Indapamide Retard is used to lower blood pressure and reduce edema, the occurrence of which is associated with a violation of the heart and a change in the state of blood vessels. Its advantages include not only accessibility, but also good portability. The latter quality is of particular importance, as some patients are forced to take an antihypertensive drug for life.
Material Content:
The composition of the drug
The properties of the drug are determined by the active substance indapamide. In tablets marked Retard, its proportion is 1.5 mg. The stability of the structure of the active substance and its subsequent dissolution in the stomach are ensured by such components as lactose, hypromellose, colloidal form of silicon dioxide and magnesium stearate.
The medicine is found exclusively in the form of tablets. One unit of such a preparation is film coated. The coating contains macrogol, hypromellose, glycerol, as well as compounds of magnesium and titanium.
Incoming components color the tablet white. The medicinal unit is given a rounded, flattened shape on both sides. The tablets are sealed in a PVC substrate, which is coated with aluminum foil.
The outer packaging is a cardboard bundle. The medicine is used for three years from the date of manufacture.
Pharmacological action and pharmacokinetics
The active component of the tablets is derived from the chemical compound sulfonamide. It has the ability to increase the amount of urine produced, and also improves the outflow of fluid from the body. Promotes the removal of sodium and chlorine ions, and in a smaller amount - potassium and magnesium.
The compound prevents the reverse absorption of fluid secreted by the kidneys and an increase in the concentration of sodium and chlorine in the blood. This explains his ability to relax the smooth muscles of blood vessels and stabilize blood pressure. The fact that the active ingredient works similarly to a thiazide diuretic, which weaken the bond of calcium and chlorine, expel mainly chlorine from the body, preserving calcium, is considered positively.
One of the positive properties of the drug is its ability to improve the anatomy of blood vessels and the heart. It reduces the permeability of arteries, increases their elasticity, and also stops the process of abnormal proliferation of tissues of the left ventricle.
The drug has good digestibility (more than 90%). Food practically does not affect the degree of absorption, but it can inhibit this process. Three quarters of the substance absorbed by the gastric mucosa form bonds with plasma proteins. A small percentage combines with vascular elastin. Indapamide is well distributed throughout the body and easily penetrates many physiological barriers, including the placental one.
Twelve hours after receipt of the substance in the blood, its highest concentration is formed. The effect of the drug accumulates gradually. A week later, the concentration in the serum reaches stable values. At the end of treatment, the substance is eliminated in half only after 18 hours.
The compound is actively processed by the liver and kidneys. It is excreted mainly with urine, only to some extent with feces. In the internal organs does not accumulate.
The medicine refers to the so-called "dose-dependent drugs." Its maximum effect is determined by a specific amount of substance. With a further increase in the dose, the effect is not enhanced, however, adverse reactions become more pronounced.
Indications Indapamide Retard
Indications:
- high blood pressure;
- swelling associated with impaired heart function.
However, not all cases accompanied by edema can be treated with indapamide.
Instructions for use and dosage
Tablets labeled Retard have a longer effect in connection with the slow release of the active substance. They do not need to be broken or cracked, but should be swallowed whole, washed down with a decent portion of water.
A single tablet is taken per day, usually in the morning. The duration of treatment is set individually. Lifetime appointments are not uncommon.
Indapamide Retard 1.5 mg can be combined with other blood pressure lowering drugs, but only with the consent of the doctor. If after one or two months of treatment the desired effect is not observed, other antihypertensive drugs are additionally prescribed. However, these drugs should not belong to the class of diuretics, since their combined effect can lead to an increase in the diuretic effect.
To increase the dose in the case when the tablets Indapamide Retard do not work, it is impractical, since this will not lead to increased efficiency, but can enhance adverse reactions.
During pregnancy and lactation
Instructions for use directly indicate a ban on the appointment of funds during pregnancy and lactation. Such use can provoke the appearance of deviations in the formation of the fetal cardiac system. Due to the negative effects, diuretics should not be used to treat physiological edema of pregnant women.
Interaction with other drugs
Undesirable combinations:
- With lithium-containing drugs.Diuretics can increase the concentration of lithium in the plasma, which can provoke an overdose.
- With diuretics that promote the excretion of potassium ions. As a consequence, hypokalemia may develop. It is one of the factors in the appearance of ventricular tachycardia. Before starting combined treatment, it is necessary to monitor the electrolyte balance, as well as evaluate the work of the heart using ECG.
- Together with antiarrhythmic drugs and antipsychotics. There is a risk of tachycardia.
- Simultaneously with non-steroidal type anti-inflammatory drugs that inhibit the production of cyclooxygenase. These medicines may even out the effects of Indapamide Retard. Also, in the case of co-administration, there is a possibility of developing renal failure.
- With ACE inhibitors, an enzyme involved in the regulation of blood pressure. Among the consequences are a sharp drop in pressure and kidney failure.
- With drugs that are not related to diuretics, but are able to lower the level of potassium - laxatives, glucocorticosteroids. The development of hypokalemia is likely.
- When taken with cardiac glycosides, an increase in the toxicity of these drugs may be observed.
- Against the background of simultaneous administration with potassium-sparing diuretics, electrolyte imbalance is likely.
- In conditions of simultaneous administration of metformin and indapamide, the development of acidosis is likely.
- Combination with iodine-containing substances can lead to dehydration.
- Against the background of simultaneous administration with calcium preparations, hypercalcemia occurs.
- Immunosuppressants (cyclosporin, tacrolimus) taken together with indapamide increase the level of creatinine in the blood and disrupt muscle energy metabolism.
The consequences of the use of poorly combined drugs should be calculated by the attending physician.
Alcohol compatibility
There are no direct instructions on the incompatibility of the drug with alcohol in the instructions for use. However, it is worth considering that such a combination is undesirable. Both that and another substance enhance the outflow of fluid from the body. Accordingly, with simultaneous administration, the load on the kidneys increases, and a failure occurs in the electrolyte balance.
Contraindications, side effects and overdose
Contraindications include:
- severe renal or liver failure;
- potassium deficiency;
- period of pregnancy and lactation;
- less than eighteen years of age;
- severe urinary retention;
- disturbances in the process of assimilation of any of the components that make up the sustained-release tablet.
For patients with a shift in electrolyte balance, diabetes mellitus, cardiac ischemia, heart failure, ascites and gout, pills for high blood pressure are prescribed with extreme caution.
In case of intolerance, the following symptoms and conditions appear:
- dry mouth, irritation of the gastric mucosa, nausea, problems with bowel movements, abdominal pain, food rejection, pancreatitis;
- muscle tension, cramps, weakness, headache, loss of strength, anxious mood, impaired falling asleep, depressed state;
- frequent infectious lesions of the respiratory tract;
- violation of the rhythm of the heart, changes in the graph of the cardiogram;
- diseases of the urinary system of an infectious nature;
- hemorrhagic vasculitis, skin itching, allergic rashes;
Very rarely observed violations in the process of hematopoiesis, as well as changes in the structure of the bone marrow.
In case of poisoning with high doses of the drug, the victim's blood pressure drops significantly, digestive disorders open up, breathing is depressed, and the water-salt balance is disturbed. There is no specific antagonist for indapamide, therefore, the patient is assisted in the form of gastric lavage and an electrolyte infusion.
Diuretic analogues
Among the funds with an identical composition, there are such drugs as the following:
- Acripamide;
- Arifon;
- Indap;
- Ionic
- Ravel SR;
- Retapres
- Tensar;
Analogues of Indapamide Retard are available both in capsule form and in tablet form.
Numerous reviews indicate that the medicine is well tolerated. This is a serious point, since a diuretic is often prescribed for continuous use.
However, we should not forget that violations of the heart can be associated with other diseases that are on the list of contraindications for the appointment of Indapamide. Therefore, the final conclusion about the appropriateness of treatment should be made by a doctor.
