Indapamid

General characteristics. Structure:

Active agent: индапамид 2.5 mg.

Pharmacological properties:

Tiazidopodobny diuretic, anti-hypertensive means. Causes decrease in a tone of smooth muscles of arteries, reduction of OPSS, has also moderate saluretichesky activity caused by disturbance of a reabsorption of ions of sodium, chlorine and water in a cortical segment of a Henle's loop and a proximal gyrose tubule of nephron. Reduction of OPSS is caused by several mechanisms: decrease in sensitivity of a vascular wall to noradrenaline and angiotensin II; increase in synthesis of prostaglandins having vazodilatiruyushchy activity; oppression of inflow of calcium ions to smooth muscle elements of a vascular wall. In therapeutic doses practically does not influence lipidic and carbohydrate metabolism.
The hypotensive effect is shown only at initially raised ABP, develops by the end of the first week and reaches a maximum in 3 months of systematic reception.

Pharmacokinetics. After intake it is quickly and completely absorbed from a GIT, Cmax in plasma is reached in 1-2 h. Linkng with proteins of plasma makes 79%. It is widely distributed in an organism. Does not kumulirut.
T1/2 makes 18 h. 5% - in not changed look are removed by kidneys mainly in the form of metabolites.

Indications to use:

Arterial hypertension; a delay of sodium and water at chronic heart failure.

Route of administration and doses:

Accept inside 2.5 mg 1 time/days (morning). At insufficient expressiveness of hypotensive effect after 2 weeks of treatment the dose is increased to 5-7.5 mg/days.
The maximum daily dose makes 10 mg, divided into 2 receptions (in the first half of day).

Features of use:

With care apply at patients with a diabetes mellitus (control of level of glucose, especially in the presence of a hypopotassemia is necessary), gout (increase in number of attacks is possible), at patients with instructions in the anamnesis on allergic reactions to derivatives of sulfonamides.

In the course of treatment it is necessary to control the level of electrolytes in a blood plasma (potassium, sodium, calcium).

Side effects:

From the alimentary system: nausea, feeling of discomfort or pain in epigastriums.
From TsNS: weakness, fatigue, dizziness, nervousness.
From cardiovascular system: orthostatic hypotension.
From a metabolism: hypopotassemia, hyperuricemia, hyperglycemia, hyponatremia, hypochloraemia.
Allergic reactions: skin manifestations.

Interaction with other medicines:

At simultaneous use of GKS, tetrakozaktid for system use the hypotensive effect owing to a delay of water and ions of sodium under the influence of GKS decreases.

At simultaneous use with APF inhibitors the risk of development of a hyponatremia increases.

At simultaneous use with NPVS (for system use) decrease in hypotensive action of an indapamid is possible. At considerable loss of liquid the acute renal failure can develop (because of sharp decrease in glomerular filtering).

At simultaneous use with drugs of calcium development of a hypercalcemia owing to decrease in excretion of calcium ions with urine is possible.

At simultaneous use with cardiac glycosides, corticosteroids the risk of development of a hypopotassemia increases.

At simultaneous use of means which can cause a hypopotassemia (B Amphotericinum, glyuko-and mineralokortikoida, тетракозактид, the purgatives stimulating an intestines peristaltics) the risk of development of a hypopotassemia increases.

At simultaneous use with tricyclic antidepressants (including with Imipraminum) hypotensive action amplifies and the risk of development of orthostatic hypotension (the additive effect) increases.

At simultaneous use with astemizoly, bepridily, the risk of development of arrhythmia like "pirouette" arises erythromycin (in/in), pentamidine, sultopridy, terfenadiny, Vincaminum, quinidine, Disopyramidum, Amiodaronum, a bretylium tosylate, sotaloly.

At simultaneous use with Baclofenum the hypotensive effect amplifies.

At simultaneous use with galofantriny the probability of emergence of disturbances of a cordial rhythm increases (including ventricular arrhythmia like "pirouette").

At simultaneous use from lithium a carbonate the risk of development of toxic effect of lithium against the background of decrease in its renal clearance increases.

At simultaneous use with Metforminum emergence of lactic acidosis which is connected, apparently, with development of the functional renal failure caused by effect of diuretics (preferential loopback) is possible.

At simultaneous use with cyclosporine increase in content of creatinine in a blood plasma is possible that is observed even at the normal content of water and ions of sodium.

Contraindications:

Acute disorder of cerebral circulation, the expressed renal failures and/or a liver, severe forms of a diabetes mellitus and gout, hypersensitivity to an indapamid.

Use at pregnancy and feeding by a breast
Adequate and well controlled researches of safety of use of an indapamid at pregnancy and in the period of a lactation were not conducted. Use for this category of patients is not recommended.

Use at abnormal liver functions
It is contraindicated at the expressed abnormal liver functions.

Use at renal failures
It is contraindicated at the expressed renal failures.

Overdose:

It is not described.

Storage conditions:

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

Issue conditions:

According to the recipe

Packaging:

Tablets, покр. obol., 2.5 mg: 10, 20, 30, 40 or 50 pieces.