Presentation and Status in Health Basket
30 X 2.5 mg
Adults: The dosage of one tablet, containing 2.5mg indapamide, to be taken daily in the morning.
Renal failure: In severe renal failure (creatinine clearance below 30 ml/min), treatment is contraindicated. Thiazides and related diuretics are fully effective only when renal function is normal or only minimally impaired.
Elderly: As for adults. In the elderly, the plasma creatinine must be adjusted in relation to age, weight and gender. Elderly patients can be treated with indapamide when renal function is normal or only minimally impaired.
Hepatic impairment: In severe hepatic impairment, treatment is contraindicated.
Children and adolescents: Indapamide is not recommended for use in children and adolescents due to a lack of data on safety and efficacy.
The action of indapamide is progressive and the reduction in blood pressure may continue and not reach a maximum until several months after the start of therapy. A larger dose than 2.5mg of indapamide daily is not recommended as there is no appreciable additional anti-hypertensive effect but a diuretic effect may become apparent. If a single daily tablet of indapamide does not achieve a sufficient reduction in blood pressure, another antihypertensive agent may be added; those which have been used in combination with Indapamide include beta-blockers, ACE inhibitors, methyldopa, clonidine and other adrenergic blocking agents.
The co-administration of indapamide with diuretics may cause hypokalaemia and, therefore, is not recommended.
There is no evidence of rebound hypertension on withdrawal of indapamide.
Pamid tablets are for oral administration only.
Hypertension, fluid retention.
– Severe renal failure
– Hepatic encephalopathy or severe impairment of liver function
– Hypersensitivity to sulfonamides, indapamide or any other ingredients
– Recent cerebrovascular accident
Cardiac glycosides, lithium, insulin, oral hypoglycemics, cholestyramine, colestipol. Acetazolamide, corticosteroids, ACTH, carbenoxolone, indapamide, amphotericin. Antiarrhythmics, estrogens, probenecid, sodium chloride, sodium bicarbonate, NSAIDs. Allopurinol, calcium supplements, laxatives, non-depolarizing muscle relaxants.
Pregnancy and Lactation
Pregnancy: As a general rule, the administration of diuretics should be avoided in pregnant women and should never be used to treat physiological oedema of pregnancy. Diuretics can cause foetoplacental ischaemia, with a risk of impaired foetal growth.
Lactation: Breast feeding is inadvisable (Indapamide is excreted in human milk).
Symptoms: Indapamide has been found to be free of toxicity up to 40 mg, i.e. 16 times the therapeutic dose.
Signs of acute poisoning take the form above all of water/electrolyte disturbances (hyponatraemia, hypokalaemia). Clinically, there is a possibility of nausea, vomiting, hypotension, cramps, vertigo, drowsiness, confusion, polyuria or oligouria possibly to the point of anuria (by hypovolaemia).
Management: Initial measures involve the rapid elimination of the ingested substance(s) by gastric washout and/or administration of activated charcoal. Subsequent treatment would be symptomatic, directed at correcting the electrolyte abnormalities in a specialized centre.