Indapamide 20mg
It is a white to yellow-white crystalline tetragonal powder. The oral administration of 2. The oral administration of 5 mg two 2. The half-life of indapamide in whole blood is approximately 14 hours. Indapamide is preferentially and reversibly taken up by the erythrocytes in the peripheral blood. The urinary elimination of 14C-labeled indapamide and metabolites is biphasic with a terminal half-life of excretion of total radioactivity of 26 hours.
In a parallel design double-blind, placebo controlled trial in hypertension, daily doses of indapamide between 1. Athletes The attention of athletes is drawn to the fact that this medicinal product contains a drug substance, which may give a positive reaction in doping tests.
However, if the use of diuretics is necessary, careful monitoring of plasma lithium and dose adjustment are required. Combinations requiring precautions for use Torsades de pointes-inducing drugs - class Ia antiarrhythmics quinidine, hydroquinidine, disopyramide , - class III antiarrhythmics amiodarone, sotalol, dofetilide, ibutilide , - some antipsychotics: Increased risk of ventricular arrhythmias, particularly torsades de pointes hypokalaemia is a risk factor.
Monitor for hypokalaemia and correct, if required, before introducing this combination. Clinical, plasma electrolytes and ECG monitoring. Use substances which do not have the disadvantage of causing torsades de pointes in the presence of hypokalaemia. Risk of acute renal failure in dehydrated patients decreased glomerular filtration.
Hydrate the patient; monitor renal function at the start of treatment. In hypertension, when prior diuretic treatment may have caused sodium depletion, it is necessary: In congestive heart failure, start with a very low dose of ACE inhibitor, possibly after a reduction in the dose of the concomitant hypokalaemic diuretic.
In all cases, monitor renal function plasma creatinine during the first weeks of treatment with an ACE inhibitor. Other compounds causing hypokalaemia: Monitoring of plasma potassium and correction if required. Must be particularly borne in mind in case of concomitant digitalis treatment.
Baclofen Hydrate the patient; monitor renal function at the start of treatment. Digitalis preparations Hypokalaemia predisposing to the toxic effects of digitalis.
Monitoring of plasma potassium and ECG and, if necessary, adjust the treatment. Combinations to be taken into consideration Potassium-sparing diuretics amiloride, spironolactone, triamterene Whilst rational combinations are useful in some patients, hypokalaemia or hyperkalaemia particularly in patients with renal failure or diabetes may still occur.
Plasma potassium and ECG should be monitored and, if necessary, treatment reviewed. If progressive renal impairment is observed in a patient receiving indapamide, withholding or discontinuing diuretic therapy should be considered. Renal function tests should be performed periodically during treatment with indapamide. Impaired Hepatic Function Indapamide, like the thiazides, should be used with caution in patients with impaired hepatic function or progressive liver disease , since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
Glucose Tolerance Latent diabetes may become manifest and insulin requirements in diabetic patients may be altered during thiazide administration. A mean increase in glucose of 6. Serum concentrations of glucose should be monitored routinely during treatment with Lozol indapamide.
Calcium Excretion Calcium excretion is decreased by diuretics pharmacologically related to indapamide. After six to eight weeks of indapamide 1. Prolonged treatment with drugs pharmacologically related to indapamide may in rare instances be associated with hypercalcemia and hypophosphatemia secondary to physiologic changes in the parathyroid gland ; however, the common complications of hyperparathyroidism , such as renal lithiasis, bone resorption , and peptic ulcer , have not been seen.
Treatment should be discontinued before tests for parathyroid function are performed. Like the thiazides, indapamide may decrease serum PBI levels without signs of thyroid disturbance. Interaction With Systemic Lupus Erythematosus Thiazides have exacerbated or activated systemic lupus erythematosus and this possibility should be considered with indapamide as well. Carcinogenesis, Mutagenesis, Impairment of Fertility Both mouse and rat lifetime carcinogenicity studies were conducted.
There was no significant difference in the incidence of tumors between the indapamide-treated animals and the control groups. Postnatal development in rats and mice was unaffected by pretreatment of parent animals during gestation. There are, however, no adequate and well-controlled studies in pregnant women.
Generally, doses of 2. At daily doses of 2. In hypertensive patients, daily doses of 1. The drug decreases peripheral resistance, with little or no effect on cardiac output, rate or rhythm.
Chronic administration of Indapamide to hypertensive patients has little or no effect on glomerular filtration rate or renal plasma flow. Indapamide had an antihypertensive effect in patients with varying degrees of renal impairment, although in general, diuretic effects declined as renal function decreased. In a small number of controlled studies, Indapamide taken with other antihypertensive drugs such as hydralazine, propranolol, guanethidine, and methyldopa, appeared to have the additive effect typical of thiazide-type diuretics.
Indications and Usage for Indapamide Indapamide tablets are indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs. Indapamide tablets are also indicated for the treatment of salt and fluid retention associated with congestive heart failure. Diuretics do not prevent development of toxemia of pregnancy, and there is no satisfactory evidence that they are useful in the treatment of developed toxemia.
Edema during pregnancy may arise from pathological causes or from the physiologic and mechanical consequences of pregnancy. Dependent edema in pregnancy, resulting from restriction of venous return by the expanded uterus, is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary.
There is hypervolemia during normal pregnancy which is not harmful to either the fetus or the mother in the absence of cardiovascular disease , but which is associated with edema, including generalized edema in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances, this edema may cause extreme discomfort which is not relieved by rest. In these cases, a short course of diuretics may provide relief and may be appropriate.
Indapamide, Oral Tablet
Electrolyte determinations are particularly important in patients who are vomiting excessively or receiving parenteral fluids, in patients subject to electrolyte imbalance including those with heart failurekidney disease, and cirrhosisand in patients on a salt-restricted diet. Interference with adequate oral intake of electrolytes will also contribute to hypokalemia. Hypovolaemia, secondary to the loss of water and sodium induced by the diuretic at the start of treatment causes a reduction in glomerular filtration. Dependent edema in pregnancy, resulting buy adipex with mastercard restriction of venous return by the expanded uterus, is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. Thus, patients should be indapamide at the 1. The antihypertensive effect of the drug may be enhanced in the post-sympathectomized patient. Doses of 5 mg and 10 mg were not distinguishable from each other although each was differentiated from placebo and 1. Imipramine-like antidepressants, neuroleptics Antihypertensive effect and increased risk 20mg orthostatic hypotension increased additive effect. In a parallel design double-blind, placebo controlled trial in hypertension, daily doses of Indapamide between 1. Hydrate indapamide patient; monitor renal function at the start of treatment. In severe 20mg, hypotension and depressed respiration may be observed.
Indapamide 2.5mg Tablets
Monitor for hypokalaemia and correct, if required, before introducing this combination. Name of the medicinal product Indapamide 2. Indapamide had an antihypertensive effect in patients indapamide varying degrees of renal impairment, although in general, diuretic effects declined as renal function decreased. Use substances which do not have the disadvantage of causing torsades de pointes in the presence of hypokalaemia. Pharmaceutical form Round, white, film-coated tablet with S6 20mg on one side 4. Thiazide-like diuretics have been shown to increase the urinary excretion of magnesium ; this may result in hypomagnesemia, indapamide 20mg. Renal lisinopril teva pharmaceuticals tests should be performed periodically during treatment with Indapamide. Rehydration before administration of the iodinated indapamide. Detection of hypokalaemia requires its correction. Doses of 5 mg and 10 mg were not distinguishable from each other 20mg each was differentiated from placebo and 1. In a small number of controlled studies, Indapamide taken with other antihypertensive drugs indapamide as hydralazine, propranolol, guanethidine, and methyldopa, appeared to have the additive effect 20mg of thiazide-type diuretics. The half-life of indapamide in whole blood is approximately 14 hours. If progressive renal impairment is observed in a patient receiving Indapamide, indapamide 20mg, withholding or discontinuing diuretic therapy should be considered. Serum concentrations of uric acid should, indapamide, be monitored periodically during treatment. In other parallel design, dose-ranging clinical trials in hypertension and edema, daily doses of indapamide between 0, indapamide 20mg. In general, diuretics should not be given concomitantly with lithium 20mg they reduce its renal clearance and add a high risk of lithium toxicity.