Xipamide

Xipamide is a thiazide-like diuretic used to treat edema associated with conditions such as congestive heart failure, cirrhosis, and nephrotic syndrome, and it may be used in certain cases of essential hypertension. It is typically administered orally.

Xipamide acts on the kidney by inhibiting the sodium-chloride cotransporter in the distal convoluted tubule. This reduces reabsorption of sodium and chloride, leading to increased excretion of water, sodium, and chloride. The diuretic effect contributes to decreased extracellular fluid volume and can help lower blood pressure.

The onset of diuresis generally occurs within a few hours after dosing, with the effect lasting roughly 24 hours. As with other diuretics, the clinical response should be monitored and used in combination with other treatments as needed.

Pharmacokinetically, xipamide is taken by mouth and is primarily excreted by the kidneys, with hepatic metabolism playing a minor role. Dosing is commonly once daily and is adjusted according to renal function and therapeutic response.

Adverse effects include electrolyte disturbances such as hypokalemia and hyponatremia, dehydration, and increased uric acid which can provoke gout. Sensitivity to sunlight and orthostatic hypotension are possible. Drug interactions include reduced diuretic efficacy with NSAIDs and potential additive hypotension with other antihypertensives. Contraindications include anuria and known hypersensitivity to sulfonamides; caution is advised in patients with gout, significant renal impairment, or dehydration.