Indap is a drug from the group of non-thiazide sulfonamides, which has a diuretic effect, which reduces the tone of the smooth muscles of the arteries and reduces the total peripheral resistance of the vessels. It is used for hypertension.
Release form and composition
Indap dosage form - hard gelatin capsules.
The active ingredient of the drug is indapamide. 1 capsule contains 2.5 mg.
Auxiliary components: magnesium stearate, lactose monohydrate, titanium dioxide, indigo carmine, corn starch, colloidal silicon dioxide, microcrystalline cellulose, gelatin.
Capsules packaged in 10 pieces are sold. in blisters, on 3 blisters in one cardboard pack.
Indications for use
Indap is intended for the treatment of hypertension.
The drug is contraindicated:
- During pregnancy;
- Breastfeeding women;
- Children and teenagers under 18;
- Simultaneously with drugs that extend the QT interval;
- In case of hypersensitivity to indipamide, other sulfonamide derivatives or any auxiliary component.
In addition, Indap should not be taken when:
- Severe renal failure and anuria;
- Acute disorders of cerebral circulation;
- Hepatic failure;
- Lactose intolerance, galactosemia, glucose / galactose absorption disorder syndrome.
During the period of treatment, patients with:
- Moderate renal impairment;
- Diabetes mellitus in decompensation;
- Hyperuricemia, especially if it is accompanied by urate nephrolithiasis and gout;
- Hyponatremia and other disorders of water and electrolyte metabolism;
- Liver disease;
- Mild and moderate chronic renal failure;
- Lengthening the QT interval;
- Chronic heart failure;
Dosing and Administration
Take the drug should be 1 capsule once a day in the morning.
Indap can be used both as monotherapy and in combination with other antihypertensive drugs (ACE inhibitors, slow calcium channel blockers, beta-blockers).
The antihypertensive effect, as a rule, develops by the end of the first week of treatment and persists for a day (in the case of a single dose), reaches its maximum 8-12 weeks after the start of therapy.
Increasing the dose is not recommended, because increased antihypertensive effect is not observed, but increases the risk of side effects. For this reason, if after 4-8 weeks the desired effect is not achieved, at the same time with Indap, another drug is prescribed that is intended for the treatment of hypertension, but is not a diuretic. When taking two drugs at the same time, the dose of Indap is not adjusted.
Possible side effects of the drug:
- On the part of the digestive system: dry mouth, nausea and / or vomiting, gastralgia, abdominal discomfort, constipation or diarrhea, anorexia; in patients with hepatic impairment, hepatic encephalopathy;
- From the side of the central nervous system: lethargy, lethargy, fatigue, vertigo, muscle spasm, nervousness, weakness, tension, headache, irritability, asthenia, agitation, insomnia or drowsiness, dizziness, anxiety, depression;
- On the part of the cardiovascular system: palpitations, arrhythmia, orthostatic hypotension, ECG changes;
- From the senses: visual impairment, conjunctivitis;
- From the side of blood-forming organs: leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplasia of the bone marrow;
- On the part of the respiratory system: cough, rhinitis, sinusitis, pharyngitis;
- On the part of the urinary system: polyuria, nocturia, an increase in the incidence of infections;
- Allergic reactions: rash, pruritus, urticaria, hemorrhagic vasculitis;
- From the laboratory parameters: hypochloremia, hyperuricemia, hyponatremia, hypercalcemia, hyperglycemia, hypercreatininemia, increased plasma urea nitrogen, glycosuria, hypokalemia;
- Other: rhinorrhea, weight loss, pain in the chest and back, exacerbation of systemic lupus erythematosus, flu-like syndrome, sweating, pancreatitis, paresthesia in the limbs, reduced potency and / or libido.
Overdose of indapamide may manifest as water and electrolyte disorders, nausea, vomiting, general weakness, dysfunction of the gastrointestinal tract. In more severe cases, there is an excessive decrease in blood pressure and respiratory depression. In patients with cirrhosis, there is a risk of developing hepatic coma. In case of taking too large doses of Indap, gastric lavage should be done. There is no specific antidote. Further treatment is symptomatic, aimed, inter alia, at the correction of water and electrolyte balance.
Capsules can not be divided into parts or chew, because damage to the integrity of the shell disrupts the process of indapamide release, which is fraught with the release of too much of it, and this, in turn, can lead to rapid absorption of the active substance, violation of the required dose-effect ratio and, as a consequence, the development of uncontrolled side effects.
Due to its good tolerance, Indap can be used to treat arterial hypertension in patients with diabetes mellitus, patients with mild and moderate chronic renal failure, hyperlipidemia. However, it should be borne in mind that when insulin-dependent diabetes mellitus may require an increase in insulin dosage. All patients with this disease need to control blood sugar levels.
Disorders of electrolyte metabolism are most often observed with prolonged use of Indap, in patients with liver diseases, chronic heart failure, as well as with diarrhea and vomiting, adherence to a salt-free diet. These diseases and conditions are the reason for controlling electrolytes in the blood.
During treatment with indapamide, it is necessary to control the concentration of uric acid and residual nitrogen in the plasma. The drug increases the excretion of magnesium in the urine, which is fraught with the development of hypomagnesemia.
Elderly patients, patients with hyper aldosteronism and patients taking cardiac glycosides need control of creatinine and potassium.
Opioid analgesics, barbiturates and ethanol (including alcoholic beverages) should not be taken at the same time as Indap, since with this combination there is a risk of orthostatic hypotension.
Significant dehydration can lead to acute renal failure, so patients must compensate for the loss of water. Monitoring of renal function is necessary at the beginning of treatment
During the doping control, indapamide can give a positive result.
It should be borne in mind that while applying Indap with:
- Astemizole, sultoprid, pentamidine, terfenadine, erythromycin (IV), vincamine, antiarrhythmic drugs IA (quinidine and disopyramide) and class III (amiodarone, bretilium, sotalol) - it is possible that the hypotensive effect of indapamide may weaken and arrhythmia may occur if the type of "pyramide, sotalol) is weakened, and the development of arrhythmia by type" indapamide "and the development of arrhythmia by type" ip, sotalol "is possible;
- Glucocorticosteroids, nonsteroidal anti-inflammatory drugs, adrenostimulants and tetracosactids decrease the hypotensive effect;
- Baclofen - hypotensive effect increases;
- Metformin - possible aggravation of lactic acidosis;
- Antipsychotic drugs and tricyclic antidepressants - the antihypertensive effect may increase, the risk of developing orthostatic hypotension increases;
- Cyclosporin - possible increase in creatinine in the blood;
- With indirect anticoagulants - their effect decreases;
- Non-depolarizing muscle relaxants - increased blockade of neuromuscular transmission.
When Indap is used with lithium preparations, the risk of their toxic effects increases; with calcium preparations - hypercalcemia; with cardiac glycosides - digitalis intoxication; with ACE inhibitors - arterial hypotension and / or acute renal failure (especially in patients with renal artery stenosis); with iodine-containing contrast agents in high doses during dehydration of the body - renal failure; cardiac glycosides, laxatives, loop and thiazide saluretics, gluco-and mineralocorticosteroids, tetracosactids, amphotericin B (w / w) - hypokalemia.
Some patients may have an effective combination of Indap with potassium-sparing diuretics, but the likelihood of hyper- or hypokalemia should not be ruled out, especially in renal failure and diabetes.
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Terms and conditions of storage
Indap's shelf life is 3 years. Store the tablets in their original packaging in a dark place at temperatures up to 25 ºC.