Indapamide mv pills 1,5mg №30

Active ingredient and dosage form

Indapamide MB modified release coated tablets yellow, round, biconvex; on cross section two layers are visible.
1 pill contains Indapamide 1.5 mg;
Excipients:metacel, lactose, colloidal silicon dioxide (aerosil), Magnesium stearate, hydroxypropyl methyl cellulose, titanium dioxide, polyethylene glycol 4000, talc, tropeolin "O";
30 pills per pack.

Mechanism of action

Indapamide MB - diuretic, antihypertensive drug. Pharmacologically similar to thiazide diuretics (mechanism of action is associated with impaired sodium reabsorption in the cortical segment of the loop of Henle). Increases urinary excretion of sodium and chlorine ions, and to a lesser extent - potassium and magnesium ions. Possessing the ability to selectively block slow Calcium channels, it increases the elasticity of the artery walls and lowers the round fist. Helps to reduce left ventricular hypertrophy. Does not affect the content of lipids in the blood plasma (TG, LDL, HDL) and carbohydrate metabolism (including in patients with concomitant diabetes). Reduces the sensitivity of the vascular wall to norepinephrine (noradrenaline) and angiotensin II, stimulates the synthesis of prostaglandin E2, reduces the production of free and stable oxygen radicals.

The antihypertensive effect persists for 24 hours when the drug is taken 1 time / day, the optimal therapeutic effect develops by the end of the first week of administration.

Arterial hypertension.

Dosage and administration

Tablets are taken orally, without chewing, with a sufficient amount of liquid.
Daily dose Indapamide MB is 1.5 mg (1 tab.) 1 time / day (in the morning).

Adverse reactions

From the digestive system: nausea, anorexia, dry mouth, gastralgia, vomiting, diarrhea, constipation, abdominal pain, may develop hepatic encephalopathy; rarely - pancreatitis.
From the side of the central nervous system: asthenia, nervousness, headache, dizziness, drowsiness, vertigo, insomnia, depression; rarely - increased fatigue, general weakness, malaise, muscle spasm, tension, irritability, anxiety.
Respiratory: cough, pharyngitis, sinusitis; rarely - rhinitis.
Cardiovascular: orthostatic hypotension, ECG changes (hypokalemia), arrhythmia, palpitations.
Urogenital: frequent infections, nocturia, polyuria.
Allergic reactions: rash, urticaria, pruritus, hemorrhagic vasculitis.
From the laboratory indicators: hyperuricemia, hyperglycemia, hypokalemia, hypochloremia, hyponatremia, hypercalciuria, an increase in urea nitrogen in the blood plasma, hypercreatininemia, glycosuria.
Hemic and lymphatic: in rare cases, thrombocytopenia, leukopenia, agranulocytosis, bone marrow aplasia and hemolytic anemia.
Other: exacerbation of systemic lupus erythematosus.

Contraindications

• severe renal failure (anuria stage);
• hypokalemia;
• severe hepatic impairment (including encephalopathy);
• pregnancy;
• lactation period;
• age up to 18 years;
• simultaneous use of drugs that extend the QT interval;
• hypersensitivity to the drug and other sulfonamide derivatives.

WITH caution prescribe the drug for violations of the liver and / or kidneys, impaired water and electrolyte balance, hyperparathyroidism, patients with an increased QT interval on the ECG or receiving combined therapy, diabetes mellitus in the stage of decompensation, hyperuricemia (especially accompanied by gout and urate nephrolithiasis).

When prescribing the drug to patients taking cardiac glycosides, laxative drugs on the background of hyper aldosteronism, as well as elderly people, regular monitoring of the content of potassium ions and creatinine level is shown.

When taking indapamide, the concentration of potassium, sodium, magnesium ions in the blood plasma (electrolyte disturbances), pH, glucose, uric acid and residual nitrogen should be systematically monitored.

The most careful control is shown in patients with cirrhosis of the liver (especially with edema or ascites because of the risk of developing metabolic alkalosis, which intensifies the manifestations of hepatic encephalopathy), as well as in IHD,heart failure and the elderly. Patients with an increased QT interval on an ECG (congenital or developed on the background of any pathological process) also belong to an increased risk group. The first determination of the concentration of potassium ions in the blood should be carried out during the first week of use of the drug.

Hypercalcemia with indapamide may be due to previously undiagnosed hyperparathyroidism.

In patients with diabetes, it is extremely important to control the level of glucose in the blood, especially in the presence of hypokalemia.

Significant dehydration can lead to the development of acute renal failure (reduced glomerular filtration). Patients need to compensate for the loss of water and at the beginning of treatment carefully monitor kidney function.

Indapamide can give a positive result during the doping control.

Patients with arterial hypertension and hyponatremia (due to diuretic administration) should stop receiving diuretics 3 days before taking ACE inhibitors (if necessary, diuretic administration can be resumed a little later), or ACE inhibitors are prescribed in low initial doses.

When prescribing indapamide, it should be borne in mind that sulfonamide derivatives can aggravate the course of systemic lupus erythematosus.

Overdosage

Symptoms: nausea, vomiting, weakness, dysfunction of the gastrointestinal tract, impaired water and electrolyte balance, in some cases - an excessive decrease in blood pressure, respiratory depression. Patients with cirrhosis may develop hepatic coma.
Treatment: gastric lavage, correction of water and electrolyte balance; if necessary, conduct symptomatic therapy. There is no specific antidote.

Storage conditions

Store in a dry, protected from light and out of reach of children at a temperature not exceeding 25 ° C.