indapamide hemihydrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
indapamide hemihydrate: clinical details
Prescribing considerations
- Licensed for essential hypertension in adults; safety and efficacy are not established in children or adolescents.
- Thiazide-like diuretics are fully effective only when renal function is normal or minimally impaired.
- Assess dehydration, postural symptoms and medicines affecting renal function, electrolytes or cardiac rhythm.
- Use particular care in older or malnourished people and in cirrhosis, coronary disease, heart failure, diabetes, hyperuricaemia or prolonged QT.
- Photosensitivity and rare sulfonamide-associated choroidal effusion, transient myopia and acute angle-closure glaucoma are recognised.
Contraindications and cautions
- Hypersensitivity to indapamide, other sulfonamides or a formulation excipient
- Severe renal failure
- Hepatic encephalopathy or severe hepatic impairment
- Existing hypokalaemia
- Selected tablets contain lactose and are unsuitable for certain rare hereditary disorders of galactose metabolism
Monitoring
- Blood pressure and postural symptoms
- Renal function and volume status
- Plasma sodium and potassium before treatment and periodically thereafter
- Magnesium where hypokalaemia is present or refractory, or arrhythmia risk is increased
- Calcium where clinically indicated
- Blood glucose in diabetes and uric acid in people susceptible to gout
- ECG and electrolytes when cardiac glycosides or QT-prolonging medicines are involved
Clinical pharmacology
Indapamide is a lipid-soluble, thiazide-like non-thiazide sulfonamide. Its antihypertensive action includes reduced arteriolar and peripheral resistance. It is rapidly and extensively absorbed, highly protein and erythrocyte bound, and substantially metabolised before renal and gastrointestinal elimination.
Formulation and product differences
- Both selected products are conventional oral tablets containing indapamide hemihydrate; they should not be confused with prolonged-release indapamide products.
- Both contain lactose, but tablet appearance, lactose quantity, coating and other excipients differ.
- Check the product-specific leaflet when excipient allergy, intolerance or swallowing considerations are relevant.
indapamide hemihydrate preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 1.5 mg
Tablet
Route: Oral
Strengths: 2.5 mg
indapamide hemihydrate interactions
Check prescribed, non-prescription and complementary products with a pharmacist or prescriber. Important examples include:
Lithium
Indapamide can increase lithium concentrations and toxicity; the combination is generally avoided or requires close monitoring.
NSAIDs, including ibuprofen
They may reduce blood-pressure control and increase kidney-injury risk, especially during dehydration.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.