Indapamide is an oral antihypertensive/diuretic. Its molecule contains both a polar sulfamoyl chlorobenzamide moiety and a lipid-soluble methylindoline moiety. It differs chemically from the thiazides in that it does not possess the thiazide ring system and contains only one sulfonamide group. The chemical name of indapamide is 4-Chloro-N-(2-methyl-1-indolinyl)-3-Sulfamoylbenzamide, and its molecular weight is 365.84. The compound is a weak acid, pKa=8.8, and is soluble in aqueous solutions of strong bases. It is a white to yellow-white crystalline (tetragonal) powder.
Indapamide tablets are indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs.
Indapamide tablets are also indicated for the treatment of salt and fluid retention associated with congestive heart failure.
Usage in Pregnancy
The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard (see PRECAUTIONS below).
Diuretics do not prevent development of toxemia of pregnancy, and there is no satisfactory evidence that they are useful in the treatment of developed toxemia.
Edema during pregnancy may arise from pathological causes or from the physiologic and mechanical consequences of pregnancy. Indapamide is indicated in pregnancy when edema is due to pathologic causes, just as it is in the absence of pregnancy (however, see PRECAUTIONS below). Dependent edema in pregnancy, resulting from restriction of venous return by the expanded uterus, is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. There is hypervolemia during normal pregnancy which is not harmful to either the fetus or the mother (in the absence of cardiovascular disease), but which is associated with edema, including generalized edema in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances, this edema may cause extreme discomfort which is not relieved by rest. In these cases, a short course of diuretics may provide relief and may be appropriate.
Published Studies Related to Indapamide
Large volume injection of 1-octanol as sample diluent in reversed phase liquid chromatography: application in bioanalysis for assaying of indapamide in whole blood. [2011.04.05]
Large volume injection of samples in strong diluents immiscible with the mobile phases used in reversed phase liquid chromatography (RPLC) has been recently introduced in practice. In the present work, the potential of the technique has been evaluated for bioanalytical applications...
Effects of a fixed combination of perindopril and indapamide in patients with type 2 diabetes and chronic kidney disease. [2010.12]
CONCLUSION: The treatment benefits of a routine administration of a fixed combination of perindopril-indapamide to patients with type 2 diabetes on cardiovascular and renal outcomes, and death, are consistent across all stages of CKD at baseline. Absolute risk reductions are larger in patients with CKD highlighting the importance of blood pressure-lowering in this population.
Management of high blood pressure in type 2 diabetes: perindopril/indapamide fixed-dose combination and the ADVANCE trial [corrected]. [2010.07]
IMPORTANCE OF THE FIELD: The increase in type 2 diabetes mellitus is associated to cardiovascular morbidity and mortality. This review focuses on the benefits of the fixed-dose combination of perindopril and indapamide on cardiovascular and renal end points in the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) trial...
Combination therapy with angiotensin-converting enzyme inhibitors and indapamide impairs glucose tolerance in Chinese hypertensive patients. [2010.04]
CONCLUSION: Fosinopril+indapamide combination therapy impaired GT in Chinese hypertensive patients, and fosinopril alone was able to reverse fosinopril+indapamide-induced GT impairment in part of these patients.
Combination of an ACE inhibitor and indapamide improves blood pressure control, but attenuates the beneficial effects of ACE inhibition on plasma adiponectin in patients with essential hypertension. [2009.12]
CONCLUSIONS: The combination of an ACEI and indapamide improved BP control, but attenuated the beneficial effects of ACE inhibition on plasma adiponectin in patients with essential hypertension. Such a combination may be best reserved for improved BP control rather than for metabolic protection in clinical hypertension.
Clinical Trials Related to Indapamide
Indapamide Versus Hydrochlorothiazide in Elderly Hypertensive Patients With Renal Insufficiency [Not yet recruiting]
The purpose of this study is to evaluate the effects of indapamide SR 1. 5 mg on renal
function, endothelial function, blood pressure variability by comparison with
hydrochlorothiazide 25 mg, in patients with Mild to Moderate Renal Insufficiency and
A Comparison of Indapamide SR 1.5 mg With Hydrochlorothiazide 25 mg, in Combination With an ACE-inhibitor, in Patients With Mild to Moderate Hypertension and Type 2 Diabetes Mellitus [Recruiting]
The aim of this study is to evaluate the effects of indapamide SR 1. 5 mg on blood pressure,
blood tests (glucose metabolism, lipids, minerals, and uric acid), cardiac function,
endothelial and arterial function, by comparison with hydrochlorothiazide 25 mg, in patients
with hypertension and type 2 diabetes mellitus. In order to achieve a better control of
blood pressure in these patients, each diuretic treatments will be added to an ACE inhibitor
(quinapril 10-40 mg/day). Therefore, eventually, the study will provide data on the
comparison between combination indapamide SR 1. 5 mg + quinapril versus hydrochlorothiazide
25 mg + quinapril.
Comparison of Losartan Associated With Indapamide Versus Indapamide for Treatment of Hypertension [Not yet recruiting]
IDEAL Study: Identification of the Determinants of the Efficacy of Arterial Blood Pressure Lowering Drugs [Recruiting]
The principal scientific objective of the trial is to identify the factors that are
associated with differential blood pressure responses between drugs. This may allow
investigators to produce new hypotheses on the pathophysiology of hypertension and on the
mechanisms of drug action.
These factors can be of different types:
- Environmental factors (sodium or alcohol intake);
- Morphological (height, weight, body mass index, body surface area);
- Initial blood pressure;
- Electrocardiogram (ECG) parameters of left ventricular hypertrophy;
- Biological parameters as the activity level of the renin angiotensin aldosterone
- Genetic polymorphisms.
Non-invasive Haemodynamic Assessment in Hypertension [Recruiting]
Arterial hypertension (AH) is an important clinical social and economic problem. In the
pathogenesis of AH increased BP is a result of complex mechanisms i. e. fluid retention,
increased vascular resistance and hyperkinetic heart function. Impedance cardiography (ICG)
is a simple and safe, non-invasive method of hemodynamic monitoring which allows
simultaneous assessment of i. e. BP, cardiac index, heart rate, the fluid content in the
chest and systemic vascular resistance.
The detailed effect of treatment based on ICG has not been evaluated so far in the long-term
observation and for other clinically relevant parameters, such as central blood pressure,
left ventricular hypertrophy, metabolic disturbances, parameters of antioxidative-oxidative
balance and endothelial function. Therefore, the following main objectives of the study were
- Evaluation of usefulness of impedance cardiography in optimizing treatment of patients
with hypertension in the area of reduction and control of blood pressure, hemodynamic
parameters, biochemical markers and quality of life.
- Evaluation of complex pathophysiological mechanisms associated with hypertension
including hemodynamic, anthropometric, psychological and biochemical parameters as well
as the effect of antihypertensive treatment on these phenomena.
The study will be randomized (1: 1), prospective and controlled in parallel with conventional
treatment. The subjects will be divided into groups according to the pre-established random
1. empiric group (GE), in which treatment choice will be based on clinical data and
2. hemodynamic group (HD), in which treatment choice will be based on clinical data and
current guidelines considering hemodynamic parameters established with ICG method.
All patients will undergo a detailed examination three times: before treatment, then after 3
and 12 months of treatment.
The authors expect that the study will consolidate the importance of ICG in the diagnosis of
patients with AH. Simultaneous multiparametric evaluation of the subjects guarantees a
unique and innovative results which can enhance our knowledge in pathophysiology of AH and
reversibility of adverse mechanisms associated with this disease.
Reports of Suspected Indapamide Side Effects
Renal Failure Acute (22),
Disseminated Intravascular Coagulation (20),
Multi-Organ Failure (20),
Cardiac Arrest (19),
Leukocytosis (17), more >>
Page last updated: 2011-12-09