Nurses Compass
Drug Guide
Indapamide
Classification
Therapeutic: Antihypertensive, Diuretic
Pharmacological: Thiazide-like diuretic
FDA Approved Indications
- Hypertension
- Edema associated with congestive heart failure
Mechanism of Action
Indapamide inhibits sodium reabsorption in the distal convoluted tubule of the nephron, leading to increased excretion of sodium, chloride, and water, which decreases blood volume and blood pressure.
Dosage and Administration
Adult: Initially 2.5 mg once daily. Dose may be increased to 5-10 mg daily depending on response.
Pediatric: Not approved for pediatric use.
Geriatric: Start at lower dose due to increased sensitivity; monitor closely.
Renal Impairment: Use caution; dose adjustment may be necessary depending on severity.
Hepatic Impairment: Use with caution; monitor closely.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed in body tissues.
Metabolism: Minimal hepatic metabolism.
Excretion: Excreted primarily in the urine.
Half Life: 14-24 hours.
Contraindications
- Hypersensitivity to indapamide or sulfonamides.
- Anuria.
Precautions
- Electrolyte imbalances (hypokalemia, hyponatremia).
- Renal impairment.
- Hepatic impairment.
- Diabetes mellitus (may alter glucose tolerance).
- Monitor for dehydration and electrolyte disturbances.
Adverse Reactions - Common
- Electrolyte disturbances (hypokalemia, hyponatremia) (Common)
- Dizziness or orthostatic hypotension (Common)
- Gastrointestinal disturbances (Common)
Adverse Reactions - Serious
- Electrolyte imbalance leading to arrhythmias (Serious)
- Hypersensitivity reactions (Serious)
- Severe dehydration (Serious)
Drug-Drug Interactions
- Increased risk of electrolyte imbalances with other diuretics, ACE inhibitors, or ARBs.
- Lithium toxicity risk increased.
- NSAIDs may reduce antihypertensive effect and impair renal function.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure, weight, serum electrolytes, renal function.
Diagnoses:
- Risk for electrolyte imbalance.
- Risk for dehydration.
- Ineffective tissue perfusion.
Implementation: Administer in the morning to avoid nocturia. Monitor electrolyte levels regularly. Adjust dose based on blood pressure and lab results.
Evaluation: Assess for reduction in blood pressure, signs of side effects, and electrolyte balance.
Patient/Family Teaching
- Take medication as prescribed, usually in the morning.
- Report signs of electrolyte imbalance: muscle weakness, cramps.
- Avoid potassium-rich foods unless directed.
- Rise slowly from sitting or lying position to prevent orthostatic hypotension.
Special Considerations
Black Box Warnings:
- None specifically for indapamide.
Genetic Factors: No specific genetic testing recommended.
Lab Test Interference: May cause hypokalemia and hypomagnesemia, affecting ECG readings.
Overdose Management
Signs/Symptoms: Severe dehydration, electrolyte disturbances, hypotension, dizziness.
Treatment: Discontinue drug, restore electrolyte balance, and manage blood pressure as needed. Supportive care, IV fluids.
Storage and Handling
Storage: Store at room temperature, away from moisture and heat.
Stability: Stable under recommended storage conditions.