Indapamide
A thiazide-like diuretic used for high blood pressure and for salt and fluid retention in heart failure.
Drug card
- Class
- Thiazide diuretic
- How it works
- Blocking salt reabsorption in the distal tubule, so more salt and water leave
- Used for
- High blood pressure
- Salt and fluid retention in heart failure
- Known for
- Severe low sodium, mostly in older women
- Low potassium (hypokalemia)
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does indapamide work?
Indapamide, an indoline sulfonamide without the thiazide ring, blocks sodium and chloride reabsorption in the distal tubule and may also relax blood vessels directly. It concentrates in red blood cells, is extensively metabolized (only about 7% leaves unchanged), and has a whole-blood half-life of about 14 hours.
Like other thiazide and thiazide-like diuretics: They block the sodium-chloride cotransporter in the distal convoluted tubule, so more sodium, chloride and water leave in the urine, along with potassium and magnesium, while calcium and uric acid are held back. The lasting fall in blood pressure comes mainly from lower peripheral resistance, by a mechanism that is not fully understood.
Uses
What is indapamide used for?
- High blood pressure
- Salt and fluid retention in heart failure
Side effects
Side effects of indapamide
- Severe low sodium, mostly in older womenKnown forSerious
- Low potassium (hypokalemia)Known forSerious
- Raised uric acid (hyperuricemia)
- Raised blood sugar (hyperglycemia)
- Headache
- Dizziness
- Low blood pressure on standing
- Rash
- Nausea
- Impotence or reduced libido
- Sensitivity to sunlight (photosensitivity)
- PancreatitisSerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Older women are most at risk of severe hyponatremia with hypokalemia, so the lowest dose is used.
- Check potassium, especially with heart rhythm problems or digoxin.
- Diuretics cut lithium clearance, so the pair risks lithium toxicity.
Good to know: An indoline rather than a true thiazide; its label warns most of severe hyponatremia, mostly in older women.
Remember it
A way to remember it
GLUC
- G
- Glucose up
- L
- Lipids up
- U
- Uric acid up
- C
- Calcium up
Think 'hyper-GLUC': thiazides raise blood glucose, lipids, uric acid and calcium, while potassium, sodium and magnesium fall.
A mnemonic widely used in teaching
Its class
Thiazide and thiazide-like diuretics
Other thiazide and thiazide-like diuretics with a card:
Easily mixed up with loop diuretics and mineralocorticoid receptor antagonists.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Blood pressure
Indapamide is one of 27 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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