Indap

The indap is a diuretic, a vasodilator.

Indications of the indapa

It is used to reduce elevated blood pressure values.

[1], [2]

Release form

Release of the medication is carried out in capsules, 10 pieces inside a blister pack. In a pack - 3 such packages.

[3], [4]

Pharmacodynamics

The active element of the drug is indapamide. The drug has antihypertensive properties. According to its pharmacological parameters, the Indap is similar to diuretics of the thiazide type - the mechanism of action is based on the disorder of sodium ions reabsorption inside the cortical part in the loop region of Henle. The medication enhances the excretion of chlorine, sodium ions, magnesium, and also potassium along with urine. The drug selectively blocks slow Ca channels, reduces OPSS, and in addition increases the elasticity of the vessel walls.

The drug does not affect plasma lipids and carbohydrate metabolism - this is important when using drugs in people with diabetes mellitus. Exposure to the drug reduces the sensitivity of the vessel walls with respect to the effect of norepinephrine with angiotensin-2.

The medicament stimulates the production of prostaglandin PgI2 and PgE2, reduces the binding of free, as well as stable oxygen radicals. Elevated portions of drugs lead to increased diuresis, but at the same time do not affect the severity of the decrease in pressure.

After a multiple use stable effect of the effect of the medication is observed on the 2nd week.

[5], [6], [7],

Pharmacokinetics

Suction.

The bioavailability level of the substance is 93%. Peak values within the blood plasma with a 2.5 mg dose are noted after 1-2 hours.

Distribution processes.

Synthesis of a substance with a plasma protein is more than 75%.

The half-life is within 14-24 hours (mean values are 18 hours).

With the constant use of Indap, its stable plasma parameters (in comparison with the level of indapamide after consuming a single dose) increase. This indicator inside the blood plasma retains its stability for a long time, and there is no accumulation of the substance.

Excretion.

The values of clearance within the kidneys are 60-80% of its total indices.

The active element is excreted mainly in the form of metabolic products, and another part of it is excreted unchanged - it is 5% and excreted through the kidneys.

[8], [9], [10], [11], [12], [13],

Dosing and administration

Medication should be taken orally, in the morning.

The size of the initial daily portion at an elevated level of blood pressure is 1.25-2.5 mg (if a non-slow-acting form of the drug is used) or 1.5 mg (with a prolonged form).

In the absence of the required result after 1-2 months of therapy, a medicamental agent is added to the curative scheme, which has a different mechanism of therapeutic effect.

It is not advisable to increase the dosage level of the drug, because it also increases the severity of the side symptoms, and in addition, increasing the dose does not help to achieve the required blood pressure.

[17], [18]

Use of the indapa during pregnancy

Prescribe diuretics for pregnant women is prohibited (you can not also use them to eliminate physiological swelling in pregnant women). Diuretic substances can cause fetoplacental ischemia, because of which the fetus may experience growth retardation.

When lactation indapamide can not be used, because this substance can be excreted together with the mother's milk.

Contraindications

It is forbidden to use Indap for anuria and hypokalemia, but also for kidney disease, severe hepatic disorders, and hypersensitivity to indapamide.

The drug is not used in diabetes mellitus decompensated nature, against which there is ketoacidosis, and in addition to the disorder of cerebral circulation in acute degree, hypolactasia, galactosemia and malabsorption syndrome of galactose or glucose.

Caution is required for people with moderate liver / kidney failure, ascites, water balance disorders and electrolytes, prolongation of the QT interval, hyponatremia, ischemic heart disease and CHF, Bernet's syndrome, hyperuricemia, and urate form of nephrolithiasis and gout.

[14]

Side effects of the indapa

The degree of severity of side symptoms is mainly determined by the size of the portion of the drug. Among the possible violations:

• manifestations in the field of digestive organs: stool disorders, nausea, epigastric pains, dyspeptic disorders, gastralgia, dry mouth mucous membranes, problems with appetite and vomiting;
• disorders affecting the function of the NS: a feeling of nervousness, irritability, lethargy, drowsiness, tension, and besides anxiety, malaise and severe fatigue. In addition, there are dizziness, insomnia, vertigo, asthenia, lethargy, headaches, agitation, depression and spasm in the area of muscle fibers;
• disorders of the sensory organs: development of conjunctivitis and problems with visual perception;
• symptoms from the respiratory system: the occurrence of cough, pharyngitis and a cold;
• disturbances in the SSS area: development of arrhythmia, orthostatic collapse, palpitation and hypokalemia;
• problems with urinary function: the appearance of nocturia or polyuria, and besides this, the frequent development of infections in the area of the urination system.

Along with this, disorders such as pain in the sternum or back, flu-like syndrome, infection, rhinorrhea, hyperhidrosis and paresthesia in the limb region can be noted. There are also problems with potency and libido, allergy symptoms, weight loss, hypochloraemia, hyponatremia, glucosuria, hyperglycemia, hypercreatinemia, hyperuricemia and hypercalcemia, and in addition an increase in nitrogen values in urea.

[15], [16]

Overdose

Intoxication is manifested by disorders of the digestive function, suppression of respiratory processes, a strong decrease in blood pressure, vomiting, a sense of weakness, as well as nausea and impaired balance of water and electrolytes. People with hepatic cirrhosis have a hepatic coma.

To get rid of the disorders, it is necessary to conduct symptomatic procedures in a timely manner, rinse the stomach with the patient and adjust the balance of water and electrolytes. The drug has no antidote.

[19], [20], [21]

Interactions with other drugs

Indap increases the indices of lithium ions inside the blood, weakening the process of their excretion through the kidneys. Lithium may provoke the development of a pronounced nephrotoxic effect. Due to the dehydration of the body, potentiation of the damaging effect on the kidneys is observed when using contrastive drugs containing iodine. Before the implementation of medical measures, it is necessary to fill the loss of fluid.

The drug weakens the properties of anticoagulants of indirect effects.

After using non-depolarizing muscle relaxants, potentiation of the blockade occurs during the transmission of neuromuscular impulses.

Use with tetrakozaktidt, laxative drugs, GCS, amphotericin B, SG, diuretic drugs of loop or thiazide type, as well as with saluretics increases the risk of hypokalemia.

The combination with SG can also increase the likelihood of digitalis poisoning.

Use with calcium medicines leads to hypercalcemia; together with metformin - to acidosis of a milky-acidic nature.

Combination with sultopride, pentamidine, and in addition astemizole, quinidine, erythromycin, disopyramide and vincamine, as well as terfenadine, amiodarone, antiarrhythmic drugs, sotalol and thoracyl tosilate lead to pirouette-type arrhythmias due to synergistic effects.

Combination with terakozaktidom, adrenostimulyatorami and GCS leads to a decrease in the severity of antihypertensive effects, and with baclofen - causes a backlash.

When using a medication in combination with ACE inhibitors, the probability of acute renal insufficiency increases significantly.

Orthostatic collapse can occur when Indap is combined with imipramine antidepressants, nephroliths and tricycles.

Combination of drugs with cyclosporine leads to hypercreatininaemia.

[22], [23]

Storage conditions

The adapter must be kept in a dark and dry place, away from children's access. The temperature is within the limits of 15-25 ° C.

[24], [25], [26]

Shelf life

Indap is allowed to be used for 3 years from the date of release of the therapeutic drug.

[27], [28], [29]

Application for children

The medicine is forbidden to prescribe to children, because there is not enough information about its effectiveness and safety when used in this category of patients.

Analogues

Analogues of the drug are such drugs: Vasopamide with Indapres, Lauras and Arifon, and in addition Indapamid, Ravel, Indir, Indapen and Hemopamide.

[30], [31], [32], [33], [34]

Reviews

Indap receives good reviews of doctors - he is considered an effective tool for eliminating edema and reducing blood pressure. In this case, doctors insist that the medicine must necessarily be drunk a full course. They also remind that the medicine does not eliminate the problems with BP indices forever.

The reviews also often show a large number of adverse symptoms and contraindications.