Indapamide-Teva 2,5mg tablets 30
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Active substance: indapamide - 2.5 mg;
Excipients: ludipress, magnesium stearate, aerosil (silicon dioxide colloidal), hydroxypropyl methylcellulose, titanium dioxide, polyethylene oxide, talc.
Thiazide-like diuretic, antihypertensive agent. It causes a decrease in the tone of the smooth muscles of the arteries, a decrease in OPSS, also has a moderate saluretic activity due to a violation of the reabsorption of sodium, chlorine and water ions in the cortical segment of the Henle loop and the proximal convoluted tubule of the nephron. The decrease in OPSS is due to several mechanisms: a decrease in the sensitivity of the vascular wall to norepinephrine and angiotensin II; increasing the synthesis of prostaglandins, having vasodilating activity; inhibition of the inflow of calcium ions into the smooth muscle elements of the vascular wall. In therapeutic doses, it practically does not affect lipid and carbohydrate metabolism.
The hypotensive effect is manifested only with initially elevated blood pressure, develops by the end of the first week and reaches a maximum after 3 months of systematic administration.
Indications for use
- hypersensitivity to indapamide, other sulfonamide derivatives and components of the drug;
- acute violation of cerebral circulation;
- severe hepatic (including with encephalopathy) and / or renal failure, anuria;
- simultaneous administration of drugs that prolong the QT interval;
- lactose intolerance, galactosemia, glucose absorption syndrome, galactose;
- lactation (breastfeeding);
- age up to 18 years (efficacy and safety have not been established).
With caution: diabetes mellitus in the stage of decompensation, hyperuricemia (especially accompanied by gout and urate nephrolithiasis), hyponatremia and other disorders of water-electrolyte metabolism, moderate hepatic and / or renal failure, ascites, coronary artery disease, chronic heart failure, prolongation of the QT interval; Hyperparathyroidism.
Use in pregnancy and lactation
Indapamide is contraindicated for use during pregnancy and lactation (breastfeeding).
Use in case of impaired liver function
Contraindicated in severe violations of liver function. With caution with moderate hepatic insufficiency.
Use in renal dysfunction
Contraindicated in severe renal dysfunction, anuria. With caution in moderate renal failure.
Use in childrenContraindicated in children under 18 years of age
Use in elderly patientsIn the elderly, careful monitoring of the content of potassium and creatinine is indicated.
Indapamide is effective for the treatment of patients with arterial hypertension of the risk group, i.e. with concomitant pathology (diabetes mellitus of mild and moderate severity or with chronic renal failure, patients with hyperlipidemia).
With prolonged use of indapamide, electrolyte metabolism disorders can sometimes occur, such as hyponatremia, hypokalemia, hypercalcemia and hypochloremic alkalosis. These disorders are more often observed in patients with chronic heart failure, liver diseases, vomiting and diarrhea, as well as in persons on a salt-free diet, which necessitates the control of blood electrolytes.
Indapamide increases the excretion of magnesium in the urine, which can lead to hypomagnesemia.
When using indapamide, the content of uric acid and residual nitrogen in the blood plasma should also be systematically monitored.
Perhaps the appearance of orthostatic hypotension, which can be provoked by alcohol intake, barbiturates, opioid analgesics, as well as other antihypertensive drugs.
In the case of hypokalemia caused by indapamide, the toxicity of cardiac glycosides may increase. In patients taking cardiac glycosides, laxatives, with hyperaldosteronism, as well as in the elderly, careful monitoring of the content of potassium and creatinine is indicated.
The most careful monitoring is indicated in patients with cirrhosis of the liver (especially with edema or ascites - the risk of developing metabolic alkalosis, which increases the manifestations of hepatic encephalopathy), coronary artery disease, chronic heart failure, as well as in the elderly. The high-risk group also includes patients with an increased QT interval on the ECG (congenital or developed against the background of any pathological process).
The first measurement of the concentration of potassium in the blood should be carried out within 1 week of treatment.
Hypercalcemia while taking indapamide may be a consequence of previously undiagnosed hyperparathyroidism.
In patients with diabetes mellitus, 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 (decreased glomerular filtration). Patients need to compensate for the loss of water and carefully monitor kidney function at the beginning of treatment.
Indapamide can give a positive the result during doping control.
Patients with arterial hypertension and hyponatremia (due to taking diuretics) should stop taking diuretics 3 days before the start of taking ACE inhibitors (if necessary, diuretics can be resumed a little later), or they are prescribed initial low doses of ACE inhibitors.
Indapamide can worsen the course of systemic lupus erythematosus.
Despite the fact that indapamide practically does not affect carbohydrate metabolism, in patients with insulin-dependent diabetes mellitus, it is possible to increase the required dose of insulin, and with latent diabetes mellitus, it is necessary to monitor blood glucose.
Dosage and Administration
The drug is prescribed orally, in the morning, regardless of food intake. The capsule should be swallowed without chewing, washed down with water.
Assign 2.5 mg (1 caps.) 1 time / day.
The drug can be used in as monotherapy or in combination with other antihypertensive drugs (with beta-blockers, blockers of "slow" calcium channels, ACE inhibitors). If after 4-8 weeks of treatment the desired therapeutic effect is not achieved, the dose of the drug is not recommended to be increased (the risk of side effects increases without enhancing the antihypertensive effect). Instead, it is advisable to add another antihypertensive drug to the treatment regimen, which is not a diuretic. In cases where treatment should begin with taking 2 drugs, the dose of Indapamide remains equal to 2.5 mg in the morning 1 time / day.
Symptoms: nausea, vomiting, weakness, impaired gastrointestinal function, water-electrolyte disorders, in some cases - excessive decrease in blood pressure, respiratory depression. In patients with cirrhosis of the liver, the development of hepatic coma is possible.
Treatment: gastric lavage, correction of water-electrolyte balance, symptomatic therapy. There is no specific antidote.
From the digestive system: nausea, vomiting, anorexia, dry mouth, abdominal discomfort, gastralgia, constipation or diarrhea, hepatic encephalopathy (against the background of liver failure).
From the side of the central nervous system: asthenia, headache, general weakness, increased fatigue, lethargy, lethargy, lethargy, malaise, vertigo, muscle spasm, nervousness, tension, irritability, agitation; anxiety, insomnia, depression, dizziness, drowsiness.
From the senses: conjunctivitis, visual impairment.
From the respiratory system: rhinitis, rarely - cough, pharyngitis, sinusitis.
From the cardiovascular system: orthostatic hypotension, arrhythmia, palpitations, changes in the ECG (hypokalemia).
From the urinary system: nocturia, polyuria, increased frequency of infections.
Allergic reactions: itching, rash, urticaria, hemorrhagic vasculitis.
From the organs of hematopoiesis: thrombocytopenia, leukopenia, agranulocytosis, bone marrow aplasia, hemolytic anemia.
On the part of laboratory indicators: hypercalcemia, hyperuricemia, hypochloremia, hyponatremia, hyperglycemia, hypokalemia, increased urea nitrogen in the blood plasma, hypercreatininemia, glucosuria.
Other: flu-like syndrome, chest pain, back pain, decreased potency and / or libido, rhinorrhea, sweating, weight loss, paresthesia in the limbs, exacerbation of systemic lupus erythematosus, pancreatitis.
The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 ° C.
Shelf life - 5 years. Do not use after the expiration date.
- Dosage form
- 10 mg
- Number of tablets
- INN Russian