indapamida

Indapamide is a thiazide-like diuretic of the sulfonamide class used to treat essential hypertension and edema associated with congestive heart failure, liver cirrhosis, or nephrotic syndrome. It is typically prescribed as a once-daily oral medication and is available both as a generic and under brand names such as Lozol.

Mechanism of action: Indapamide inhibits the sodium–chloride symporter in the distal convoluted tubule, promoting sodium and water excretion. In addition to its diuretic effect, it has direct vasodilatory properties on vascular smooth muscle, which helps lower peripheral resistance and contribute to blood pressure reduction.

Pharmacokinetics: After oral administration, indapamide is well absorbed with peak plasma levels arising within a few hours. It has a relatively long duration of action, with a half-life around 14 to 18 hours, supporting once-daily dosing. It is largely excreted by the kidneys, with some metabolism in the liver.

Uses and dosing: For hypertension, typical doses range from 1.25 to 2.5 mg once daily, adjusted for response and tolerability. For edema, doses may be higher, though this is less common in modern practice. Indapamide is frequently found in fixed-dose combinations with other antihypertensives.

Adverse effects and precautions: Common adverse effects include electrolyte disturbances (notably hypokalemia and hyponatremia), dehydration, dizziness, and fatigue. It can worsen gout and hyperglycemia in susceptible individuals. Contraindications include hypersensitivity to sulfonamides, anuria, or severe renal impairment. Caution is advised during pregnancy and lactation. Monitoring of electrolytes, uric acid, and glucose is recommended, particularly with long-term use. Interactions include reduced effects with NSAIDs and potential additive hypotension with other antihypertensives.