Natrilix ®


Servier

Indapamide is a non-thiazide sulphonamide diuretic drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated cardiac failure. The US trade name for indapamide is Lozol.[1] Indapamide is marketed as Natrilix outside of the US . Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.

It is described as a thiazide-like diuretic.[2]

Form and composition

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.[3]

Indications

Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension.

Dosage and administration

The adult dosage is 1.25 to 5 mg by mouth once daily usually in the morning.

Contraindications

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe renal failure, hepatic encephalopathy or severe hepatic failure and hypokalemia (low blood potassium levels).
There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.

Interactions

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, vincamine).

Precautions

Monitoring of potassium and uric acid serum levels is recommended, especially in subjects with a predisposition or a sensitivity to hypokalemia and in patients with gout.

Adverse effects

Commonly reported adverse events are hypokalemia (low potassium levels), fatigue, orthostatic hypotension (blood pressure decrease on standing up) and allergic manifestations.

Overdosage

Symptoms of overdosage would be those associated with a diuretic effect: electrolyte disturbances, hypotension, and muscular weakness. Treatment should be symptomatic, directed at correcting the electrolyte abnormalities.