GENERIC NAME: indapamide

BRAND NAME: Lozol

DRUG CLASS AND MECHANISM: Indapamide is a diuretic (water pill) that is primarily used for the treatment of high blood pressure. It works by preventing the kidney from reabsorbing (retaining in the body) salt and water that is destined to be eliminated in the urine. This results in increased urine output (diuresis). Indapamide also is thought to reduce the salt in the smooth muscle of the walls of blood vessels. (The salt ultimately is eliminated in the urine.) The loss of salt from the muscle causes the muscle to relax, and the relaxation of the vessels results in reduced blood pressure. Indapamide was approved by the FDA in 1983.

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 1.25mg and 2.5mg.

STORAGE: All forms should be stored between 15° (59°F) and 30°C (86°F).

PRESCRIBED FOR: Indapamide is used to treat hypertension (high blood pressure). It also is used to eliminate fluid when the body accumulates excess fluid, such as with edema and congestive heart failure.

DOSING: Indapamide is taken as a single daily dose, generally in the morning before breakfast. It can be taken with or without food. Antacids have no effect on the activity of Indapamide.

DRUG INTERACTIONS: Like other diuretics, indapamide can cause hypokalemia (low potassium) and hypomagnesemia (low magnesium). These changes can increase the risk of patients on digoxin (Lanoxin) to toxicity, possibly resulting in fatal arrhythmias. Use of amiodarone (Cordarone) and indapamide can also lead to cardiac arrhythmias.

The ability of the kidney to eliminate lithium is decreased in patients receiving diuretics, including indapamide. The use of these two drugs together could result in lithium toxicity.

PREGNANCY: The use of indapamide in pregnancy has not been well-studied. Risks to the fetus are not well-understood. Physicians may elect to use it if its benefits are judged to outweigh its potential risks.

NURSING MOTHERS: The use of indapamide in nursing mothers has not been studied.

SIDE EFFECTS: Dehydration may occur during indapamide therapy. Hypokalemia (low blood potassium due to elimination of potassium in the urine) is one of the most common adverse effects associated with the thiazide class of diuretics and may cause abnormal cardiac rhythms. The most common symptom associated with hypokalemia is muscle weakness. Patients receiving indapamide may need potassium supplements to prevent hypokalemia. Hypomagnesemia (low blood magnesium) also may occur.

Other possible side effects include excessive loss of sodium (particularly of concern in elderly patients), increased cholesterol (this effect tends to diminish with continued use), increased uric acid concentrations in the blood, dizziness, lightheadedness, headache, blurred vision, tingling of the extremities, nervousness, impotence, rash, photosensitivity (skin rashes due to sunlight), fatigue, irritability, and agitation.