Consider the instructions for use and contraindications "Indapamide". It is a drug with vasodilatory, diuretic and hypotensive properties. It is produced by several foreign and Russian pharmaceutical companies: Teva (Israel), PRANAPHARM LLC, Valenta Pharmaceuticals OJSC (Russia), German STADA Artsneimittel, Hemofarm (Serbia and Montenegro), Ukrainian JSC Stoma.
Composition and release form
We will talk about the contraindications and side effects of Indapamide below. In the meantime, let's figure out what is in the composition of the medication.
It comes in several forms:
- Capsules that are packaged in blisters of 5, 6, 7, 10, 30 pcs. or in jars of 10, 20, 30, 40, 50, 100 pieces
- Long-acting film-coated tablets - in blister packs of 10 pcs. or 30 pcs. in banks.
- Coated tabletswith modified release - in blister blister packs of 10 and 14 pcs.
This medicine contains an active element - indapamide. Auxiliary components of the capsules are: magnesium stearate, microcrystalline cellulose. Additional substances in the composition of tablets: hypromellose, lactose monohydrate, magnesium stearate, colloidal anhydrous silicon dioxide, polyethylene glycol, croscarmellose sodium, crospovidone, povidone K30, talc, sodium lauryl sulfate. Contraindications "Indapamide" is important to find out in advance.
Pharmacological action
This is a sulfonamide derivative, and its pharmacological action is similar to that of thiazide diuretics. The drug is characterized by diuretic and saluretic effects of moderate severity, due to a slowdown in the reabsorption of sodium, chlorine and, to some extent, potassium and magnesium ions in the proximal tubules of the kidneys and the cortical zone of the distal tubule of the nephron.
This pharmaceutical agent can reduce the tone of smooth arterial muscles, has a vasodilating property, and also provides a decrease in systemic peripheral vascular resistance. These actions of the drug are due to a decrease in the reactivity of the vascular walls to norepinephrine and angiotensin II, the suppression of calcium current in the cells of smooth vascular fibers, and the activation of the production of prostaglandin E2, which is characterized by a vasodilating property.
When using the drug "Indapamide" observedreduction of left ventricular hypertrophy in the heart. The substance has antihypertensive properties when taken in dosages that do not have a significant diuretic effect. For thiazide-like and thiazide diuretics, after increasing a certain dose, the formation of a plateau in the therapeutic effect is characteristic, while the degree of undesirable side effects continues to increase. Therefore, it is not recommended to increase the dose of the drug if a positive effect is not achieved during therapy at the recommended dosage. And, of course, you should remember about the contraindications of Indapamide tablets, which are described below.
Indications for use
Medication is prescribed for the treatment of arterial hypertension. Do not use this drug without consulting a doctor.
List of Indapamide contraindications
The presence of the following pathological conditions must be reported to the attending doctor. The following diseases should be noted as contraindications to Indapamide:
- renal failure (severe form, in the stage of anuria);
- galactosemia;
- hypokalemia;
- severe liver failure (including with encephalopathy);
- impaired glucose/galactose absorption, lactose intolerance;
- co-administration with drugs that prolong the QT interval;
- pregnancy, lactation;
- excessive sensitivity to the composition of the drug, as well as to other sulfonamide derivatives;
- age less than 18 years (effectiveness and safety of usemedicines for this age category have not been established).
Use with care
In general, the contraindications of "Indapamide" must be strictly observed. In addition to the main ones, there are also relative ones. The medicine should be used with caution in the following situations:
- with functional disorders of the liver or kidneys;
- with diabetes mellitus (decompensation stage);
- with hyperuricemia (if accompanied by gout and urate nephrolithiasis);
- in violation of water or electrolyte balance;
- with hyperparathyroidism, with an increased QT interval on the ECG;
- people on antiarrhythmic medications.
Instructions for use
If there are no contraindications to Indapamide tablets, then you must read the instructions before taking them. This medication is taken orally in the morning, once, washed down with liquid and not chewed. Daily dosage - 1 pc. (in the form of tablets with a modified release or prolonged action, as well as capsules). If after 1-2 months of using the drug the necessary therapeutic effect is not observed, it is not recommended to increase the dosage of the drug (due to the high risk of side effects without enhancing antihypertensive effects). In such cases, it is desirable to include other antihypertensive drugs that are not diuretics in the drug regimen.
When taking two different medications, there is no need toadjust dosage. If contraindications are taken into account and the instruction "Indapamide" is studied properly, then the likelihood of developing negative reactions will be less.
Side effects
During therapy with this medication, some pathological conditions may develop:
- Heart and blood vessels: orthostatic hypotension, ECG abnormalities (hypokalemia), arrhythmia, palpitations.
- CNS: asthenia, nervousness, cephalgia, dizziness, drowsiness, sleep disturbance, depression, vertigo, malaise, fatigue, severe weakness, muscle spasm, tension, irritability, anxiety.
- Digestive system: abdominal pain, dry mouth, nausea, anorexia, gastralgia, vomiting, constipation, diarrhea, possible hepatic encephalopathy and pancreatitis.
- Urinary system: frequent infectious pathologies, nocturia, polyuria. But, of course, contraindications and side effects of Indapamide are not always interconnected. In some cases, the drug is allowed to be taken, but it still causes negative reactions in the body.
- Respiratory organs: pharyngitis, sinusitis, rhinitis, cough.
- Hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis, bone marrow aplasia and hemolytic type anemia.
- Laboratory indicators: hyperuricemia, hypercalcemia, hypokalemia, hyponatremia, hyperglycemia, hypochloremia, increased nitrogen and plasma urea, hypercreatininemia, glycosuria.
- Allergic reactions: rashes, hemorrhagic vasculitis, itching. Urticaria.
- Other pathological phenomena: exacerbation of lupus erythematosus.
Overdose symptoms
It is important not only to take into account the contraindications to the use of "Indapamide", but also strictly observe the dosage. It is possible to determine the development of a drug overdose state by such signs as oliguria or polyuria up to anuria (as a result of hypovolemia), a sharp decrease in pressure, water and electrolyte changes (hyponatremia, hypokalemia), depression of the respiratory center, drowsiness, lethargy, confusion, convulsive seizures, dizziness, nausea, vomiting. Hepatic coma may occur in patients with cirrhosis of the liver. As a therapy, symptomatic treatment is recommended (gastric lavage, taking sorbents, measures to normalize water and electrolyte balance).
Special Recommendations
Indapamide's indications and contraindications are described in detail in the instructions. Elderly patients and people taking glycosides and laxatives against the background of hyperaldosteronism are advised to regularly monitor the content of creatinine and potassium ions. During therapy with Indapamide, it is necessary to systematically monitor the content of magnesium, sodium and potassium ions in plasma (due to the possibility of developing electrolyte disorders), residual nitrogen, glucose, uric acid, and also the pH level. The initial study of potassium levels is carried out in the first week of treatment. Tohigh-risk categories also include people with a prolonged QT interval on the ECG (congenital type or developed against the background of a certain pathological process).
People with cirrhosis of the liver (mainly edema or ascites associated with the likelihood of metabolic alkalosis, which exacerbates liver encephalopathy), CAD, heart failure, and elderly patients need careful monitoring. Hypercalcemia that developed during the use of the drug may indicate previously undiagnosed hyperparathyroidism.
In addition, it is recommended to control glucose levels in people with diabetes. Significant dehydration can lead to acute kidney failure (reduced glomerular filtration rate). Patients need to compensate for the loss of fluid in the body and, at the beginning of therapeutic measures, control the functionality of the kidneys.
The drug "Indapamide" can give positive results in the implementation of doping control. In case of hyponatremia and arterial hypertension, 3 days before the start of the use of angiotensin-converting enzyme inhibitors, diuretics should be interrupted or initial angiotensin-converting enzyme inhibitors should be used in small dosages. Sulfonamide derivatives can provoke an exacerbation of lupus erythematosus. In some cases, individual phenomena associated with changes in blood pressure are possible during treatment, including when another antihypertensive drug is included in the therapeutic regimen. ATas a result, the ability to drive vehicles and perform tasks that require concentration may be reduced.
Prescription for lactation and pregnancy
The use of the medical product "Indapamide" during pregnancy is not recommended, since its administration can provoke fetoplacental ischemia, which can slow down the development of the fetus. Since the main element of the drug penetrates into mother's milk, it should not be prescribed during lactation. If it is necessary to take the medication by nursing patients, breastfeeding should be suspended. It is better to collect information about contraindications and side effects of Indapamide in advance.
Drug Interactions
When used concomitantly with other medicines, undesirable effects may develop:
- cardiac glycosides plus laxatives, saluretics, tetracosactide, amphotericin B, gluco- and mineralocorticoids: increased likelihood of hypokalemia and digitalis intoxication;
- astemizole, erythromycin, pentamidine, terfenadine, vincamine, sultopride, class I A antiarrhythmic drugs (quinidine, disopyramide) and class III (amiodarone, sotalol): torsade de pointes arrhythmia;
- anti-inflammatory nonsteroidal drugs, tetracosactide, glucocorticosteroids, sympathomimetics: decrease in hypotensive properties;
- tricyclic (imipramine) antidepressants and antipsychotics: increased hypotensive effectsand increased likelihood of orthostatic hypotension;
- calcium preparations: the likelihood of developing hypercalcemia;
- Metformin: likely to increase symptoms of lactic acidosis;
- cyclosporine: risk of hypercreatininemia;
- high-dose iodine-containing contrast agents: risk of developing renal dysfunction and dehydration (it is recommended to restore fluid loss before the introduction of iodine-containing substances);
- angiotensin-converting enzyme inhibitors: risk of developing acute renal failure and arterial hypotension (especially with diagnosed renal artery stenosis);
- baclofen: increased hypotensive effect;
- indirect anticoagulants (coumarin or indandione derivatives): suppression of their effect (dose adjustment required);
- potassium-sparing diuretics: occurrence of hyper- or hypokalemia;
- non-depolarizing muscle relaxants: blockade of neuromuscular transmissions that develop under their influence increases.
The drug "Indapamide" increases the concentration of lithium ions in the plasma (inhibition of urinary excretion), and lithium, in turn, has a nephrotoxic effect.
Analogues
Among the analogs of the pharmacological agent "Indapamide" it should be noted:
- Indapamid Retard.
- Indapamid-Teva.
- "Arifon Retard".
- Indapamid MV Shtada.
- Ionic.
- Indap.
- Tenzar.
- Lorvas.
- Indapen.
- Indopress.
- "Acrylamide".
- "Hydrochlorothiazide".
- Cyclomethiazide.
- Oxodoline.
Price
On average, the cost of the medical preparation "Indapamide" in the form of capsules varies from 22 to 30 rubles (30 pieces per pack). The price of long-acting tablets is approximately 90-140 rubles (30 pcs.). Modified release tablets cost approximately 100‒107 rubles (30 pcs.).
Find out if Indapamide Retard 1.5 mg has any contraindications.
Means difference
In addition to the classic drug Indapamide, on the shelves of pharmacies you can find the drug Indapamide Retard, 1.5 mg. These funds contain the same active element and have identical indications for use. As for contraindications and side effects, Indapamide Retard has exactly the same as a conventional drug.
However, in some ways these medicines are different, and the most obvious difference is the different manufacturer. Another difference between drugs is the mechanism of release of the main substance. The half-life of drugs also differs, and in view of this, the latter has a prolonged property.
Reviews on contraindications and side effects of "Indapamide"
Not only patients who were prescribed Indapamide, but also medical specialists who say that this medicine should never be takenindependently, without a doctor's prescription. This is due to the fact that in the treatment of hypertension it is necessary to clearly diagnose the disease, choose the right dosage, and minimize the likelihood of negative consequences, which in the case of this drug can be quite serious. Doctors also point out that if it is possible to prescribe another, safer remedy for pressure, it is better not to use this medication.
Patients who took the drug "Indapamide", in the reviews note that in the first stages of treatment, it almost always causes side effects. These are digestive disorders and changes in the functioning of the nervous system, which are characterized by dizziness, drowsiness, excessive weakness and lethargy. Many people have experienced frequent headaches while taking Indapamide. Patients often had dyspeptic disorders and stool disorders. The therapeutic effect, according to patients, was achieved in most cases when taking the medicine.
We reviewed the instructions, indications and contraindications of Indapamide.
