Indap

Indap – anti-hypertensive means, diuretic.

Form of release and structure

Is issued in capsules: the size No. 4, firm gelatinous, with a lid of blue color and the case – white; contents – powder of white or almost white color (can be the pressed column which is breaking up when pressing or to have weight pieces in structure) (on 10 pieces in the blister, on 3 blisters in a cardboard pack).

Active ingredient: индапамид, in 1 capsule – 2,5 mg.

Auxiliary components: the granulated cellulose microcrystallic, silicon dioxide colloid, magnesium stearate, titanium dioxide, starch corn, gelatin, lactoses monohydrate, dye indigo carmine.

Indications to use

Indap – drug for treatment of arterial hypertension.

Contraindications

Absolute:

• Hypopotassemia;
• The anury expressed hepatic (including with encephalopathy) and/or a renal failure;
• Acute disorder of cerebral circulation;
• Lactose intolerance, syndrome of disturbance of absorption of a glucose/galactose, galactosemia;
• Simultaneous use of the drugs extending QT interval;
• Age up to 18 years;
• Pregnancy and lactation;
• Hypersensitivity to components of drug or other derivatives of sulfonamides.

Relative (during treatment by Indap the most careful control of a condition of patients in connection with risk of development of complications is necessary):

• Dekompensirovanny diabetes mellitus;
• Moderate renal and/or liver failure;
• Hyperparathyreosis;
• Coronary heart disease;
• Ascites;
• Lengthening of an interval of QT;
• Chronic heart failure;
• Hyperuricemia (especially if it is followed by an uratny nephrolithiasis and gout), hyponatremia or other disturbances of water and electrolytic exchange.

Route of administration and dosage

Indap it is necessary to accept inside, in the morning, regardless of meal, swallowing of the capsule entirely, washing down with enough water.

The standard daily dose makes 2,5 mg (1 capsule).

If necessary drug can be used in a combination with other anti-hypertensive means (inhibitors of an angiotensin-converting enzyme, blockers of slow calcium channels, beta adrenoblockers). If 4-8 weeks of treatment of desirable therapeutic effect later it is not possible to reach, it is reasonable to add other hypotensive drug which is not diuretic. The dose of an indapamid in this case remains invariable – 2,5 mg of 1 times a day. It is inexpedient to increase Indap's dose as the risk of development of side effects without strengthening of anti-hypertensive effect increases.

Side effects

• From the central nervous system: general weakness, indisposition, slackness, increased fatigue, вертиго, adynamy, tension, nervousness, irritability, headache, drowsiness or sleeplessness, lethargy, depression, agitation, alarm, spasm of muscles;
• From the alimentary system: discomfort in a stomach, dryness in a mouth, a gastralgia, anorexia, a lock or diarrhea, nausea, vomiting, hepatic encephalopathy (at patients with a liver failure);
• From respiratory system: rhinitis; seldom – pharyngitis, cough, sinusitis;
• From an urinary system: polyuria, nocturia, increase in frequency of development of infections;
• From cardiovascular system: heartbeat, arrhythmia, orthostatic hypotension, changes on the electrocardiogram (hypopotassemia);
• From bodies of a hemopoiesis: agranulocytosis, leukopenia, marrow aplasia, thrombocytopenia, hemolitic anemia;
• From sense bodys: vision disorder, conjunctivitis;
• Allergic reactions: rash, itch, urticaria, hemorrhagic vasculitis;
• From laboratory indicators: a hyponatremia, a hypochloraemia, a hyperglycemia, a hyperuricemia, a hypopotassemia, a hypercalcemia, a hypomagnesiemia, a glucosuria, a giperkreatininemiya, increase in an urea nitrogen in a blood plasma;
• Others: thorax pain and in a back, grippopodobny syndrome, perspiration, rhinorrhea, pancreatitis, aggravation of a system lupus erythematosus, decrease in body weight, decrease in a potentiality and/or libido, paresthesia in extremities.

Special instructions

Indap is effective at treatment of the patients with arterial hypertension who are in risk group, i.e. patients with the accompanying pathology, for example, with a diabetes mellitus (easy or moderate severity), a lipidemia, a chronic renal failure.

During therapy it is regularly necessary to control the content of residual nitrogen and uric acid in a blood plasma.

Within the first week of treatment it is necessary to take the first measurement of potassium concentration in blood.

At prolonged treatment development of disturbances of electrolytic exchange, such as hypercalcemia, hyponatremia, gipokhloremichesky alkalosis, hypopotassemia is possible. These disturbances arise at diarrhea and vomiting, at patients with diseases of a liver and chronic heart failure, at the people adhering to an electrolyte-deficient diet more often. For this reason during therapy it is necessary to control electrolytic composition of blood.

Sick diabetes mellitus control of level of glucose in blood, especially in the presence of the accompanying hypopotassemia is necessary.

The patients receiving индапамид have a probability of development of orthostatic hypotension which can be provoked by reception of other antihypertensives, opioid analgetics, barbiturates, alcohol.

The hypopotassemia caused indapamidy can increase toxicity of glycosides. For this reason it is necessary to control the content of creatinine and potassium at elderly people, patients accepting cardiac glycosides or purgatives and at patients with a hyper aldosteronism.

It must be kept in mind that the hypercalcemia which developed in the period of use of Indap can be a consequence of earlier not diagnosed hyperparathyreosis.

Considerable dehydration during treatment can lead the entire period of use of drug to development of an acute renal failure therefore at the beginning of therapy it is necessary to offset water loss, – to control function of kidneys.

At the patients receiving индапамид receiving a positive take when carrying out a drug test is possible.

In need of purpose of inhibitors of an angiotensin-converting enzyme to patients with the arterial hypertension and a hyponatremia which developed owing to reception of diuretics, Indap it is necessary to cancel in 3 days. A bit later reception of diuretic can be resumed.

Indapamid can worsen a current of a system lupus erythematosus.

At patients with an insulin-dependent diabetes mellitus индапамид can increase the need for insulin. At a latent diabetes mellitus it is necessary to control glucose level in blood.

Medicinal interaction

• Lithium drugs: the risk of development of toxic effect of lithium increases (such combination is not recommended);
• Astemizol, сультоприд, pentamidine, Vincaminum, терфенадин, erythromycin (intravenously), antiarrhytmic drugs of the class IA (quinidine, Disopyramidum) and III (бретилиум, Amiodaronum, соталол): hypotensive action of an indapamid is weakened, development of arrhythmia in the pirouette type is possible;
• Glucocorticosteroids, non-steroidal anti-inflammatory drugs, adrenostimulyator, тетракозактид: the hypotensive effect of an indapamid decreases;
• Baclofenum: anti-hypertensive action of an indapamid amplifies;
• Saluretics (loopback, thiazide), glyuko-and mineralokortikosteroida, laxative drugs, cardiac glycosides, Amphotericinum In (intravenously), тетракозактид: the risk of development of a hypopotassemia increases;
• Cardiac glycosides: the probability of development of digitalis intoxication increases;
• Metforminum: aggravation of lactic acidosis is possible;
• Calcium drugs: the risk of development of a hypercalcemia increases;
• Kaliysberegayushchy diuretics: the risk of development hypo - or hyperpotassemias, especially at patients with a renal failure and a diabetes mellitus increases;
• Inhibitors of an angiotensin-converting enzyme: the risk of development of arterial hypotension and/or acute renal failure increases (especially at patients with a renal artery stenosis);
• Tricyclic antidepressants, antipsychotic means: anti-hypertensive action of an indapamid amplifies, the risk of orthostatic hypotension increases;
• Cyclosporine: creatinine level increases in a blood plasma;
• Not depolarizing muscle relaxants: the neuromuscular transmission blockade caused by them amplifies;
• Indirect anticoagulants (derivatives of coumarin or indandion): their efficiency decreases;
• Iodinated contrast agents in high doses (against the background of organism dehydration): the risk of development of a renal failure (before introduction of these means it is necessary to recover liquid loss) increases.

Terms and storage conditions

To store at a temperature of 15-25 ºС in the place protected from light and moisture unavailable to children.

Period of validity – 3 years.