxicity.
Hypokalemia may ↑ risk of digoxin toxicity.

Drug-Natural Products:

Licorice and stimulant laxative herbs (aloe, senna) may ↑ risk of potassium depletion.

PO (Adults ): Hypertension: 1.25–5 mg once daily in the morning; may be ↑ at 4-wk intervals up to 5 mg/day. Edema secondary to HF: 2.5 mg once daily in the morning; may be ↑ after 1 wk to 5 mg/day.

(Generic available)

Tablets: 1.25 mg; 2.5 mg

Monitor BP, intake and output, and daily weight and assess feet, legs, and sacral area for edema daily.
Assess patient, especially if taking digoxin, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion; report signs of electrolyte imbalance. Patients taking digoxin have an increased risk of digitalis toxicity due to the potassium-depleting effect of the diuretic.
Assess patient for allergy to sulfonamides.

Lab Test Considerations:

Monitor electrolytes (especially potassium), blood glucose, BUN, serum creatinine, and uric acid levels periodically during therapy. May cause ↓ potassium, sodium, and chloride concentrations. May ↑ serum glucose; diabetic patients may require ↑ oral hypoglycemic or insulin dose. ↑ uric acid level an average of 1.0 mg/100 mL; may precipitate an episode of gout.

Administer in the morning to prevent disruption of sleep cycle.
PO: May be given with food or milk to minimize GI irritation.

Instruct patient to take this medication at the same time each day. Take missed doses as soon as remembered but not just before next dose is due. Do not double doses. Advise patients using indapamide for hypertension to continue taking the medication even if feeling well. Indapamide controls but does not cure hypertension.
- Caution patient to change positions slowly to minimize orthostatic hypotension. This may be potentiated by alcohol.
- Advise patient to use sunscreen (avoid those containing PABA) and protective clothing when in the sun to prevent photosensitivity reactions.
- Instruct patient to follow a diet high in potassium (see Food Sources for Specific Nutrients).
- Advise patient to report muscle weakness, cramps, nausea, or dizziness to health care professional.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products,.
- Emphasize the importance of routine follow-up exams.
Hypertension: Instruct patient and family on proper technique of BP monitoring. Advise them to check BP at least weekly and to report significant changes.
- Encourage patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, regular exercise, smoking cessation, moderation of alcohol consumption, and stress management).

Control of hypertension.
Decrease in edema secondary to HF.

NDC Code

0228- Actavis Pharma, Inc.
- 0228-2571- Indapamide
  - 0228-2571-11- 100 TABLET, FILM COATED in 1 BOTTLE (0228-2571-11)

0228- Actavis Pharma, Inc.
- 0228-2571- Indapamide
  - 0228-2571-96- 1000 TABLET, FILM COATED in 1 BOTTLE (0228-2571-96)

0228- Actavis Pharma, Inc.
- 0228-2597- Indapamide
  - 0228-2597-11- 100 TABLET, FILM COATED in 1 BOTTLE (0228-2597-11)

0228- Actavis Pharma, Inc.
- 0228-2597- Indapamide
  - 0228-2597-96- 1000 TABLET, FILM COATED in 1 BOTTLE (0228-2597-96)

0378- Mylan Pharmaceuticals Inc.
- 0378-0069- Indapamide
  - 0378-0069-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0069-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0069- Indapamide
  - 0378-0069-05- 500 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0069-05)

0378- Mylan Pharmaceuticals Inc.
- 0378-0080- Indapamide
  - 0378-0080-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0080-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0080- Indapamide
  - 0378-0080-10- 1000 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0080-10)

0378- Mylan Pharmaceuticals Inc.
- 0378-0080- Indapamide
  - 0378-0080-77- 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0080-77)

42291- AvKARE, Inc.
- 42291-348- Indapamide
  - 42291-348-90- 90 TABLET, FILM COATED in 1 BOTTLE (42291-348-90)

42291- AvKARE, Inc.
- 42291-349- Indapamide
  - 42291-349-90- 90 TABLET, FILM COATED in 1 BOTTLE (42291-349-90)

43975- Amerigen Pharmaceuticals Inc.
- 43975-217- INDAPAMIDE
  - 43975-217-10- 100 TABLET in 1 BOTTLE (43975-217-10)

43975- Amerigen Pharmaceuticals Inc.
- 43975-217- INDAPAMIDE
  - 43975-217-11- 1000 TABLET in 1 BOTTLE (43975-217-11)

43975- Amerigen Pharmaceuticals Inc.
- 43975-304- INDAPAMIDE
  - 43975-304-10- 100 TABLET in 1 BOTTLE (43975-304-10)

43975- Amerigen Pharmaceuticals Inc.
- 43975-304- INDAPAMIDE
  - 43975-304-11- 1000 TABLET in 1 BOTTLE (43975-304-11)

50090- A-S Medication Solutions
- 50090-0510- Indapamide
  - 50090-0510-0- 90 TABLET, FILM COATED in 1 BOTTLE (50090-0510-0)

51079- Mylan Institutional Inc.
- 51079-868- Indapamide
  - 51079-868-20- 100 BLISTER PACK in 1 CARTON (51079-868-20) > 1 TABLET, FILM COATED in 1 BLISTER PACK (51079-868-01)

51407- Golden State Medical Supply Inc.
- 51407-024- Indapamide
  - 51407-024-01- 100 TABLET, FILM COATED in 1 BOTTLE (51407-024-01)

51407- Golden State Medical Supply Inc.
- 51407-025- Indapamide
  - 51407-025-01- 100 TABLET, FILM COATED in 1 BOTTLE (51407-025-01)

55700- Lake Erie Medical DBA Quality Care Products LLC
- 55700-641- Indapamide
  - 55700-641-90- 90 TABLET, FILM COATED in 1 BOTTLE (55700-641-90)

62559- ANI Pharmaceuticals, Inc.
- 62559-510- Indapamide
  - 62559-510-01- 100 TABLET, FILM COATED in 1 BOTTLE (62559-510-01)

62559- ANI Pharmaceuticals, Inc.
- 62559-511- Indapamide
  - 62559-511-01- 100 TABLET, FILM COATED in 1 BOTTLE (62559-511-01)

63629- Bryant Ranch Prepack
- 63629-7892- Indapamide
  - 63629-7892-1- 30 TABLET, FILM COATED in 1 BOTTLE (63629-7892-1)

68788- Preferred Pharmaceuticals Inc.
- 68788-7247- Indapamide
  - 68788-7247-1- 100 TABLET, FILM COATED in 1 BOTTLE (68788-7247-1)

68788- Preferred Pharmaceuticals Inc.
- 68788-7247- Indapamide
  - 68788-7247-3- 30 TABLET, FILM COATED in 1 BOTTLE (68788-7247-3)

68788- Preferred Pharmaceuticals Inc.
- 68788-7247- Indapamide
  - 68788-7247-6- 60 TABLET, FILM COATED in 1 BOTTLE (68788-7247-6)

68788- Preferred Pharmaceuticals Inc.
- 68788-7247- Indapamide
  - 68788-7247-9- 90 TABLET, FILM COATED in 1 BOTTLE (68788-7247-9)

70518- REMEDYREPACK INC.
- 70518-1324- Indapamide
  - 70518-1324-0- 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (70518-1324-0)

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Canadian Brand Names ⬆ ⬇

Code ⬆