Names and pronunciation
(in-dap′a-mide) Lozide
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Individual generic drug information
Extracted information for indapamide only.
(in-dap′a-mide) Lozide
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Func. class.: Diuretic—thiazide-like, antihypertensive
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Chem. class.: Indoline I
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ACTION: Acts on proximal section of distal renal tubule by inhibiting reabsorption of sodium; may act by direct vasodilation caused by blocking of calcium channels
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USES: Edema of HF, mild-moderate hypertension may be used alone or in combination
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Extracted information for indapamide only.
CONTRAINDICATIONS: Hyper- sensitivity to this product or sulfon- amides; anuria, hepatic coma Precautions: Breastfeeding, hypokalemia, dehydration, ascites, hepatic disease, severe renal disease, CCr <30 mL/min (not effec- tive), diabetes mellitus, gout, pregnancy, cardiac dysrhythmias, geriatrics
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SIDE EFFECTS CNS: Headache, dizziness, fatigue, weakness, nervousness, agitation, extremity numbness, depression CV: Orthostatic hypotension, volume depletion, palpitations, dysrhythmias, PVCs, vasculitis EENT: Blurred vision, nasal congestion, increased intraocular pressure ELECT: Hypochloremic alkalosis, hypo magnesemia, hyperuricemia, hyper calcemia, hyponatremia, hypokalemia, hyperglycemia GI: Nausea, diarrhea, dry mouth, vomit- ing, anorexia, cramps, constipation, abdominal pain, hypercholesterolemia GU: Polyuria, nocturia, urinary fre- quency, impotence HEMA: Agranulocytosis, anemia INTEG: Rash, pruritus, Stevens-Johnson syndrome MS: Cramps
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INTERACTIONS Increase: Dysrrthmias, torsades de pointes risk: class Ia, III antidysrhyth- mias, phenothiazides, benzamide/butyro- phenone antipsychotics Increase: hyperglycemia—diazoxide Increase: toxicity of muscle relaxants, steroids, lithium, digoxin Increase: hypokalemia—corticosteroids, amphotericin B, loop diuretics, thiazide diuretics Decrease: effects—antidiabetics, anti- gout agents, anticoagulants Decrease: absorption—cholestyramine, colestipol Decrease: hypotensive effect— indomethacin, NSAIDs Drug/Food Increase: severe hypokalemia—licorice Drug/Herb Increase: antihypertensive effect— hawthorn Drug/Lab Test Increase: calcium, parathyroid test, glu- cose, uric acid
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TREATMENT OF OVERDOSE: Lavage if taken orally; monitor electro- lytes, administer IV fluids; monitor hydration, CV, renal status
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Extracted information for indapamide only.
DOSAGE AND ROUTES Edema • Adult: PO 2.5 mg/day in AM; may be increased to 5 mg/day if needed after 1 wk Antihypertensive • Adult: PO 1.25 mg/day in AM; may increase to 2.5 mg/day after 4 wk; if not effective after 4 wk, may increase to max dose of 5 mg/day
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Available forms: Tabs 1.25, 2.5 mg
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Administer: • In AM to avoid interference with sleep • With food if nausea occurs; absorption may be decreased slightly • If ineffective at 2.5 mg/day, may add another antihypertensive agent (hyper- tension)
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Extracted information for indapamide only.
Assess: • Weight, I&O daily to determine fluid loss; effect of product may be decreased if used daily • Rate, depth, rhythm of respirations, effect of exertion • B/P lying, standing; postural hypoten- sion may occur • Electrolytes: potassium, magnesium, sodium, chloride: include BUN, CBC, se- rum creatinine, blood pH, ABGs, uric acid, Ca, glucose • Signs of metabolic alkalosis, hypokalemia • Rashes, fever daily; allergy to sulfa products • Confusion, especially in geriatric patients; take safety precautions if needed • Hydration: skin turgor, thirst, dry mu- cous membranes • Beers: use with caution in older adults; may cause or exacerbate syndrome of inap- propriate antidiuretic hormone secretion • Pregnancy/breastfeeding: use only if benefit outweighs fetal risk; do not breastfeed, excretion unknown
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Evaluate: • Therapeutic response: improvement in edema of feet, legs, sacral area daily; decreased B/P
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To consume diet high in potassium; to rise slowly from lying or sitting position • To recognize adverse reactions: mus- cle cramps, weakness, nausea, dizziness • To take with food, milk for GI symp- toms; to take early in day to prevent nocturia; to avoid alcohol • To notify prescriber if urinary output decreases; to monitor daily weight • Not to stop product abruptly
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Extracted information for indapamide only.
PHARMACOKINETICS Well absorbed (PO); widely distributed; metabolized by liver; excreted by kidney (small amounts); onset 1-2 hr; peak 2 hr; duration up to 36 hr; excreted in urine, feces; half-life 14-18 hr
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Filter the extracted dose blocks for this individual drug.
Edema
• Adult: PO 2.5 mg/day in AM; may be increased to 5 mg/day if needed after 1 wk Antihypertensive
Candidate age grouping · source page 695
Edema
• Adult: PO 1.25 mg/day in AM; may increase to 2.5 mg/day after 4 wk; if not effective after 4 wk, may increase to max dose of 5 mg/day
Candidate age grouping · source page 695