Indapamide is a thiazide-like diuretic[2]drug used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are available. The thiazide-like diuretics (indapamide and chlorthalidone) reduce risk of major cardiovascular events and heart failure in hypertensive patients compared with hydrochlorothiazide with a comparable incidence of adverse events.[3] Both thiazide diuretics and thiazide-like diuretics are effective in reducing risk of stroke.[3][4][5] Both drug classes appear to have comparable rates of adverse effects as other antihypertensives such as angiotensin II receptor blockers and dihydropyridine calcium channel blockers and lesser prevalence of side-effects when compared to ACE-inhibitors and non-dihydropyridine calcium channel blockers.[3][6]
Its indications include hypertension and edema due to congestive heart failure. Indapamide has been shown to reduce stroke rates in people with high blood pressure.[5][9][10] Studies have shown that the blood pressure lowering effects of indapamide in combination with perindopril reduce the rate of stroke in high risk patients (those with a history of high blood pressure, stroke or type two diabetes).[5][10][11] HYVET study showed that indapamide (sustained release), with or without perindopril as antihypertensive treatment in persons 80 years of age or older with sustained systolic blood pressure of 160 mmHg or higher, demonstrated significant reduction in all-cause mortality when treated to a target of 150/80 mmHg, but there was found to be no significant reduction in risk of death from cardiac causes.[5] Two systematic reviews identified that indapamide with or without perindopril significantly reduced all cause mortality in young-elderly patients with a history of stroke, cardiovascular disease and type 2 diabetes mellitus, when greater reductions in mean office blood pressure are achieved, significant cardiovascular benefit was only observed when trials including the >75 years old cohort was included.[5][12][13]
There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.
Adverse effectsedit
Commonly reported adverse events are low potassium levels, fatigue, orthostatic hypotension (an exaggerated decrease in blood pressure upon standing, often associated with syncope), and allergic manifestations.
Symptoms of over dosage would be those associated with a diuretic effect (i.e. electrolyte disturbances), low blood pressure, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.
^"Active substance(s): indapamide" (PDF). List of nationally authorised medicinal products. Human Medicines Evaluation Division, European Medicines Agency. 22 July 2021.[permanent dead link]
^ abcOlde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ (May 2015). "Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis". Hypertension. 65 (5): 1033–1040. doi:10.1161/HYPERTENSIONAHA.114.05122. PMID 25733241.
^"Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party". BMJ. 304 (6824): 405–412. February 1992. doi:10.1136/bmj.304.6824.405. PMC1995577. PMID 1445513.
^ abcdeBeckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. (May 2008). "Treatment of hypertension in patients 80 years of age or older". The New England Journal of Medicine. 358 (18): 1887–1898. doi:10.1056/NEJMoa0801369. PMID 18378519.
^Suchard MA, Schuemie MJ, Krumholz HM, You SC, Chen R, Pratt N, et al. (November 2019). "Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis". Lancet. 394 (10211): 1816–1826. doi:10.1016/s0140-6736(19)32317-7. PMC6924620. PMID 31668726.
^Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 457. ISBN9783527607495.
^World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
^Liu L, Wang Z, Gong L, Zhang Y, Thijs L, Staessen JA, Wang J (November 2009). "Blood pressure reduction for the secondary prevention of stroke: a Chinese trial and a systematic review of the literature". Hypertension Research. 32 (11): 1032–1040. doi:10.1038/hr.2009.139. PMID 19798097.
^ abPROGRESS Collaborative Group (September 2001). "Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack". Lancet. 358 (9287): 1033–1041. doi:10.1016/s0140-6736(01)06178-5. PMID 11589932. S2CID 10053225.
^Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, et al. (September 2007). "Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial". Lancet. 370 (9590): 829–840. doi:10.1016/s0140-6736(07)61303-8. PMID 17765963. S2CID 21153924.
^Olde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ (May 2015). "Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis". Hypertension. 65 (5): 1033–1040. doi:10.1161/HYPERTENSIONAHA.114.05122. PMID 25733241.
^Chalmers J, Mourad JJ, De Champvallins M, Mancia G (July 2019). "Benefit of Indapamide-Based Treatment on Mortality". Journal of Hypertension. 37: e57. doi:10.1097/01.hjh.0000570928.33807.a8. ISSN 0263-6352.
External linksedit
"Indapamide". Drug Information Portal. U.S. National Library of Medicine.
indapamide, thiazide, like, diuretic, drug, used, treatment, hypertension, well, decompensated, heart, failure, combination, preparations, with, perindopril, inhibitor, antihypertensive, available, thiazide, like, diuretics, indapamide, chlorthalidone, reduce,. Indapamide is a thiazide like diuretic 2 drug used in the treatment of hypertension as well as decompensated heart failure Combination preparations with perindopril an ACE inhibitor antihypertensive are available The thiazide like diuretics indapamide and chlorthalidone reduce risk of major cardiovascular events and heart failure in hypertensive patients compared with hydrochlorothiazide with a comparable incidence of adverse events 3 Both thiazide diuretics and thiazide like diuretics are effective in reducing risk of stroke 3 4 5 Both drug classes appear to have comparable rates of adverse effects as other antihypertensives such as angiotensin II receptor blockers and dihydropyridine calcium channel blockers and lesser prevalence of side effects when compared to ACE inhibitors and non dihydropyridine calcium channel blockers 3 6 IndapamideClinical dataTrade namesLozol NatrilixAHFS Drugs comMonographMedlinePlusa684062PregnancycategoryAU CRoutes ofadministrationBy mouthATC codeC03BA11 WHO Legal statusLegal statusUK POM Prescription only EU Rx only 1 Pharmacokinetic dataProtein binding71 79 MetabolismLiverElimination half life14 18 hoursIdentifiersCAS Number26807 65 8 YPubChem CID3702IUPHAR BPS7203DrugBankDB00808 YChemSpider3574 YUNIIF089I0511LKEGGD00345 YChEMBLChEMBL406 YCompTox Dashboard EPA DTXSID7044633ECHA InfoCard100 043 633Chemical and physical dataFormulaC 16H 16Cl N 3O 3SMolar mass365 83 g mol 13D model JSmol Interactive imageSMILES O S O N c1c Cl ccc c1 C O NN3c2ccccc2CC3CInChI 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 YKey NDDAHWYSQHTHNT UHFFFAOYSA N Y verify It was patented in 1968 and approved for medical use in 1977 7 It is on the World Health Organization s List of Essential Medicines 8 Contents 1 Medical uses 2 Contraindications 3 Adverse effects 4 Interactions 5 Overdose 6 See also 7 References 8 External linksMedical uses editIts indications include hypertension and edema due to congestive heart failure Indapamide has been shown to reduce stroke rates in people with high blood pressure 5 9 10 Studies have shown that the blood pressure lowering effects of indapamide in combination with perindopril reduce the rate of stroke in high risk patients those with a history of high blood pressure stroke or type two diabetes 5 10 11 HYVET study showed that indapamide sustained release with or without perindopril as antihypertensive treatment in persons 80 years of age or older with sustained systolic blood pressure of 160 mmHg or higher demonstrated significant reduction in all cause mortality when treated to a target of 150 80 mmHg but there was found to be no significant reduction in risk of death from cardiac causes 5 Two systematic reviews identified that indapamide with or without perindopril significantly reduced all cause mortality in young elderly patients with a history of stroke cardiovascular disease and type 2 diabetes mellitus when greater reductions in mean office blood pressure are achieved significant cardiovascular benefit was only observed when trials including the gt 75 years old cohort was included 5 12 13 Contraindications editIndapamide 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 Adverse effects editCommonly reported adverse events are low potassium levels fatigue orthostatic hypotension an exaggerated decrease in blood pressure upon standing often associated with syncope and allergic manifestations Monitoring the serum levels of potassium and uric acid is recommended especially in subjects with a predisposition to low levels of potassium in the blood and gout Interactions editCaution is advised in the combination of indapamide with lithium and drugs causing prolonged QT interval on EKG or wave burst arrhythmia i e astemizole bepridil IV erythromycin halofantrine pentamidine sultopride terfenadine and vincamine Overdose editSymptoms of over dosage would be those associated with a diuretic effect i e electrolyte disturbances low blood pressure and muscular weakness Treatment should be symptomatic directed at correcting electrolyte abnormalities See also editPerindopril indapamide a fixed dose combination used for essential hypertensionReferences edit Active substance s indapamide PDF List of nationally authorised medicinal products Human Medicines Evaluation Division European Medicines Agency 22 July 2021 permanent dead link Indapamide at the U S National Library of Medicine Medical Subject Headings MeSH a b c Olde Engberink RH Frenkel WJ van den Bogaard B Brewster LM Vogt L van den Born BJ May 2015 Effects of thiazide type and thiazide like diuretics on cardiovascular events and mortality systematic review and meta analysis Hypertension 65 5 1033 1040 doi 10 1161 HYPERTENSIONAHA 114 05122 PMID 25733241 Medical Research Council trial of treatment of hypertension in older adults principal results MRC Working Party BMJ 304 6824 405 412 February 1992 doi 10 1136 bmj 304 6824 405 PMC 1995577 PMID 1445513 a b c d e Beckett NS Peters R Fletcher AE Staessen JA Liu L Dumitrascu D et al May 2008 Treatment of hypertension in patients 80 years of age or older The New England Journal of Medicine 358 18 1887 1898 doi 10 1056 NEJMoa0801369 PMID 18378519 Suchard MA Schuemie MJ Krumholz HM You SC Chen R Pratt N et al November 2019 Comprehensive comparative effectiveness and safety of first line antihypertensive drug classes a systematic multinational large scale analysis Lancet 394 10211 1816 1826 doi 10 1016 s0140 6736 19 32317 7 PMC 6924620 PMID 31668726 Fischer J Ganellin CR 2006 Analogue based Drug Discovery John Wiley amp Sons p 457 ISBN 9783527607495 World Health Organization 2021 World Health Organization model list of essential medicines 22nd list 2021 Geneva World Health Organization hdl 10665 345533 WHO MHP HPS EML 2021 02 Liu L Wang Z Gong L Zhang Y Thijs L Staessen JA Wang J November 2009 Blood pressure reduction for the secondary prevention of stroke a Chinese trial and a systematic review of the literature Hypertension Research 32 11 1032 1040 doi 10 1038 hr 2009 139 PMID 19798097 a b PROGRESS Collaborative Group September 2001 Randomised trial of a perindopril based blood pressure lowering regimen among 6 105 individuals with previous stroke or transient ischaemic attack Lancet 358 9287 1033 1041 doi 10 1016 s0140 6736 01 06178 5 PMID 11589932 S2CID 10053225 Patel A MacMahon S Chalmers J Neal B Woodward M Billot L et al September 2007 Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus the ADVANCE trial a randomised controlled trial Lancet 370 9590 829 840 doi 10 1016 s0140 6736 07 61303 8 PMID 17765963 S2CID 21153924 Olde Engberink RH Frenkel WJ van den Bogaard B Brewster LM Vogt L van den Born BJ May 2015 Effects of thiazide type and thiazide like diuretics on cardiovascular events and mortality systematic review and meta analysis Hypertension 65 5 1033 1040 doi 10 1161 HYPERTENSIONAHA 114 05122 PMID 25733241 Chalmers J Mourad JJ De Champvallins M Mancia G July 2019 Benefit of Indapamide Based Treatment on Mortality Journal of Hypertension 37 e57 doi 10 1097 01 hjh 0000570928 33807 a8 ISSN 0263 6352 External links edit Indapamide Drug Information Portal U S National Library of Medicine Portal nbsp Medicine Retrieved from https en wikipedia org w index php title Indapamide amp oldid 1213031588, wikipedia, wiki, book, books, library,
