Indapamide

About Indapamide

Indapamide makes the kidneys pass more salt and water and, over weeks, relaxes blood vessels, which lowers blood pressure. Its label covers high blood pressure, alone or with other blood pressure medicines, and the salt and fluid retention of congestive heart failure. It is taken once a day in the morning. For blood pressure the label starts at 1.25 mg and lets the prescriber raise the dose after four weeks if the response is not enough; for heart failure it starts at 2.5 mg, with a possible increase after one week, and patients are kept on the lowest dose that works.

There is no boxed warning, but the label’s main warning is about salt balance: severe cases of low sodium together with low potassium have occurred at recommended doses, mostly in older women, so both are checked periodically, and muscle cramps, weakness or a fast or irregular heartbeat should be reported. Headache, dizziness, tiredness and more frequent urination are common at first and usually ease. It can raise uric acid and bring on gout, it can raise blood sugar, and it should not be given with lithium, whose levels it raises.

Indapamide contains a sulfonamide group, so anyone who has reacted to indapamide or to other sulfonamide-derived drugs must not take it, and it is not used when the kidneys produce no urine; kidney or liver disease calls for caution. The prescriber may pair it with a low-salt diet, potassium-rich foods or a potassium supplement, which is the prescriber’s call, not something to add on your own.

Taking Indapamide

How to take it

Once a day in the morning, with or without food, at about the same time each day. Keep taking it even if you feel well; only the prescriber changes the dose.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture, out of reach of children.

Interactions to know about

It should not be taken with lithium, whose clearance it slows. It adds to the effect of other blood pressure medicines, low potassium is more dangerous with digoxin, and corticosteroids increase potassium loss. Tell the prescriber about diabetes, gout, kidney or liver disease and any planned surgery, and report a racing or irregular heartbeat, severe rash, or trouble breathing or swallowing.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Indapamide differs from pharmacy to pharmacy

Indapamide is an old generic that costs pharmacies little, but far fewer companies make it than make hydrochlorothiazide or chlorthalidone, so it is not on every flat-price list. A pharmacy that fills it rarely may order it in and price it as a slow-moving item, while one that stocks it routinely can quote much less for the same tablet.

Ways to pay less for Indapamide without insurance

• Ask whether indapamide is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Ask for a ninety-day prescription once your dose and blood tests are stable.
• If your dose is 2.5 mg, make sure the prescription is written for one 2.5 mg tablet rather than two 1.25 mg tablets.
• If it is quoted high, ask the prescriber whether chlorthalidone or hydrochlorothiazide, which more pharmacies keep on flat-price lists, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Indapamide

1. 1.When will my sodium and potassium be checked?
2. 2.Which symptoms of low sodium or low potassium mean I should call?
3. 3.Is it safe with my sulfa allergy, gout or diabetes?
4. 4.Does it interact with my lithium, digoxin or other blood pressure medicines?

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