Indapamide patient

In long-term treatment, the thia2ides may produce hypokalemia, hyperglycemia, hypemricemia, and a 5% increase in plasma cholesterol indapamide has been shown not to increase plasma cholesterol or Hpids at therapeutic doses (21—23). The decrease of plasma potassium, ie, hypokalemic effect, is dose-dependent, and can be avoided if high doses are avoided (24,25). Thia2ides can cause hyponatremia in patients with large water intake while on the dmg (26,27) hyponatremia may be associated with nausea, vomiting, and headaches. 

Renal function impairment Use with caution in severe renal disease because these agents may precipitate azotemia. Cumulative effects of the drug may develop in patients with impaired renal function. Monitor renal function periodically. Metolazone is the only thiazide-like diuretic that may produce diuresis in patients with GFR less than 20 mL/min. Indapamide may also be useful in patients with impaired renal function. 

The metabolic effects of indapamide appear to be as common as those of thiazides (SEDA-14, 185 SEDA-15, 216). The metabolic effects of hydrochlorothiazide 25 mg/day and indapamide 2.5 mg/day for 6 months have been compared in a randomized, double-blind study in 44 patients with mild to moderate hypertension (485). There was little difference between the effects of the drugs on a wide range of lipid parameters, glucose, and potassium. The purported metabolic differences with indapamide are unlikely to be of sufficient magnitude to warrant its preferential use in hyperlipidemia. 

Spence JD, Huff M, Barnett PA. Effects of indapamide versus hydrochlorothiazide on plasma lipids and lipoproteins in hypertensive patients a direct comparison. Can J Clin Pharmacol 2000 7(l) 32-7. 

Indapamide Indapamide [in DAP a mide] is a lipid soluble, nonthiazide diuretic that has a long duration of action. At low doses, it shows significant antihypertensive action with minimal diuretic effects. Indapamide is often used in advanced renal failure to stimulate additional diuresis on top of that achieved by loop diuretics. Indapamide is metabolized and excreted by the gastrointestinal tract and the kidneys it therefore is less likely to accumulate in patients with renal failure and may be useful in their treatment. 

Antihypertensive drugs PROGRESS Perindopril indapamide versus placebo after TIA or ischemic stroke in patients with or without hypertension... 

The LIVE (Left ventricular regression, Indapamide Versus Enalapril) study was a 1-year, prospective, randomized, double-blind comparison of modified-release indapamide 1.5 mg and enalapril 20 mg in reducing left ventricular mass in 411 hypertensive patients with left ventricular hypertrophy (9). For equivalent reductions in blood pressure, indapamide was significantly more effective than enalapril in reducing left ventricular mass index. 

One patient had several episodes of fixed drug eruption during treatment with indapamide (5). The diagnosis was confirmed by positive controlled oral challenge. 

Once-daily administration of 2.5 mg of indapamide has shown the drug to be a safe and effective agent to use in lowering blood pressure of hypertensive patients with normal renal function as well as patients with various degrees of renal impairment and those undergoing long-term maintenance hemodialysis (4). Results from clinical trials indicate that indapamide effectively reduces arterial blood pressure in approximately two-thirds of patients with mild to moderate hypertension, is well tolerated and does not induce biochemical abnormalities that constitute cardiovascular risk factors (3). Indapamide has also been shown to produce a clinically significant decrease in edema (5) as well as a reduction in total peripheral resistance (6). 

Indapamide is extensively metabolized to at least 15 different metabolites. Only about 52 is excreted as unchanged drug in the urine (25,29). Several workers have suggested that hydroxylation of the indoline ring with conjugation may be a major route of metabolism (25). The glucuronide and sulphate conjugates of indapamide have been detected in the urine of patients (26). 

One study indicated that indapamide in a single daily dose of 2.5 mg is safe and effective for hypertensive patients with various degrees of renal impairment. 

Indapamide did not significantly affect the function of patients with renal impairment and did not accumulate in the blood. In addition, the calculated half-life for indapamide in hypertensive hemodialysis patients is found to be very similar to the half-life observed in hypertensive patients with normal and compromised renal function (30). No adverse effect of indapamide on renal function is evident in normal volunteers, hypertensive patients or geriatric hypertensive patients after monitoring glomerular filtration rate or effective renal plasma flow (24). 

Metabofism Glucose Indapamide increases the blood glucose concentration, increasing the risk of cardiovascular events. Patients with hypertension inadequately controlled with angiotensin II receptor antagonists were given indapamide 1 mg/day for 3 months and... 

Yamada H, Mishiro Y, Kusunose K, Sata M. Effects of additional administration of low-dose indapamide on patients with hypertension treated with angiotensin II receptor blocker. J Cardiovasc Pharmacol Ther 2010 15(2) 145-50. 

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