Indapafon
Indapafon: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Indapafon
ATX code: C03BA11
Active ingredient: indapamide (Indapamide)
Manufacturer: JSC "Borisov Plant of Medical Products" (JSC "BZMP") (Republic of Belarus)
Description and photo update: 2019-09-07
Indapafon is a thiazide-like diuretic used in the treatment of hypertension.
Release form and composition
Dosage form - coated tablets: biconvex, the color of the shell is blue, two layers stand out on the cross-section (in a cardboard box there are 3 blister packs of 10 tablets and instructions for use of Indapafon).
Composition of 1 tablet:
- active substance: indapamide - 2.5 mg;
- auxiliary components: starch 1500, lactose monohydrate, calcium stearate, partially pregelatinized corn starch, hydroxypropyl methylcellulose, Opadry II (partially hydrolyzed polyvinyl alcohol, macrogol 3350, talc, blue pigment color, soy lecithin, aluminum titanium dioxide lacquer iron oxide).
Pharmacological properties
Pharmacodynamics
Indapamide - the active substance of Indapafon, is a sulfonamide derivative, a thiazide-like diuretic with a long-term effect of moderate severity. It causes a moderate diuretic and saluretic effect, which is associated with inhibition of the reabsorption of hydrogen ions, chlorine, sodium, and, to a lesser extent, potassium ions, which occurs in the proximal tubules and in the cortical segment of the distal nephron tubule.
Indapafon has an antihypertensive effect, which manifests itself only in the case of initially high blood pressure.
The main pharmacological properties of the drug:
- decreased tone of smooth muscles of the arteries;
- a decrease in the total peripheral vascular resistance, which is associated with several mechanisms - the elimination of the excess content of sodium ions in the vascular wall, due to the high lipophilicity of indapamide; an increase in the biosynthesis of prostaglandins E 2 and prostacyclins (prostaglandins I 2), which have vasodilating properties; decreased sensitivity of the vascular wall to catecholamines; inhibition of the influx of calcium ions into the smooth muscle cells of the vascular wall.
The diuretic effect of Indapafon in the case of its use in therapeutic doses is significantly lower than its vasodilating effect.
Indapamide has practically no effect on carbohydrate and lipid metabolism in therapeutic doses.
Usually, the antihypertensive effect develops 7-10 days after the start of the drug, the maximum effect develops after 3 months of daily use.
Pharmacokinetics
Indapamide is rapidly absorbed from the gastrointestinal tract after oral administration. C max (maximum concentration) in blood plasma is reached within 1–2 hours after administration.
The substance binds to plasma proteins at a level of 70–79%. The pharmacokinetic parameters of indapamide do not change with repeated administration, which is evidence of the minimal risk of cumulation.
Excreted in breast milk.
Due to its high lipophilicity, indapamide has a long half-life (T 1/2), on average it leaves 18 hours. Excretion from the body occurs very slowly, mainly by the kidneys (about 60%), most of the dose is excreted in the form of metabolites, as an unchanged substance - 5%.
Indications for use
Indapafon is prescribed for the treatment of arterial hypertension.
Contraindications
- severe violations of liver and kidney function;
- anuria;
- acute disorders of cerebral circulation;
- hypokalemia;
- gout;
- diabetes mellitus in the stage of decompensation;
- rare hereditary lactose intolerance, lactase deficiency or glucose-galactose malabsorption;
- pregnancy and lactation;
- age up to 18 years;
- individual intolerance to the components of Indapafon, as well as sulfonamide derivatives.
Indapafon, instructions for use: method and dosage
Indapafon tablets are taken orally, whole, without chewing, with water.
Single dose - 1 tablet (2.5 mg), frequency of administration - 1 time per day in the morning.
Indapafon is intended for long-term use.
Side effects
Possible adverse reactions [> 10% - very common; (> 1% and 0.1% and 0.01% and <0.1%) - rarely; <0.01% - very rare]:
- digestive system: constipation, diarrhea, nausea, xerostomia, discomfort, epigastric pain;
- cardiovascular system: rarely - orthostatic hypotension, palpitations, arrhythmia, changes in the electrocardiogram (hypokalemia);
- respiratory system: sinusitis, pharyngitis, cough; rarely - rhinitis;
- nervous system: insomnia, drowsiness, nervousness, asthenia, headache, dizziness, depression, vertigo; rarely - general weakness, increased fatigue, malaise, tension, muscle spasm, anxiety, irritability;
- urinary system: nocturia, frequent infections, polyuria;
- allergic reactions: hemorrhagic vasculitis, skin rash, itching, urticaria;
- sense organs: visual impairment, conjunctivitis;
- others: rhinorrhea, weight loss, pancreatitis, tingling in the extremities, chest pain, flu-like syndrome, back pain, infections, decreased libido, impotence, exacerbation of SLE (systemic lupus erythematosus), sweating.
Overdose
In the case of a long course or taking high doses of Indapafon, hyponatremia, hypokalemia and hypochloremic alkalosis may occur. The likelihood of an overdose increases in patients with severe heart failure (NYHA classification - III – IV functional class), chronic renal failure, liver cirrhosis, diarrhea, and also while adhering to a salt-free diet.
The main symptoms of an overdose of indapamide are arterial hypotension, disturbances in water and electrolyte balance (in the form of hyponatremia, hypokalemia), vomiting, and nausea.
Therapy: symptomatic.
special instructions
Patients with kidney and liver disease require monitoring of blood potassium levels.
With hyperuricemia, it is recommended to regularly measure the uric acid content in the blood.
Vincamine, lithium preparations, potassium-excreting diuretics should not be used during the period of therapy with Indapafon.
Against the background of hyperaldosteronism, patients taking cardiac glycosides, drugs with laxative effects, as well as elderly patients during the use of Indapafon, it is necessary to carefully monitor the content of creatinine and potassium ions.
During the period of therapy, systematic monitoring of the plasma concentration of sodium, potassium, magnesium ions (associated with the likelihood of electrolyte disturbances), pH, uric acid, residual nitrogen and glucose concentrations is necessary.
The most careful monitoring is shown in patients with cirrhosis of the liver (especially in combination with edema or ascites, which is associated with the likelihood of metabolic alkalosis, which increases the manifestations of hepatic encephalopathy), coronary heart disease, chronic heart failure, as well as the elderly. In addition, the high-risk group includes patients with an increased QT interval on the ECG (resulting from any pathological process or congenital).
The first measurement of the concentration of potassium ions in the blood should be carried out during the first week of therapy.
Hypercalcemia that occurs while taking Indapafon may be associated with previously undiagnosed hyperparathyroidism.
In diabetes mellitus, it is extremely important to control blood glucose levels, especially in patients with hypokalemia.
During doping control, Indapafon can give a positive result.
As a result of significant dehydration, the development of acute renal failure (decreased glomerular filtration) is likely. Patients need to compensate for water loss and carefully monitor kidney function at the beginning of Indapafon intake.
Patients with hyponatremia (associated with diuretic therapy) and arterial hypertension three days before the start of the course of angiotensin-converting enzyme inhibitors should stop taking diuretics (if indicated, it can be resumed somewhat later). Another option is to administer low initial doses of angiotensin-converting enzyme inhibitors.
Taking Indapafon can exacerbate the course of SLE.
Influence on the ability to drive vehicles and complex mechanisms
Patients when driving vehicles should take into account the likelihood of developing individual reactions associated with changes in blood pressure, especially at the beginning of treatment and when adding another drug with an antihypertensive effect.
Application during pregnancy and lactation
- pregnancy: the use of diuretics is recommended to be avoided, Indapafon should not be used for the treatment of physiological edema that occurs during pregnancy. Diuretics can cause fetoplacental insufficiency and lead to a threat of fetal malformation. The drug can be prescribed only when absolutely necessary after taking an anamnesis regarding pregnancy or its planning;
- lactation period: the use of Indapafon is contraindicated, since indapamide is excreted in breast milk.
Pediatric use
The safety profile of Indapafon in children has not been studied, therefore the drug should not be prescribed to patients under 18 years of age.
With impaired renal function
Indapafon tablets are contraindicated for patients with severe renal impairment.
For violations of liver function
Indapafon is contraindicated in patients with severe liver dysfunction.
Drug interactions
- cardiac glycosides: with simultaneous use, the risk of developing digitalis intoxication increases;
- Ca 2+ preparations: the risk of developing hypercalcemia increases;
- metformin: aggravation of lactic acidosis may be noted;
- lithium preparations: have a nephrotoxic effect, indapamide leads to an increase in the plasma concentration of Li ions in the blood (associated with a decrease in excretion in the urine);
- erythromycin (intravenous administration), astemizole, pentamidine, terfenadine, sultopride, vincamine, class Ia and III antiarrhythmic drugs (disopyramide, quinidine, bretilium, amiodarone, sotalol): with combined use, arrhythmias of the pirouette type may develop;
- glucocorticosteroids, non-steroidal anti-inflammatory drugs, sympathomimetics, tetracosactide: the hypotensive effect of indapamide is reduced;
- baclofen: the hypotensive effect of indapamide is enhanced;
- potassium-sparing diuretics: in some patients, the combination may be effective, however, there is a possibility of hyper- or hypokalemia, especially in patients with renal failure and diabetes mellitus;
- angiotensin-converting enzyme inhibitors: with simultaneous use, the risk of acute renal failure and / or arterial hypotension increases (especially in patients with renal artery stenosis);
- iodine-containing contrast agents (when used in high doses): the risk of developing renal dysfunction increases (associated with dehydration); before using iodine-containing contrast agents, fluid loss must be restored;
- tricyclic (imipramine) antidepressants, drugs with antipsychotic action: the hypotensive effect of indapamide increases, while the likelihood of orthostatic hypotension increases;
- cyclosporine: against the background of combined use, the likelihood of developing hypercreatininemia increases;
- indirect anticoagulants (derivatives of indandione or coumarin): their effectiveness decreases, which is associated with an increase in the concentration of coagulation factors due to a decrease in the volume of circulating blood and an increase in their production by the liver (may lead to the need for dose adjustment);
- non-depolarizing muscle relaxants: the blockade of neuromuscular transmission is enhanced.
Analogs
Indapafon analogs are Acripamide, Ravel SR, Indap, Indapres, Indapamid, Arifon, Pamid, Retapres, etc.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Indapafon
Most often, the drug is prescribed as part of the complex treatment of arterial hypertension, in which it is difficult to isolate the effect of a separate agent. In a few reviews about Indapafon, patients indicate that it is not inferior in efficiency to analogues.
Price for Indapafon in pharmacies
The price of Indapafon is unknown, since the drug is not available in pharmacies.
The approximate cost of analogs:
- Indap (30 tablets 2.5 mg each) - 113 rubles;
- Indapamide (30 tablets of 2.5 mg) - 83 rubles;
- Ravel SR (30 tablets of 1.5 mg each) - 192 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
