Indapamide - Oral: Uses, Side Effects, Dosages - Verywell Health
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What Is Indapamide?
Indapamide is an oral prescription drug used to treat hypertension (high blood pressure) alone or in combination with other medicines. It can also treat swelling due to congestive heart failure (CHF).
Indapamide is in a drug class called thiazide-like diuretics, often referred to as water pills, because they act directly on the kidneys to promote urine flow. It works by helping the kidneys eliminate excess water and salt in the urine.
Indapamide is a generic medication. Its former brand-name product, Lozol, is no longer available. However, you can still get indapamide generically. It is available as a tablet that is taken by mouth.
Drug Facts
Generic Name: Indapamide
Brand Name(s): Lozol (brand name no longer available)
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Thiazide-like diuretic
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Indapamide
Dosage Form(s): Tablet
What Is Indapamide Used For?
The U.S. Food and Drug Administration (FDA) approved indapamide to:
- Treat high blood pressure, either alone or in combination with other medications
- Treat swelling (salt and fluid retention) associated with heart failure
Indapamide is used in adults and has not been approved for children.
Thiazide-like diuretics such as indapamide are often used as first-line drugs (the first choice for treatment) for high blood pressure. They can be used as a monotherapy (single-drug treatment) or in combination with other blood pressure-lowering medications.
Indapamide stops the kidneys from absorbing sodium, causing the sodium to be excreted in your urine. As it is excreted, the sodium takes the fluid from the blood with it. This decreases the amount of fluid in the veins and arteries, thereby lowering blood pressure.
How to Take Indapamide
If prescribed indapamide, read your medication's prescription label and information leaflet. Consult your healthcare provider if you have any questions.
Use indapamide precisely as directed by your provider, and do not skip doses. Your healthcare provider may change your dose occasionally. Take the exact dose that your healthcare provider tells you to take.
While taking indapamide:
- Take it daily in the morning unless directed otherwise by your healthcare provider. Because diuretics can make you urinate frequently, it is best to take them after you wake up, so they do not interfere with sleep.
- Call your healthcare provider if you are sick with vomiting, diarrhea, or sweating more than usual. You may become dehydrated while taking indapamide, possibly causing low blood pressure and/or an electrolyte imbalance.
- Follow your healthcare provider's instructions on lab tests and blood pressure checks.
- Do not stop taking indapamide, even if you feel well unless directed by your healthcare provider. People with high blood pressure often do not have any noticeable symptoms.
Storage
Store at room temperature (between 68 F and 77 F), away from heat, direct light, and moisture. Do not store it in the bathroom. Keep this medication in its original labeled container and out of reach of children and pets to prevent accidental consumption. Keep the bottle tightly closed when not in use.
Off-Label Uses
Healthcare providers may prescribe indapamide for off-label uses, meaning for uses not specifically indicated by the FDA.
Indapamide is sometimes used off-label for swelling and fluid retention caused by health conditions other than heart disease. Talk to your healthcare provider or pharmacist for more information on its use for off-label conditions.
How Long Does Indapamide Take to Work?
Indapamide starts to reach its blood pressure-reducing effect within one or two weeks after starting it.
What Are the Side Effects of Indapamide?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.
Like other medications, indapamide can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.
Common Side Effects
Most side effects are mild and temporary. Commonly reported side effects include:
- Low potassium and sodium levels in the blood
- Increased levels of uric acid in the blood
- Rash/itching
- Stomach problems (e.g., nausea, vomiting, stomach pain)
- Orthostatic hypotension (a drop in blood pressure when standing up)
- Muscle cramps
- Tiredness
- Vertigo (feeling off-balance)
- Sun sensitivity
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Dial 911 if your symptoms feel life-threatening or if you think you're having a medical emergency. Serious side effects and their symptoms can include the following:
- Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing.
- Severe skin reaction: Symptoms may include fever, sore throat, burning eyes, red or purple rash, and/or blistering or peeling skin. These symptoms require emergency medical attention.
- Electrolyte imbalance, including low potassium levels: Be alert to symptoms such as drowsiness/tiredness, muscle or leg cramps or weakness, incoordination, fast heartbeat, numbness and tingling, vomiting, constipation, confusion, headache, slurred speech, lightheadedness, dry mouth, thirst, and/or little or no urination.
- Irregular heartbeat
- Inflammation of the pancreas: Be alert to stomach pain (that may spread to the back), nausea, and vomiting.
- Kidney failure: Be alert to less or no urination, swelling, tiredness, and shortness of breath.
- Acute angle-closure glaucoma: Get emergency medical help immediately if you have vision changes or eye pain. This is a sudden and severe eye emergency due to a build-up of pressure in the eye and can cause permanent vision loss if not treated right away.
- Low platelet levels: This can increase the risk of bruising and bleeding.
- Low white blood cell counts: This can interfere with the body's ability to fight infection.
Long-Term Side Effects
A study looking at the long-term effects of indapamide found the drug to be safe and effective when taken for three years.
Another trial looked at indapamide use over 10 years, concluding that the drug was well-tolerated and side effects were mild and rare. In some cases, mild electrolyte imbalances occurred over time, an expected effect of diuretic medication. The study found that most side effects happened in the first month of treatment.
During long-term treatment with indapamide, fewer than 10% of people had increased uric acid levels. Increased uric acid levels can lead to gout. However, only a few of the people taking indapamide developed gout. Indapamide did not affect cholesterol or blood sugar levels.
Report Side Effects
Indapamide may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Indapamide Should I Take?
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For fluid retention (edema):
- Adults—At first, 2.5 milligrams (mg) once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 5 mg.
- Children—Use and dose must be determined by your doctor.
- For high blood pressure:
- Adults—At first, 1.25 milligrams (mg) once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 5 mg.
- Children—Use and dose must be determined by your doctor.
- For fluid retention (edema):
Modifications
The following factors may affect how you take indapamide:
- Age (especially those 65 and older)
- Other medical conditions, such as liver or kidney problems and increased uric acid levels
- Pregnancy or breastfeeding
Age
You may need to use caution when taking indapamide if you are 65 years or older, especially if you are prone to dehydration or electrolyte imbalance. Some older adult women have had severe cases of low sodium and low potassium levels. Older adults are also more likely to have liver, kidney, or heart problems. If you are 65 or older, your healthcare provider may start you on a lower dose.
Other Medical Conditions
People with liver or kidney problems increased uric acid levels and/or gout, and other medical conditions may need to use indapamide with caution and be closely monitored.
Pregnancy or Breastfeeding
People who are pregnant or planning to become pregnant should consult their healthcare provider regarding indapamide use. Women who already take indapamide and find out they are pregnant should immediately notify their healthcare provider.
It is not known if indapamide passes into breast milk. High doses of diuretics may decrease milk production, so other diuretics in lower doses may be a preferred alternative to indapamide. Women who are breastfeeding should consult their healthcare provider.
Missed Dose
If you miss a dose of indapamide, take it as soon as possible. If it is almost time for the next dose, skip the missed dose. Do not take two doses together to make up for a missed dose.
Overdose: What Happens If I Take Too Much Indapamide?
Taking too much indapamide may cause low blood pressure, dehydration, weakness, and confusion, lasting up to three days.
What Happens If I Overdose on Indapamide?
If you think you or someone else may have overdosed on indapamide, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking indapamide, call 911 immediately.
Precautions
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Check with your doctor right away if you have confusion, decreased urine, dizziness, drowsiness, dry mouth, increased thirst, fast or irregular heartbeat or pulse, headache, muscle pains or cramps, nausea or vomiting, seizures, swelling of the face, ankles, or hands, trouble breathing, or unusual tiredness or weakness. These may be symptoms of an electrolyte imbalance (eg, low sodium or potassium in the blood).
This medicine may cause changes in your blood sugar levels. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.
Check with your doctor right away if you have blurred vision, difficulty in reading, eye pain, or any other change in vision during or after treatment. This could be a sign of a serious eye problem. Your doctor will want you to have your eyes checked by an ophthalmologist (eye doctor).
Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
Do not take other medicines unless they have been discussed with your doctor. This especially includes prescription or nonprescription (over-the-counter) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may increase your blood pressure.
What Are Reasons I Shouldn't Take Indapamide?
Indapamide is not appropriate for everyone. You should not take this medication if you are allergic to indapamide, sulfa drugs, such as Bactrim (trimethoprim/sulfamethoxazole), or any inactive ingredients in this medication.
People with anuria (inability to produce urine) should also not take indapamide.
Indapamide may be prescribed with caution in some people only if your healthcare provider determines it is safe. This includes older adults (65 and older) and people with:
- Severe kidney problems
- Liver problems
- Electrolyte abnormalities
- Volume depletion (low fluid volume)
- Seizure disorders
- Irregular heartbeat
- History of a procedure called a sympathectomy
- Diabetes
- Lupus
- A history of gout
- A history of pancreas inflammation
- High blood pressure during pregnancy
What Other Medications Interact With Indapamide?
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter (OTC) drugs and vitamins or supplements. While taking indapamide, do not start any new medications without approval from your healthcare provider.
Indapamide may interact with the following:
Sometimes, a drug interaction can be used to its advantage. For example, indapamide, in combination with another blood pressure drug, can have an additive effect on lowering blood pressure. Many people require more than one medication to control blood pressure. Using several drugs allows them to work in different ways to control blood pressure. In these cases, blood pressure will be carefully monitored to avoid lowering blood pressure too much.
Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with indapamide.
What Medications Are Similar?
Indapamide is a thiazide-like diuretic. It works in a part of the kidneys called the distal convoluted tubule. Other thiazide or thiazide-like diuretics include:
- Chlorthalidone
- Microzide (hydrochlorothiazide) (this drug is also found as an ingredient in many combination drugs with other types of blood pressure medications, such as Hyzaar, which contains losartan and hydrochlorothiazide)
- Metolazone
Loop diuretics are named such because they work in a part of the kidneys called the loop of Henle. These diuretics include:
Potassium-sparing diuretics are weaker diuretics that do not cause potassium loss. Examples include:
Potassium-sparing diuretics are often taken in combination with other types of diuretics. For example, Dyazide contains triamterene (a potassium-sparing diuretic) and hydrochlorothiazide (a thiazide-like diuretic).
Although the above list focuses on diuretics, many other drugs are used for blood pressure and/or heart failure.
This is a list of drugs also prescribed for use as diuretics. It is NOT a list of drugs recommended to take with indapamide. Talk to your pharmacist or a healthcare provider if you have questions.
How Can I Stay Healthy While Taking Indapamide?
While taking indapamide, ask your healthcare provider how much (and what type of) liquids you should drink. People taking diuretics must be careful about becoming overheated or dehydrated, especially when outside in hot temperatures, during exercise, or if they are not drinking enough liquids.
Thiazide diuretics are known for causing sun sensitivity. When taking indapamide, avoid tanning beds and stay out of the sun when you can. If you are in the sun, wear protective clothing and apply sunscreen of at least SPF 30. Reapply sunscreen regularly, especially if you are swimming or sweating. See a dermatologist at regular intervals for skin screenings.
Medical Disclaimer
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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