Indapamide

What it is

Indapamide is a thiazide-like diuretic. It acts on the distal tubule of the kidney to reduce sodium and water reabsorption, and it also relaxes vascular smooth muscle, so blood pressure falls by more than the fluid loss alone would explain. It is used for high blood pressure, and for fluid retention where the label allows; the UK licence (MHRA) is for essential hypertension only.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Hypertension
• Oedema

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It can be taken with or without food and is normally a morning medicine, since taking it later means being woken to pass urine. Losses run to potassium and magnesium as well as water, so potassium and sodium are checked, along with uric acid, glucose and creatinine, which this class can move. Low potassium makes the heart more sensitive to digoxin, which is why the combination is watched closely. Adequate fluid matters, and the skin becomes more sensitive to sunlight, so strong sun is best avoided.

When to see a doctor

Muscle cramps, marked weakness, palpitations, confusion or fainting can point to a low potassium or sodium level and are reasons to see a doctor. The same applies to a painful swollen joint suggesting gout, or to signs of dehydration during hot weather or a stomach upset.

Worth knowing

• Can lower potassium
• Drink enough water
• Avoid strong sun

Markers to watch

• Potassium
• Sodium
• Uric acid
• Glucose
• Creatinine

Nutrients affected

• potassium — depleted by (Potassium)
• magnesium — depleted by (Glucose, HOMA-IR, Magnesium)