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Indap
Last reviewed: 03.07.2025
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Indap is a diuretic, vasodilator.
Pharmacodynamics
The active ingredient of the drug is indapamide. The drug has antihypertensive properties. In its pharmacological parameters, Indap is similar to thiazide-type diuretics - the mechanism of action is based on the disorder of the reabsorption processes of sodium ions inside the cortical section in the area of the loop of Henle. The drug increases the excretion of chlorine, sodium ions, magnesium, and potassium with urine. The drug selectively blocks slow Ca channels, reduces OPSS, and also increases the elasticity of the vessel walls.
The drug does not affect plasma lipid indices or carbohydrate metabolism – this is important when using the drug in people with diabetes. The drug reduces the sensitivity of the vessel walls to the influence of norepinephrine with angiotensin-2.
The drug stimulates the production of prostaglandin PgI2 and PgE2, reduces the binding of free and stable oxygen radicals. Increased doses of the drug lead to increased diuresis, but at the same time do not affect the severity of the decrease in pressure indicators.
After repeated stable use, the effect of the drug is noted in the 2nd week.
Pharmacokinetics
Suction.
The bioavailability level of the substance is 93%. Peak values in the blood plasma when consuming a 2.5 mg portion are noted after 1-2 hours.
Distribution processes.
The synthesis of the substance with plasma protein is more than 75%.
Half-life is within 14-24 hours (average value is 18 hours).
With continuous use of Indap, its stable plasma indices increase (compared to the level of indapamide after taking a single dose). This index in the blood plasma remains stable for a long time, and no accumulation of the substance occurs.
Excretion.
The clearance values inside the kidneys make up 60-80% of its total values.
The active element is excreted mainly in the form of metabolic products, and another part of it is excreted unchanged - it makes up 5% and is excreted through the kidneys.
Dosing and administration
The medication should be taken orally in the morning.
The size of the initial daily dose for elevated blood pressure is 1.25-2.5 mg (if the non-prolonged form of the drug is used) or 1.5 mg (when using the prolonged form).
If the desired result is not achieved after 1-2 months of therapy, a medication with a different mechanism of therapeutic effect is added to the treatment regimen.
Increasing the dosage of the drug is not advisable, because this increases the severity of side effects, and in addition, increasing the dose does not help achieve the required blood pressure levels.
Use Indapa during pregnancy
Diuretics are prohibited for pregnant women (they also cannot be used to eliminate physiological edema in pregnant women). Diuretics can cause fetoplacental ischemia, which can cause growth retardation in the fetus.
Indapamide should not be used during lactation, because this substance can be excreted in breast milk.
Contraindications
Indap is contraindicated in cases of anuria and hypokalemia, as well as in cases of kidney disease, severe liver dysfunction and hypersensitivity to indapamide.
The medication is not used in decompensated diabetes mellitus, against the background of which ketoacidosis is observed, as well as in cases of acute cerebral circulation disorder, hypolactasia, galactosemia and galactose or glucose malabsorption syndrome.
Caution is required when used in people with moderate liver/renal impairment, ascites, water and electrolyte imbalance, QT prolongation, hyponatremia, coronary heart disease and CHF, Burnett syndrome, hyperuricemia, as well as with urate nephrolithiasis and gout.
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Side effects Indapa
The severity of side effects is mainly determined by the size of the dose of the medication. Possible side effects include:
- manifestations in the digestive system: bowel disorders, nausea, epigastric pain, dyspeptic disorders, gastralgia, dry mouth, problems with appetite and vomiting;
- disorders affecting the function of the nervous system: a feeling of nervousness, irritability, lethargy, drowsiness, tension, as well as anxiety, malaise and severe fatigue. In addition, dizziness, insomnia, vertigo, asthenia, lethargy, headaches, agitation, depression and spasm in the area of muscle fibers appear;
- disorders of the sense organs: development of conjunctivitis and problems with visual perception;
- symptoms from the respiratory system: the occurrence of cough, pharyngitis and runny nose;
- disorders in the cardiovascular system: development of arrhythmia, orthostatic collapse, palpitations and hypokalemia;
- problems with urinary function: the appearance of nocturia or polyuria, and in addition, the frequent development of infections in the urinary system.
Along with this, such disorders as pain in the sternum or back, flu-like syndrome, infections, rhinorrhea, hyperhidrosis and paresthesia in the limbs may be noted. Also observed are problems with potency and libido, allergy symptoms, weight loss, hypochloremia, hyponatremia, glucosuria, hyperglycemia, hypercreatininemia, hyperuricemia and hypercalcemia, as well as an increase in the nitrogen values in urea.
Overdose
Intoxication is manifested by digestive disorders, suppression of respiratory processes, a strong decrease in blood pressure, vomiting, a feeling of weakness, as well as nausea and disturbances in the balance of water and electrolytes. In people with liver cirrhosis, hepatic coma is observed.
To get rid of the disorders, it is necessary to carry out symptomatic procedures in a timely manner, wash the patient's stomach and correct the balance of water and electrolytes. The drug has no antidote.
Interactions with other drugs
Indap increases the lithium ion levels in the blood, weakening the process of their excretion through the kidneys. Lithium can provoke the development of a pronounced nephrotoxic effect. Due to dehydration of the body, there is a potentiation of the damaging effect on the kidneys when using contrast drugs containing iodine. Before performing therapeutic measures, it is necessary to replenish the loss of fluid.
The drug weakens the properties of indirect anticoagulants.
After the use of non-depolarizing muscle relaxants, there is a potentiation of the blockade during the transmission of neuromuscular impulses.
Use with tetracosactide, laxatives, GCS, amphotericin B, glycemic control, loop or thiazide diuretics, and saluretics increases the risk of hypokalemia.
Combination with SG may also increase the risk of developing digitalis poisoning.
Use together with calcium drugs leads to hypercalcemia; together with metformin – to lactic acidosis.
Combination with sultopride, pentamidine, and also astemizole, quinidine, erythromycin, disopyramide and vincamine, as well as terfenadine, amiodarone, antiarrhythmic drugs, sotalol and bretylium tosylate leads to the appearance of pirouette-type arrhythmia due to synergistic effects.
Combination with teracozactide, adrenergic stimulants and GCS leads to a weakening of the antihypertensive effect, and with baclofen it causes the opposite reaction.
When using the drug in combination with ACE inhibitors, the likelihood of acute renal failure increases significantly.
Orthostatic collapse may occur when Indap is combined with imipramine antidepressants, nephroleptics and tricyclics.
The combination of drugs with cyclosporine leads to hypercreatininemia.
Application for children
The drug is prohibited for use in children because there is not enough information regarding its effectiveness and safety when used in this category of patients.
Analogues
The following medications are analogs of the drug: Vasopamide with Indapres, Lorvas and Arifon, as well as Indapamide, Ravel, Indiur, Indapen and Hemopamide.
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Reviews
Indap receives good reviews from doctors - it is considered an effective remedy for eliminating edema and reducing blood pressure. At the same time, doctors insist that the medication must be taken in full. They also remind that the drug does not eliminate problems with blood pressure forever.
Reviews also often note a large number of side effects and contraindications.
Attention!
To simplify the perception of information, this instruction for use of the drug "Indap" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.