Indapamide is an affordable and effective drug for arterial hypertension. Indapamide (Indapamide)
1. Pharmacological action
Non-potassium-sparing diuretic drug of medium potency. Lowers blood pressure (by reducing vascular tone) and helps to reduce total resistance vascular wall peripheral arteries (due to a decrease in the sensitivity of the vascular wall to the effects of adrenaline and an increase in the synthesis of prostaglandins).downgrade blood pressure observed only when initially increased rates one week after the first dose and reaches its maximum after 3 months of treatment.
After oral administration, the drug is rapidly and completely absorbed, almost completely binding to plasma proteins and reaching its maximum concentration after 2 hours. It does not have the ability to form clusters, It is excreted by the kidneys after 36 hours in the form of decay products.
2. indications for use
- Prolonged increase in blood pressure;
- Phenomena of stagnation of fluid and sodium ions in chronic functional heart failure.
3. How to use
The drug should be used in the morning on an empty stomach, without chewing and grinding with any other accessible way and drinking plenty of warm drinking water.Application Features:
- During the use of the drug, monitoring of the percentage of electrolytes is necessary;
- Increasing the dosage only affects the increase in the diuretic effect of Indapamide;
- Before using the drug, a number of studies should be carried out in order to identify conditions of electrolyte imbalance.
- Diabetes mellitus (the use should be accompanied by constant monitoring of blood glucose levels);
4. Side effects
- Violations digestive system(stool disorders, nausea, inflammation of the pancreas, feeling of dry mouth, functional disorders liver activity)
- Violations nervous system(headache, general weakness, involuntary muscle contractions, muscle pain, fatigue, dizziness);
- Violations respiratory system(inflammation of the paranasal sinuses, inflammation of the larynx, cough);
- Violations of the hematopoietic system (various changes in the percentage of blood cells);
- Violations of cardio-vascular system(violations heart rate, sharp decline blood pressure);
- Various allergic reactions (systemic lupus erythematosus occurring in the acute stage, skin rashes, purpura);
- Violations of various clinical indicators(decrease in the content of potassium ions, increase in the content of calcium ions, decrease in the content of chlorine ions, increase in the content uric acid, delay of the orthostatic reflex (change in pressure with a change in body position)).
5. Contraindications
6. During pregnancy and lactation
Despite the fact that there have been no reliable studies confirming or refuting the negative effect of the drug on the body of the mother or child, the use of Indapamide at all stages of pregnancy Not recommended.If necessary, the drug can be used during breastfeeding only after its complete cessation throughout the treatment, until the complete removal of decay products from the mother's body.
7. Interaction with other drugs
- Simultaneous use with drugs that have a blocking effect on the ACE enzyme, the risk of developing a sharp decrease in the level of sodium ion concentration increases;
- Simultaneous use with hormonal drugs cortical zones of the adrenal glands and anti-inflammatory drugs of a non-steroidal nature, the therapeutic effect of Indapamide associated with a decrease in blood pressure decreases;
- Simultaneous use with drugs containing calcium ions in their composition leads to an increased content of calcium ions in the body;
- Simultaneous use with cardiac glycosides, hormonal preparations of the adrenal cortex or any other drugs that increase the excretion of potassium ions from the body, a decrease in the concentration of potassium ions is observed;
- Simultaneous use with, tricyclic antidepressants leads to increased therapeutic effect Indapamide, associated with lowering blood pressure;
- Simultaneous use with Halofantrine, Terfenadine, Quinidine, Vincamine, Pentamidine, Bepridil, Astemizole, Sotalol, Sultopride, Erythromycin, Disopyramide and Amioradon leads to the development of cardiac arrhythmias;
- simultaneous use with Lithium Carbonate, there is a development side effects associated with high content lithium ions in the body;
- Simultaneous use with Cyclosporine, there is an increase in creatinine levels;
- Simultaneous use with Metformin leads to the development of functional kidney failure and the subsequent development of a shift in acid-base balance to the left.
8. Overdose
Overdose symptoms develop when the drug is used at a dosage that is 40 times the recommended one.- Digestive system disorders (nausea, vomiting);
- Nervous system disorders (drowsiness, dizziness);
- urinary tract disorder ( various violations formation and excretion of urine).
9. Release form
Capsules, 2.5 mg - 10, 14, 20, 24 or 30 pcs.Film-coated tablets, 2.5 mg - 10, 20, 30, 40 or 50 pcs.
Tablets of prolonged action, film-coated, 1.5 mg - 20, 30 or 60 pcs.
10. Storage conditions
There are no special instructions.11. Composition
1 tablet:
- indapamide - 2.5 mg;
- Excipients: pregelatinized starch, microcrystalline cellulose, colloidal silicon dioxide (aerosil), magnesium stearate, hypromellose, macrogol, lactose monohydrate, titanium dioxide.
1 capsule:
- indapamide - 2.5 mg.
12. Terms of dispensing from pharmacies
The drug is released according to the prescription of the attending physician.Found an error? Select it and press Ctrl + Enter
*Instruction for medical use for Indapamide is published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, IT IS NECESSARY TO CONSULT WITH A SPECIALIST
High blood pressure provokes the occurrence of many pathologies and can cause a stroke or heart attack. For effective reduction pressure indicators, doctors often prescribe the drug Indapamide. Complete information about the drug Indapamide and why it is prescribed, will tell the attending physician.
Description of the drug Indapamide
Indapamide is a diuretic that is prescribed to successfully reduce pressure. It is produced in the form of tablets and a substance - a powder. The main active substance is indapamide. Also, the composition includes additional substances that perform various auxiliary functions.
The mechanism of action on the body
Indapamide is prescribed for conditions requiring hypotensive, diuretic and vasodilating effects. The mechanism of action of Indapamide is based on a decrease in the strength of contractions of peripheral vessels. Sodium is excreted in the urine, thereby enhancing the functioning calcium channels, the walls of the arteries become elastic. A medication is prescribed for hypertension, to get rid of edema in chronic heart failure.
Indapamide is prescribed to actively lower blood pressure. After taking it, the therapeutic effect lasts up to 24 hours. Already a week after the start of the reception, stabilization of the condition of the sick person is felt. Maximum result from Indapamide is achieved one month after the start of treatment.
Indications for the appointment of Indapamide
The drug is prescribed for two indications - arterial hypertension, reduced swelling in heart failure. The drug is well tolerated, so Indapamide is also prescribed to patients with diabetes, hyperlipidemia ( high content cholesterol) and chronic renal failure. Because the medication showed good results, it is also prescribed to patients undergoing hemodialysis, or having one kidney.
With high blood pressure the best way will take a diuretic such as indapamide. The agent acts on the body gently, with a cumulative effect, without damaging the blood vessels. Indapamide is prescribed as an independent drug or in complex treatment as additional funds.
Side effects
The drug Indapamide is prescribed only by doctors. Indapamide can cause unwanted side effects, so the specialist must take into account the condition of the patient, his chronic pathologies, the severity of the disease, possible reactions organism.
The main side effects of Indapamide:
- allergic skin rashes;
- dry cough;
- dizziness;
- confusion;
- feeling of fear;
- arrhythmia at rest;
- dryness in the mouth;
- loss of appetite;
- dyspnea;
- bed-wetting;
- data changes clinical picture blood.
If you feel worse, you should stop taking Indapamide, consult a doctor. Taking the medication in a therapeutic dosage prescribed by specialists is well tolerated, does not cause negative changes in the state of health.
Application of Indapamide
How to take the drug Indapamide, the attending physician will indicate. Standard scheme, which is usually prescribed, is a single dose of Indapamide per day. The tablet is swallowed whole, without chewing, washed down with the required volume of liquid. It is better to take Indapamide not on an empty stomach, so as not to provoke irritation of the mucous membrane with chemicals.
If a month after taking the medication there is no positive result, then another drug is prescribed that reduces blood pressure, but not a diuretic.
Contraindications to prescribing the drug
Indapamide has contraindications, therefore, before its use, tests are often taken to monitor the patient's condition. Patients with heart failure require special attention chronic form, liver cirrhosis, ischemia. When Indapamide is prescribed to patients with such diagnoses, the likelihood of metabolic alkalosis and hepatic encephalopathy increases.
Contraindications to the appointment are:
- violation of the formation of urine;
- anuria;
- circulatory disorders in the brain structures;
- low potassium;
- allergy to the components of the drug;
- gout;
- children's age up to 18 years;
- kidney failure.
Indapamide is not prescribed to women during pregnancy, as there are no laboratory research in this group of patients. There is no data on the effect of active substances on fetal development. When breastfeeding, the drug Indapamide is also not prescribed. If it is necessary to treat a nursing woman with this particular drug, breast-feeding stop.
Possibility of overdose
Taking indapamide at a dosage higher than prescribed by doctors can lead to undesirable consequences. An overdose is dangerous for humans, so the dosage prescribed by specialists should be strictly observed. Increased reception Indapamide provokes apathy and severe dizziness, blood pressure is greatly reduced, possibly respiratory depression. Against the background of a violation of the water-salt balance, an accelerated excretion of potassium and sodium will occur. With an increase in the dose of Indapamide, which is prescribed by doctors, a malfunction in the digestive system will begin.
To treat the above symptoms, gastric lavage is usually prescribed. There is no antidote for Indapamide. Washing is prescribed before the appearance clean water instead of vomit. You can give the affected person an enterosorbent, for example, Activated carbon at the rate of 1 tablet per kilogram of body weight. Polysorb, Enterosgel are also suitable (use according to the instructions). If the condition worsens, contact medical care.
Special instructions for the use of Indapamide
Indapamide has a cumulative effect. But if during the month of admission there is no positive result in the treatment, the dosage cannot be exceeded, this will lead to complications. It is necessary to consult with the attending physician, in such cases, a new regimen for taking Indapamide is prescribed.
The best time to take Indapamide is in the morning. At the beginning of taking Indapamide, it is prescribed to drink more water so that there is no disturbance in the balance of electrolytes in the blood. Often in the first days of taking the drug, dizziness, weakness, lethargy are observed. At this time, it is better to refrain from driving vehicles, working at heights that require good attention and reaction.
When Indapamide is prescribed for high blood pressure, patients with diabetes need to adjust the daily dosage of hypoglycemic agents. Patients who take cardiac glycosides are prescribed to regularly monitor blood potassium levels and creatinine.
Similar drugs
Instead of Indapamide, other medicines from the group of drugs are sometimes prescribed, which have a similar composition and mechanism of action. Analogues are appointed by specialists, taking into account possible consequences, foreseeing the reaction of the body.
Similar drugs for Indapamide will be:
Arifon Retard. The active ingredient is indapamide. Assign to elderly patients over 80 years of age, patients with diabetes mellitus. Easy to use, well tolerated, has few side effects. It is not recommended for athletes, as it gives a positive reaction to doping tests. Do not prescribe for co-administration with antidepressants, as it can cause a sharp decrease in blood pressure.
Enziks. The active substance is indapamide. The medication is available in the form of a set of tablets of different sizes. Each has a certain amount active substance. The drug is prescribed for long-term increase blood pressure. A large tablet from the set reduces pressure, a small one is a diuretic. If after a month of taking the drug positive effect does not appear, then prescribe a large dosage. The doctor himself decides whether to strengthen or not diuretic effect drug. During pregnancy and lactation, the drug is not prescribed.
Ionic. The drug is prescribed for high blood pressure, chronic heart failure. Also in the complex treatment of diabetes mellitus and obesity, which are accompanied by high pressure. The active substance is indapamide. Do not prescribe the drug to pregnant, lactating women, since a decrease in potassium increases the risk of developing pathologies in the fetus, and a decrease in blood pressure can cause hypoxia.
Indapen. Main active substance- indapamide. With prolonged use of the drug, it is prescribed to regularly take tests for the content of calcium and sodium levels. Simultaneous reception with antidepressants contributes to a sharp decrease in blood pressure. For athletes, there is a risk of false positive doping tests during treatment. In the first days of therapy, dizziness and weakness are observed, you need to be careful when driving.
Indopress. The main active substance is indapamide. Has a cumulative effect. Positive result achieved with regular use. If it is not possible to achieve a therapeutic effect, an increase in dosage is prescribed. Produced in Ukraine. By lowering blood pressure, dizziness is possible, so driving is not recommended during the entire time of treatment with this medication. Do not prescribe to pregnant and lactating women, children under 18 years of age. Patients over 65 years of age require dose adjustment, monitoring of blood counts.
Synonyms of Indapamide are Indapsan, Indap, Lorvas, Pamid, Indapamide retard. That is, under such names, the same drug can be sold in pharmacies. What can replace original drug prescribed by doctors. But it is better to buy a real medicine than a similar one.
Many of us, having crossed the forty-year milestone, and some of us before reaching it, will find out what high blood pressure is on own experience. Modern pharmaceutical industry replete with all sorts of drugs to help fight this disease. Nobody disputes this fact. It is much more important to find out the cause that led to arterial hypertension and, if possible, eliminate it, but this cannot always be done quickly. In such a situation, the doctor selects individually antihypertensive drug. One of medicines successfully helping to cope with high blood pressure is "Indapamide" (INDAP).
Let's take a closer look at the drug Indapamide - description, instructions, price, contraindications of the drug.
Indapamide - instructions for use
Indapamide is a drug that is used to treat hypertension due to its diuretic action. This effect is achieved due to its wagging on the kidneys and vascular tone.
"Indapamide" changes the permeability of cell membranes for calcium and reduces the contractility of the walls of blood vessels. As a result, expanding small arteries, precardiac workload decreases and blood pressure decreases.
At the level of the kidneys, Indapamide prevents the reabsorption of sodium into the body and does not greatly affect the excretion of potassium, magnesium, and chlorine in the urine. When taking therapeutic doses of the drug, a hypotensive effect is noted without a significant increase in the amount of urine excreted per day.
Description of the drug Indapamide says that it does not change the metabolism of lipids, carbohydrates, including in patients with diabetes. Long-term use drug reduces left ventricular hypertrophy. Indapamide can be used even by patients on chronic hemodialysis.
After indapamide is taken orally, it is rapidly absorbed from gastrointestinal tract. If you drink the drug with food, then the rate of absorption decreases, but does not affect the amount of the drug that has entered the body. Created dosage form Indapamide with prolonged action, which allows a uniform release of the substance within 24 hours. This made it possible to prescribe the drug once a day - in the morning. The maximum concentration of Indapamide in the blood is observed 12 hours after its administration.
Indications for use and doses
The instructions say that the drug is prescribed for the treatment of arterial hypertension. It is taken orally in the morning before meals, one tablet or capsule (1.25 and 2.5 mg) without chewing, with a small amount of water. Indapamide can be prescribed alone or in combination with other antihypertensive drugs. It is not recommended to increase the dose of the drug, its ability to lower blood pressure does not increase from this, and the diuretic effect increases. Has Indapamide contraindications.
Contraindications
Severe renal dysfunction: renal insufficiency, not corrected by hemodialysis, lack of urine (anuria);
abnormal liver function, including with brain damage (hepatic encephalopathy);
allergy to Indapamide and its components;
children under 18;
pregnancy and breastfeeding;
not long ago acute disorder cerebral circulation;
in combination with drugs that increase Q-T interval ECG (cisapride);
low level potassium in the blood;
Side effects
They rarely occur, but they are listed in the instructions:
Nervous system: fast fatiguability, headaches, vertigo (feeling that either objects or the patient himself are in constant motion), muscle pain, weakness;
heart and blood vessels: lowering blood pressure, cardiac arrhythmias;
blood: anemia, decreased platelet count;
a decrease in the blood levels of microelements below the norm and entailing pathological conditions: potassium, sodium, calcium, chlorine;
an increase in the content of uric acid in the body;
digestive system: nausea, dry mouth, constipation, impaired liver function;
allergic reactions: allergic rash, urticaria;
exacerbation of systemic lupus erythematosus;
respiratory system: cough, pharyngitis, sinusitis, frontal sinusitis;
Interactions of Indapamide with others medicines
The drug Indapamide and lithium preparations are not recommended to be used together, it is possible to increase the toxic effect of lithium on the body.
The hypotensive effect of Indapamide can be reduced by its combined use with the following drugs: adrenostimulants, glucocorticoids (prednisolone) and non-steroidal anti-inflammatory drugs.
Taking certain drugs together with Indapamide can reduce the effectiveness of the latter, as well as cause arrhythmia. These are erthromycin, pentamidine, vincamine, sultopyrpd, tarfedin, astemizole, antiarrhythmic drugs(quinidine, disopyramide, amidoran, sotalol, bretilium).
The risk of a decrease in potassium in the blood is increased if Indapamide is combined with diuretics, cardiac glycosides, laxatives, glucocorticoids, amphotericin B.
Antidepressants enhance the ability of Indapamide to lower blood pressure.
The price of Indapamide depends on the manufacturer and weight of the tablet and ranges from 13 to 90 rubles for 20 tablets from 1.5 to 2.5 mg.
Attention!
This instruction in the article is given in free form, before using Indapamide, be sure to consult with your doctor.
Patients with hypertension doctors prescribe diuretics. They help to remove excess fluid from the body.
Indapamide is considered a common drug. It is worth reading the instructions for use before taking the drug.
When is Indapamide prescribed?
The purpose of Indapamide is the treatment of arterial hypertension. The drug is prescribed for persistent high blood pressure, which causes swelling and fluid retention in the body.
With the removal of excess fluid, blood pressure normalizes (decreases).Tablets from pressure Indapamide - a component in the treatment of hypertension. In addition to his doctors prescribe other drugs intended for the treatment of arterial hypertension.
At what pressure does Indapamide help? The drug is prescribed for high blood pressure, which leads to the development of high-grade arterial hypertension. A harbinger of arterial hypertension - blood pressure indicators 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 the hypotensive effect of other drugs.At the same time, diuretic properties are enhanced. Because of this, doctors do not recommend increasing the dosage on their own.
The price of Indapamide averages from 25 to 55 rubles.
Instructions for use and dosage
It is necessary to take Indapamide without chewing and drink plenty of water. Basically, doctors prescribe one tablet per day. One tablet is 2.5 mg. If after a course of treatment, which was 1 - 2 months, the patient does not have a result, then the treatment continues.
Increasing the dosage may result in backfire and complications. In this case, it is worth replacing Indapamide with another drug.
In the complex of treatment, Indapamide is replaced by 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 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 the attending physician. Once a month, the patient should take tests to determine the plasma concentration of creatinine. The body weight, age and sex of the patient are taken into account. The drug is given to patients old age who have normal kidney function.
Indapamide for hypertension
This medicine is a common way to deal with high blood pressure, has a number of advantages. 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, does not increase blood glucose and uric acid. These advantages allow us to consider the drug Indapamide in demand for hypertension.
Indapamide is not considered emergency care for high blood pressure or hypertensive crisis.
Important! Despite the benefits 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 than indapamide. But such drugs have many negative consequences.
According to the results of numerous studies, experts have determined that Indapamide is more effective when taken in combination with drugs. To maintain blood pressure within 120-130/85 millimeters of mercury, doctors prescribe Indapamide with angiotensin-acting drugs.
According to the results of studies, it was determined that Indapamide helps to reduce the risk of heart attacks, strokes and other consequences caused by hypertension.
It is easier for each patient to drink 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 combination medicine. The drug is prescribed to patients diagnosed with hypertension of the first or second degree of development, accompanied by edema. Edema is formed 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 to the bladder);
- an allergic reaction to the active ingredients of this drug;
- metabolic diseases;
- impaired cerebral circulation;
- low concentration of potassium ions in the blood;
Doctors do not recommend taking the drug to pregnant women and during breastfeeding. The active substance of the drug adversely affects 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. especially, this applies to the moment when the patient has a tendency to water-salt changes.
If the doctor prescribes the drug, then the patient donates blood every two weeks so that the doctor can monitor the 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 with a diagnosis cardiovascular failure at the chronic level, coronary heart disease, cirrhosis of the liver, then the patient is under his strict control. The patient is at increased risk of developing metabolic alkalosis and hepatic encephalopathy.
How long is the course of treatment
When patients with hypertension are prescribed antihypertensive drugs, the course of treatment is several weeks. After the blood pressure returns to normal, you can stop taking it.
The attending physician can resolve the issue. To prevent a rebound increase in blood pressure, the patient must observe proper nutrition and all instructions of the attending physician.
The duration of the course is determined by the doctor. For each patient, treatment can last differently. All this depends on individual characteristics body and the degree of hypertension.
Side effect
If you follow all the rules for the use of 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 to below 85 millimeters of mercury), heart rhythm disturbance;
- severe cough, pharyngitis ( infection larynx), sinusitis (inflammation of the mucous membrane in the nasal sinus);
- various violations by circulatory system, a change in normal blood levels;
- all sorts of allergic reactions, rashes on skin and hives.
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 every two weeks it is necessary to take tests that control the content of potassium ion and creatinine in the blood. The doctor systematically monitors the 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.
At risk are patients who have an increased QT interval. 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 an analysis for potassium concentration in the blood a few days after treatment.
In order for the patient to display excess fluid from the body and the blood pressure indicator had normal performance, 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 their glucose levels.
Against the background of dehydration, renal failure develops, 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, then you can restore their intake later. In such situations, doctors prescribe the lowest dose inhibitors. L the drug reduces attentiveness and reaction, so you should not drive a car and exercise during the period of treatment dangerous view activities.
Interaction of Indapamide with drugs
- Violation of the hypotensive action is observed while taking Indapamide with high-dose salicylates and a systemic non-steroidal anti-inflammatory agent.
- When the patient is dehydrated, Indapamide causes kidney failure. In these cases, you need to replenish the fluid.
- The level of lithium in the blood may increase if you take preparations containing a lithium salt with Indapamide. This is due to a decrease in the excretion of elements. If the patient needs to take a complex of drugs, then you need to take tests.
- Glucocorticosteroid and tetracosactide preparations can neutralize the hypotensive effect. This is due to the retention of sodium and water ions in the body.
- Laxatives can cause hyperkalemia. If the doctor prescribes these drugs in combination, then you have to monitor the level of potassium in the blood serum in order to avoid the disease.
- Hyperkalemia can develop due to the combination of diuretics with a diuretic drug that conserves potassium in the body.
- If Indapamide is used together with angiotensin-converting enzyme inhibitors, then acute renal failure and arterial hypertension may develop.
- The level of creatinine in the blood plasma may increase due to the combination of Indapamide with cyclosporine.
- The use of radiopaque agents leads to renal failure.
Taking the drug for a month, he does not give desired results, then in no case increase the dose, otherwise, serious side effects may occur.
Talk to your doctor, he will prescribe another treatment.Indapamide is taken in combination with drugs, the effect becomes pronounced.
The course of treatment with Indapamide is considered one of the longest. You can notice the results in 10-14 days, and maximum effect- in three months. The active substance begins to act a few hours after taking the tablet.
If you notice during treatment adverse reactions then contact your doctor. There are two options to get rid of them:
- The doctor cancels this drug.
- The dosage is reduced.
Often, doctors use the first option, since Indapamide has serious side reactions.
Name:
Indapamide (Indapamidum)
Pharmacological
action:
Diuretic. Indapamide is a substance resembling a thiazide diuretic in structure. It is a sulfonylurea derivative. It is used in the treatment of arterial hypertension.
Due to the peculiarities of the mechanism of action, the drug causes a decrease in blood pressure without a significant effect on the volume of urination. The point of application of the action of Indapamide is the vessels and renal tissue. Due to the high lipophilicity, Indapamide changes the permeability of membranes for calcium, resulting in a decrease in the contractility of the smooth muscle elements of the vascular wall.
Same drug stimulates the formation of vasodilators and blockers of platelet aggregation: prostacyclin PgI2 and prostaglandin PgE2. As a result of the action of the drug, there is a decrease in the total precardiac load, expansion of arterioles and a decrease in blood pressure. In the renal tissue at the level of the cortical layer, the drug 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 excretion of magnesium and potassium is negligible. The hypotensive effect of Indapamide is noticeable at dosages that do not cause a significant increase in diuresis. Therefore, taking the drug 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 mellitus. While taking the drug, there is a decrease in the severity of left ventricular hypertrophy. The hypotensive effect of Indapamide is found even in patients on chronic hemodialysis.
Absorbed from digestive tract quickly and completely. Eating at the same time as the drug slows down the rate of absorption, but does not change the content of the absorbed substance. An improved release form (tablets with prolonged action) provides a uniform release of indapamide at an active substance content of 1.5 mg, which improves the effectiveness of 24-hour blood pressure control.
Indications for
application:
Essential therapy arterial hypertension.
Mode of application:
inside, preferably in the morning, regardless of the meal, 2.5 mg (1 tablet) / with a sufficient amount of liquid.
If after 4-8 weeks of treatment the desired therapeutic effect is not achieved, it is not recommended to increase the dose of the drug (the risk of side effects increases without increasing the antihypertensive effect). Instead, in the schema drug treatment it is recommended to include another antihypertensive drug that is not a diuretic. In cases where treatment must be started with two drugs, the dose of Indapamide remains equal to 2.5 mg in the morning once a day.
From the side of metabolism: hypokalemia, hyponatremia, hypochloremic alkalosis, hypercalcemia, increased plasma urea nitrogen, hypercreatininemia, glucosuria, hyperuricemia, hyperglycemia.
From the digestive system: dryness of the oral mucosa, vomiting, gastralgia, anorexia, discomfort in the abdomen, pancreatitis, constipation or diarrhea, hepatic encephalopathy (against the background of liver failure).
From the side of the central nervous system: asthenia, dizziness, nervousness, headache, drowsiness, fatigue, general weakness, insomnia, depression, tension, irritability, anxiety, lethargy, lethargy, agitation, paresthesia, tingling sensation in the extremities.
From the sense organs: conjunctivitis, blurred vision.
From the respiratory system: rhinitis, cough, pharyngitis, sinusitis.
From the side of the cardiovascular system: orthostatic hypotension, arrhythmia, palpitations, electrocardiogram changes characteristic of hypokalemia.
From the urinary system: nocturia, polyuria, increased incidence of infections.
allergic reactions: skin rash, itching, urticaria, hemorrhagic vasculitis.
Other: flu-like syndrome, pain in chest, malaise, muscle spasm, back pain, decreased libido and potency, rhinorrhea, increased sweating, weight loss, exacerbation of systemic lupus erythematosus, cases of photosensitivity reactions are described.
Contraindications:
Acute violation of cerebral circulation;
- severe renal dysfunction (creatine clearance less than 30 ml / min) and / or liver (including with encephalopathy);
- hypokalemia;
- simultaneous reception drugs that prolong the QT interval;
- pregnancy;
- lactation period;
- age up to 18 years (efficacy and safety have not been established).
The shell of the tablet contains lactose, in connection with this, the drug should not be taken by patients with rare hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption. Hypersensitivity to indapamide, other sulfonamide derivatives or other components of the drug,
Apply the drug with caution in diabetes in the stage of decompensation, hyperuricemia (especially accompanied by gout and urate nephrolithiasis), hyponatremia and other disorders of water and electrolyte metabolism, moderate hepatic and / or renal failure, ascites, coronary disease heart, chronic heart failure, hyperparathyroidism, in debilitated patients and patients with an increased QT interval on the ECG or receiving concomitant therapy with other antiarrhythmic drugs.
Interaction
other medicinal
by other means:
Salicylates V high doses and systemic non-steroidal anti-inflammatory drugs have a negative effect on the effectiveness of the antihypertensive effect of the drug. 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 drugs containing lithium salts, there is an increase in the concentration of lithium in the blood due to a decrease in lithium excretion. This may contribute to the symptoms of an overdose of a lithium-containing drug. If such a combination is justified, then it is necessary to control the level of lithium in the blood.
Under the influence of systemic action tetracosactide and glucocorticosteroids the hypotensive effect of Indapamide is leveled due to the retention of sodium and water ions 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 potassium in the blood serum.
The combination with potassium-sparing diuretics (spironolactone, triamterene, amiloride) causes, especially in patients with renal insufficiency or diabetes, hyperkalemia.
In patients with signs of dehydration, the combination of Indapamide with angiotensin-converting factor inhibitors may 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 combining Indapamide with cardiac glycosides, there is a high risk of toxic effects of the latter. For timely diagnosis of the disorder, it is necessary to monitor the ECG parameters and the content of potassium in the blood serum.
The combination of indapamide with metformin can provoke the development of lactic acidosis due to the occurrence of renal failure.
It is not recommended to combine indapamide with bepridil, astemizole, erythromycin, pentamidine, sotalol, halofanthrinos, quinidine, sultopride, hydroquinidine, disopyramide, vincamine, amiodarone, terfenadine, bretilium, as torsade de points may occur. Harbingers of the development of torsade de points are the prolongation of the P-Q interval, a decrease in heart rate, and hypokalemia. Torsade de points - ventricular polymorphic tachycardia according to the "pirouette" variant - can provoke ventricular fibrillation.
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 hypotrophy.
It is not recommended to prescribe the drug during pregnancy. If the drug must be taken during lactation, breastfeeding is stopped, since the active substance passes into breast milk.
Overdose:
Symptoms: nausea, vomiting, weakness, dysfunction of the gastrointestinal tract, water and electrolyte disorders, lowering blood pressure, dizziness, drowsiness, confusion, respiratory depression, in patients with impaired liver function, hepatic coma may develop.