Indapamide film-coated tablets 2.5 mg blister No. 30

Pharmacological properties

Indapamide ((rs) - 4-chloro-3-sulfamol-n-(2-methyl-2,3 dihydro-1 n-indol-1-yl) benzamide) is a diuretic, antihypertensive agent of the nonthiazide sulfonamide group. Indapamide causes a decrease in the tone of smooth muscles of the arteries by changing the transmembrane current of calcium ions, a decrease in the sensitivity of the vascular wall to norepinephrine and angiotensin, which leads to a decrease in OPSS. Indapamide stimulates the synthesis of prostaglandin e2, which has a vasodilator and hypotensive effect. It exhibits a moderately pronounced diuretic effect, which is associated with blocking the reabsorption of sodium ions, chlorine, water and, to a lesser extent, potassium and magnesium ions. Indapamide does not disrupt lipid metabolism and does not have a negative effect on carbohydrate metabolism, does not affect the level of total cholesterol and triglycerides, reduces the level of phosphates in the blood serum. The therapeutic effect develops after 7-8 days, the maximum effect - after 4 weeks.

After oral administration, indapamide is rapidly absorbed, the maximum concentration in serum is reached after 2-2.5 hours and is 230-260 ng / ml. Approximately 71-79% of indapamide binds to plasma proteins, mainly to α 1 glycoprotein. Widely distributed in body tissues. Half-life - 14 hours. Metabolized in the liver. Excreted in urine (7% - unchanged within 48 hours, 70% - in the form of metabolites) and bile (about 23%).

Indication

Mild and moderate severity of angina.

Application

Adults - 2.5 mg once a day, preferably in the morning. In case of insufficient hypotensive effect, the dose is increased to 5 mg per day (in one dose in the morning). Increasing the dose of the drug enhances the diuretic effect.

Contraindication

Hypersensitivity to indapamide and other components of the drug, as well as to sulfonamides, acute cerebrovascular disorders, hyperaldosteronism, severe liver and kidney dysfunction, hypokalemia.

Side effects

Headache, increased fatigue, cramps, diarrhea, skin rash, increased urination, in rare cases - orthostatic hypotension.

Special instructions

With special caution, it is prescribed to patients with impaired liver and kidney function. During treatment with the drug, periodic monitoring of serum electrolyte levels is necessary due to the possibility of developing hypokalemia and impaired water and electrolyte balance. Patients with hyperuricemia and gout who use indapamide require periodic monitoring of serum uric acid levels.

During treatment with the drug, clinical manifestations of latent diabetes mellitus are possible, as well as a change in the need for insulin. By lowering blood pressure, the drug may affect the ability to drive vehicles and mechanisms. Indapamide should not be prescribed during pregnancy and breastfeeding.

Interactions

Potentiation of the action of other antihypertensive agents is possible when used simultaneously with indapamide. Do not prescribe simultaneously with lithium preparations, since this increases the risk of developing toxic effects of the latter (due to a decrease in the renal clearance of lithium and an increase in its concentration in the blood plasma). Indapamide may reduce the effectiveness of noradrenaline. Indapamide should not be prescribed with potassium-sparing (spironolactone, amiloride, triamterene) diuretics. Simultaneous use of potassium-sparing diuretics does not exclude the possibility of developing hypokalemia.

Overdose

Possible nausea, vomiting, weakness, impaired function of the digestive tract, impaired water and electrolyte balance, in severe cases - arterial hypotension and respiratory depression. There are no specific antidotes. Perform gastric lavage, correction of water and electrolyte balance.

Storage conditions

In a dry place, protected from light, at a temperature of 15-25 °C.