Indapamide

Indapamide

Systematic (IUPAC) name
4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)-3-sulfamoyl-benzamide
Clinical data
AHFS/Drugs.com	monograph
MedlinePlus	a684062
Pregnancy category	B(US), C (Aus)
Legal status	POMt
Routes of administration	Oral tablet
Pharmacokinetic data
Protein binding	71–79%
Metabolism	Hepatic
Biological half-life	14–18 hours
Identifiers
CAS Number	26807-65-8 Y
ATC code	C03BA11 (WHO)
PubChem	CID: 3702
IUPHAR/BPS	7203
DrugBank	DB00808 Y
ChemSpider	3574 Y
UNII	F089I0511L Y
KEGG	D00345 Y
ChEMBL	CHEMBL406 Y
Chemical data
Formula	C16H16ClN3O3S
Molecular mass	365.835 g/mol
SMILES O=S(=O)(N)c1c(Cl)ccc(c1)C(=O)NN3c2ccccc2CC3C
InChI InChI=1S/C16H16ClN3O3S/c1-10-8-11-4-2-3-5-14(11)20(10)19-16(21)12-6-7-13(17)15(9-12)24(18,22)23/h2-7,9-10H,8H2,1H3,(H,19,21)(H2,18,22,23) Y Key:NDDAHWYSQHTHNT-UHFFFAOYSA-N Y
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Indapamide is a thiazide-like diuretic drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.

Form and composition

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets. It is now also available in SR (sustained release) form.

Indications

Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension.

Dosage and administration

The adult dosage is 1.25 to 5 mg, orally and once daily, usually in the morning.

Contraindications

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level.

There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.

Interactions

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, vincamine).

Precautions

Monitoring of potassium and uric acid serum levels is recommended, especially in subjects with a predisposition or a sensitivity to hypokalemia and in patients with gout.

Adverse effects

Commonly reported adverse events are hypokalemia (low potassium levels), fatigue, orthostatic hypotension (blood pressure decrease on standing up) and allergic manifestations.

Overdosage

Symptoms of overdosage would be those associated with a diuretic effect, i.e. electrolyte disturbances, hypotension, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.