Indapamide

Indapamide is a diuretic medication that is used to treat high blood pressure (hypertension). Diuretics are also called water tablets or water pills as they can make you need to pee more frequently. With indapamide, this diuretic effect is not as strong as it only increases your volume of urine a little bit.

You can take indapamide on its own or with other blood pressure lowering medication (antihypertensives). Your doctor or nurse will treat your blood pressure in steps. This means they’ll try to maximise the effect of one medication before adding another.

You should take indapamide once a day, preferably in the morning. You should take indapamide at around the same time each day. Indapamide can be taken with or without food.

If you forget to take a tablet and it’s only been a few hours, take it as soon as you remember. If you remember at the end of the day, it’s best to wait till your next dose to take a tablet. Do not take 2 tablets to make up for a missed dose.

If you accidentally take more tablets than prescribed, contact 999 immediately. If you need to go to the hospital, take the box of indapamide with you so they know what you have taken.

Indapamide is called a thiazide-like diuretic. Diuretics are medications that increase how much water is in your urine. This lowers the pressure in your blood vessels as there is less water.

Indapamide works in 2 separate ways to lower your blood pressure:

• filtering out sodium from your kidneys into your urine which increases the volume of water in your urine
• relaxing your blood vessels (also called vasodilation)

A thiazide-like diuretic works in a similar way to thiazide diuretics, such as bendroflumethiazide. Thiazide-like diuretics have a different molecular structure to thiazide diuretics.

Indapamide is effective in lowering your blood pressure. You may start to see your blood pressure reading get lower in the first few weeks of treatment. Remember that you might not get to your target blood pressure until a few months later.

Indapamide can be taken on its own or with other antihypertensive medications.

When your doctor or nurse starts you on indapamide, you’ll need some blood tests initially and then again in a few months. This is because indapamide can affect your kidneys, so your kidney function needs to be monitored. Once you are stable on indapamide, you’ll have yearly check ups to make sure your blood pressure is still responding to treatment.

You may get some side effects when taking indapamide. Not everyone will experience side effects and they’ll usually wear off after a few days.

The most common side effect of indapamide is a skin rash that looks raised and red.

Indapamide can also make you feel tired or dizzy when you start treatment. If this happens to you, avoid driving or doing activities that require you to be alert. This side effect will disappear eventually.

The uncommon side effects of indapamide are:

• being sick
• red points on your skin called purpura

As indapamide is a diuretic, it can make you need to go to the toilet more often. This is because it increases how much water your kidneys produce. Compared to other diuretics, indapamide does this less.

Certain side effects will happen rarely, but if they do you’ll need to contact 999 immediately. These include:

• a severe allergic reaction like itching, blistering or reddening over large parts of your body
• swelling of the skin or your face, lips or tongue, also called angioedema

For more information on side effects, read the patient information leaflet that comes in your pack.

You can take indapamide if you have high blood pressure and are over 18 years old. Your doctor will prescribe indapamide once other blood pressure treatments have been tried.

In some cases you will not be able to take indapamide at all. This includes if you:

• are pregnant or think you might be pregnant
• are breastfeeding
• are allergic to indapamide or any of the ingredients in the tablets
• have severe kidney disease
• have severe liver disease
• have hepatic encephalopathy (a liver problem that affects your brain)
• have low potassium levels in your blood

If you have certain health conditions, speak to your doctor or pharmacist to find out if indapamide is suitable for you. These include:

• kidney problems
• liver problems
• problems with your vision
• muscle disorders like muscle cramps or weakness
• gout
• diabetes
• problems with your heart rhythm or heart rate (arrhythmia)
• problems with your parathyroid gland

This does not mean you cannot take indapamide, but you may need extra blood tests to make sure the medication is working safely.

As indapamide causes you to lose sodium, very low sodium can cause tiredness and other health problems. Your doctor will regularly monitor how much sodium you have in your blood.

Certain medications can interact with indapamide. This means they can interfere with how indapamide works. Speak to your doctor or pharmacist if you are taking:

• other diuretics like amiloride or spironolactone
• painkillers called non-steroidal anti inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• tricyclic antidepressants such as amitriptyline
• lithium, which is used to treat certain mental health conditions
• calcium supplements
• medication used after organ transplants, such as ciclosporin or tacrolimus
• oral steroids such as prednisolone tablets which can cause fluid retention when taken with indapamide

This does not mean you cannot take indapamide, but you may need extra blood tests to make sure the medication is safe for you to take.

For a full list of medications that may interact with indapamide, read the patient information leaflet.

There are many alternative treatments to indapamide for high blood pressure. There are a few groups of antihypertensives, but your doctor or nurse will discuss with you what the best medication is for your health.

Calcium channel blockers (CCBs) are often used alongside indapamide to control hypertension. These include amlodipine and felodipine.

Commonly used medications include ACE inhibitors and angiotensin II receptor blockers (ARBs). ACE inhibitors include perindopril and ARBs include losartan.

Doxazosin is an alpha blocker. Alpha blockers help to lower blood pressure by blocking the receptors that are activated by adrenaline. This causes your blood vessels to dilate. Doxazosin can be used alongside indapamide or on its own.

Always speak to your doctor or nurse before trying a new blood pressure treatment. Most antihypertensives need regular monitoring. This is to make sure they are working safely and effectively.