Indapamide-retard

Indapamide-retard is a cardiovascular drug from the category of diuretics of non-iazidic nature with moderate intensity of action. Contains sulfamides.

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Indications Indapamida-retard

It is used for primary hypertension.

[3]

Release form

The substance is released in tablets, 10 pieces each, packed in a blister plate. Inside the packet there are 2 plates with tablets.

[4], [5],

Pharmacodynamics

The drug has diuretic and hypotensive properties. He is a representative of the category of hypotensive / diuretic drugs - indolines (sulfonamide derivative). Has a moderate saluretic and diuretic effect due to the slowing down of the reabsorption of sodium ions inside the cortical loop segment of the nephron, and besides this, the increase in the excretion of sodium ions and chlorine and, in smaller quantities, magnesium and potassium together with urine, which results in an antihypertensive effect.

At the same time, with the development of antihypertensive effects, the effect on the transmembrane movement of ions (primarily calcium) in the smooth muscle vascular cells is very important, as a result of which they relax and peripheral vascular resistance decreases. In addition, Indapamide retard weakens the sensitivity of vascular membranes relative to noradrenaline with angiotensin 2, helps to strengthen the binding of antiaggregational and vasodilating GHG (PGE2 and PGI2) and reduces left ventricular hypertrophy within the heart.

When used in a dose of 0.0015 g per day, the drug causes a prolonged hypotensive effect lasting 24 hours, and with it a weak diuretic effect. If the dosage is increased, there is no noticeable increase in the hypotensive effect, but the diuretic effect is increased. Therapeutic dosages of drugs almost do not affect the metabolism of carbohydrates and lipids.

Pharmacokinetics

The drug form of the drug contributes to the uniform and gradual release of the fraction of the substance within the gastrointestinal tract, where it is at high speed and is fully absorbed. Indicators of blood Cmax drug reaches approximately 12 hours after oral use of a 1-time dose of 0.0015 g. After repeated use of drugs, the variation of the plasma level of indapamide in the interval between the use of the following dosages is reduced. Eating food reduces the rate of absorption, but does not affect its degree.

The bioavailability index is 93%, and the protein synthesis inside the plasma is approximately 79%. The medicinal component can be sorbed with erythrocytes. Equilibrium values of drugs reaches after the expiration of the first week of constant use. Passes through gistogematicheskie barriers (among which the placenta), but in addition to the mother's milk.

Biotransformation of the substance is carried out inside the liver, and its excretion in the form of inactive metabolic products mostly occurs through the kidneys - by 70%. 22% of the substance is removed through the intestine. The half-life is 14-24 hours.

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Dosing and administration

Take medication is recommended 1-fold per day, in the morning, in the amount of the 1st pill (volume 0.0015 g). It should be swallowed whole, washed down with plain water (0.5 cups). Grind or chew the tablet can not. The above dosage is the maximum that can be used per day.

[10]

Use Indapamida-retard during pregnancy

Indapamide-retard is not prescribed for pregnant or breast-feeding women.

Contraindications

The main contraindications:

• the presence of intolerance relative to the drug;
• failure of renal or hepatic function in severe degree;
• hepatic form of encephalopathy;
• hypokalaemia.

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Side effects Indapamida-retard

The use of drugs can lead to the development of certain side effects:

• violations of the water-salt balance: there is a single hyponatremia or -kalemia, against which hypovolemia, dehydration and orthostatic collapse develop. With the simultaneous loss of chlorine, the metabolic form of alkalosis, which has a compensatory character, sometimes arises. Also, calcium can increase individually;
• disorders of metabolic processes: an increase in glucose and urea levels within the blood plasma;
• problems with hematopoietic function: occasionally leuko- or thrombocytopenia appears, as well as agranulocytosis;
• disorders of digestive activity: occasionally there is constipation, nausea or dryness of the oral mucosa. There is a pancreatitis. People with liver failure may develop liver encephalopathy;
• lesions affecting the NA: occasionally there are dizziness, asthenia, fatigue, headaches, asthenia and paresthesia (often disappear with a decrease in dosage);
• symptoms of an allergic nature: people with a predisposition to developing allergies or asthma attacks can develop a rash on the epidermis. Occasionally there is a hemorrhagic form of vasculitis or an exacerbation of DKV;
• disorders of the function of the SSS: there is a single decrease in the level of pressure or arrhythmia.

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Overdose

Signs of an overdose: severe diuretic effects, VEB disorder (development of hypokalemia or -natriemia), vomiting, convulsions, confusion or drowsiness, nausea, dizziness and lowering blood pressure, and also polyuria or oliguria reaching the development of anuria.

For therapy in disorders, gastric lavage is performed, activated charcoal reception and further rehydration treatment with electrolyte correction are prescribed. Symptomatic measures are also performed.

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Interactions with other drugs

It is forbidden to combine with lithium medicines, because in such cases the blood level of lithium can increase.

You can not combine the drug with vincamine, sultopril and halofantrine, and in addition to terfenadine, pentamidine, astemizole and bepridilom. Also on this list are intravenous erythromycin, sotalol, prodrugarymic drugs of 1α-category and amiodarone. It is forbidden to use together with GCS, laxatives, stimulating effect on intestinal peristalsis, potassium-lowering medications, including intravenous amphotericin B, as well as tetracosactide - because this can provoke hypokalemia or arrhythmias of the heart in severe degree.

Tetrakosaktid and GCS cause sodium ions and fluid retention, which is why the antihypertensive effect of indapamide is weakened.

Combination of indapamide-retard with NSAIDs (systemic) or salicylates (in large portions) can reduce the antihypertensive effect of indapamide and lead to the appearance of failure of renal function in the acute stage - due to a sharp decrease in glomerular filtration.

Combination of the drug with SG may potentiate the cardiotoxic properties of the latter.

The antihypertensive effect of drugs is enhanced when combined with baclofen.

Strengthening the diuretic effect of indapamide together with the potentiation of negative symptoms (hyper- and hypokalemia) is noted when combined with potassium-sparing diuretics, especially in diabetics or persons with renal insufficiency.

The antihypertensive properties of the drug are enhanced by simultaneous use with other antihypertensive agents or tricyclics from the category of imipramines.

Combination of a drug with ACEI, if the patient has hyponatremia, increases the probability of a sudden decrease in blood pressure values or the development of acute renal failure. Because of this, such a combination therapy should be started with small portions of ACE with further gradual increase. Against the background of the treatment course, renal function should be constantly monitored.

It is forbidden to combine drugs with metformin if the creatinine values are below 15 mg / l (men) or 12 mg / l (women).

Combination of indapamide-retard with calcium drugs can lead to the appearance of hypercalcemia.

The combination with cyclosporins increases the blood values of creatinine, even with the optimal values of sodium ions and water.

When using radiocontrast drugs containing iodine (especially in large portions), the probability of failure of renal activity increases.

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Storage conditions

Indapamide retard is required to be kept in a dry and dark place, closed from children. The temperature level is within the range of 15-25 ° C.

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Shelf life

Indapamide retard may be administered within 36 months of the manufacture of the therapeutic agent.

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Application for children

The medicine is not used in pediatrics - to persons under 18 years of age.

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Analogues

Analogues of the medication are drugs Indapamide, Indap, Arifon with Ravel Wed, and in addition Arifon retard, 5 days and Indapamid-Teva with Indapamid retard-teva.

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Reviews

Indapamide retard helps to normalize the pressure indicators, and also has a mild diuretic effect. It is about these advantages of the drug said in reviews about it.

Of the minuses, the presence of negative symptoms is recognized.