Indapamide 💊
Always check the BNF here for up-to-date prescribing advice.
- ✔️ Refer to the BNF or equivalent (e.g., NICE, local guidelines) for safe and current use.
⚙️ Mode of Action
- Indapamide is a thiazide-like diuretic.
- Blocks sodium reabsorption in the proximal segment of the distal convoluted tubule (DCT).
- Increases delivery of sodium to the distal nephron.
- Aldosterone-sensitive Na⁺/K⁺ pump ➝ enhanced potassium and hydrogen ion excretion.
📋 Indications & Standard Dose
- Hypertension: Indapamide 2.5 mg OD (usually in the morning).
🔄 Interactions
- Often combined with ACE inhibitors or ARBs to reduce hypokalaemia risk.
- NSAIDs may reduce antihypertensive effect.
- May increase lithium levels ➝ toxicity risk.
⚠️ Cautions
- Diabetes mellitus (may worsen glycaemic control).
- Gout (may increase uric acid, precipitate attacks).
- Nephrotic syndrome.
- Systemic lupus erythematosus (SLE).
⛔ Contraindications
- Severe renal or hepatic impairment.
- Refractory hypokalaemia or hyponatraemia.
- Known hypersensitivity to thiazide/thiazide-like diuretics.
⚡ Side Effects
- Metabolic: ⬆️ calcium, glucose, urate; ⬇️ chloride, bicarbonate, potassium, magnesium, sodium.
- Acute gout.
- Haematological: ↓ granulocytes, WCC, platelets (rare).
- Skin: Rashes, photosensitivity.
- Hepatic: Cholestatic jaundice (rare).
- Pulmonary: Pneumonitis (very rare).
📚 References
📝 Revisions
- Last updated: August 2025
