Indapamide: Find Out All About It

Indapamide is a drug prescribed in the treatment of hypertension. It has a low cost, few side effects, and can be used in conjunction with other medications.
Indapamide: Find Out All About It

Last update: 15 June, 2021

Indapamide is a drug used in the treatment of hypertension. It is a diuretic from the thiazide family. It was one of the first drugs to prove effective in controlling blood pressure compared to taking a placebo.

Some studies recommend it as a preferential initial treatment for hypertension. This is partly due to its low price (it doesn’t have a trademark as it’s generic), the ability to use it alongside other drugs, and its few side effects. We’ll tell you everything you need to know.

What is indapamide used for?

Indapamide, renal action
Indapamide acts in the kidney by promoting the elimination of water and some electrolytes. This reduces the blood volume and therefore blood pressure.

Indapamide belongs to the family of thiazide diuretics which work by inhibiting the absorption of sodium by the kidneys. This means that the excess sodium is eliminated with the urine, which in turn helps reduce fluid retention. Having less fluid in the blood lowers blood pressure and helps keep the disease under control.

Indapamide helps in the management of hypertension, but not the cure. The treatment is therefore permanent, even when the patient no longer presents any symptoms.

In addition to being used to treat high blood pressure, the Food and Drug Administration (FDA) also recommends it for congestive heart failure.

Evidence indicates that this drug is particularly useful for lowering systolic blood pressure levels. For this reason, it is recommended in the elderly with this isolated condition. Its intake doesn’t replace the need for a low sodium diet, a habit that all hypertensive patients must follow.

It’s very common for it to be prescribed alongside another drug, such as perindopril. In fact, numerous studies and research suggest taking them at the same time. The usefulness of associating the vasorelaxant effects of indapamide with calcium channel blockers deserves further study.

How is indapamide taken?

The drug can only be taken orally. Doses vary depending on the context, based on age, weight, the severity of the condition, and possible drug interactions. In general, the dose ranges from 1.25 to 5 milligrams, starting with the lowest dose and increasing over the weeks. This gives time to evaluate the effects and how it’s tolerated. If the pressure reduction is favorable and there are no obvious consequences, the specialist will proceed to increase the dosage.

If the expected results aren’t achieved, another drug will be prescribed as a complement. It’s usually taken once a day, every day. The frequency and use of the drug may vary depending on the patient’s condition. If you forget to take your tablet, take it as soon as you remember, unless the time for your next dose is very close.

The drug should be stored in a dry place and at room temperature. It’s best to leave it in the original packaging, always keeping the lid closed. It should be kept out of the reach of children, to avoid episodes of intoxication from accidental ingestion.

Contraindication to the use of indapamide

Despite being among the most used drugs in the treatment of hypertension, indapamide isn’t free from contraindications. The contexts in which its use should be limited are the following:


Due to the lack of studies in this regard, taking the drug is not recommended in pregnant or lactating women.

Although increases in blood pressure are quite common during pregnancy, these are usually treated with other research-supported drugs, for example, with calcium channel blockers such as nifedipine.

Chronic diseases

Examples here are diabetes and kidney failure. Although taking the drug is safe when both diseases are controlled, we know that the use of thiazide diuretics can be counterproductive if they’re decompensated.

For this reason, the specialist must be informed if you suffer from one of these two diseases. In this way, you’ll be able to follow up on possible side effects. You should also tell your doctor if you have any liver problems.


Although the reason isn’t yet fully understood, it has been discovered that the drug can worsen syncope episodes and even cause them if taken in the presence of other diseases (such as long QT syndrome). You need to take precautions if you opt for it, as it can increase the risks.


Patients with gout should exercise caution while taking indapamide.
Gout is a chronic inflammatory disease characterized by severe pain and swelling in some joints.

Studies indicate that indapamide is related to the increase in uric acid in the body. This is why its use is contraindicated in patients suffering from gout, or at least prone to develop it. If the specialist doesn’t find an alternative, then recurrent monitoring of uric acid levels should be carried out in order to avoid complications.

Other conditions that may get worse when taking the drug are hypotension, allergies to the base component of the drug, taking certain medications, lupus, and chronic thyroid imbalances.

There is insufficient data on how the drug works in children or adolescents. If symptoms of childhood hypertension occur and if you choose to take it, the results, possible side effects, and its long-term efficacy should be carefully considered.

Side effects of taking the drug

As with any medicine, the use of indapamide can lead to the development of side effects. The most noticeable is the increased urination. This effect usually lasts for 4-6 hours after taking the drug, although it can be more extensive, depending on the case.

Other common side effects are:

  • Drowsiness
  • Vertigo
  • Confusional state
  • Muscle cramps
  • Blurred vision
  • Excessive thirst

In most cases, the effects usually go away with adherence to the drug; in other cases, they last for several months. Although they’re rare, it’s also possible to develop:

  • Weight loss
  • Difficulty breathing
  • Loss of libido
  • Chronic fatigue

If the patient is allergic to indapamide, they’ll have hives, swelling of the throat, tongue and breathing problems. In this case, it’s necessary to consult the specialist as soon as possible and temporarily suspend his intake.

Please note that the use of this and other drugs should only be carried out under medical supervision. Self-medication is contraindicated, as life-threatening ailments can even develop.

If you suspect you have hypertension, book a specialist visit to get an exact diagnosis and targeted treatment.

  • Achimastos, A., Liberopoulos, E., Nikas, S., Bairaktari, E., Miltiadous, G., Tsimihodimos, V., & Elisaf, M. The effects of the addition of micronised fenofibrate on uric acid metabolism in patients receiving indapamide. Current medical research and opinion. 2002; 18(2): 59-63.
  • Appel, L. J. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. Jama. 2002; 288(23): 3039-3042.
  • Ayala, A. E. G. Hipertensión arterial y embarazo. Farmacia professional. 2005; 19(11): 44-47.
  • Lambers Heerspink, H. , Ninomiya, T., Perkovic, V., Woodward, M., Zoungas, S., Cass, A., … & Chalmers, J. Effects of a fixed combination of perindopril and indapamide in patients with type 2 diabetes and chronic kidney disease. European heart journal. 2010; 31(23): 2888-2896.
  • London, G. M. Efficacy of indapamide 1.5 mg, sustained release, in the lowering of systolic blood pressure. Journal of human hypertension. 2004; 18(2); S9-S14.
  • Myers, M. G., Asmar, R., Leenen, F. H., & Safar, M. Fixed low-dose combination therapy in hypertension-a dose response study of perindopril and indapamide. Journal of hypertension. 2000; 18(3); 317-325.
  • Navarro, M. Á. R., Rivera, M. Á. N., & Zerón, H. M Eficacia de indapamida SR en el tratamiento de hipertensión sistólica aislada en pacientes ancianos. Revista Latinoamericana de Hipertensión. 2011; 6(3): 47-51.
  • Neglia, D., Fommei, E., Varela-Carver, A., Mancini, M., Ghione, S., Lombardi, M., … & Camici, P. G. Perindopril and indapamide reverse coronary microvascular remodelling and improve flow in arterial hypertension. Journal of hypertension. 2011; 29(2): 364-372.
  • Sinha, A. D., & Agarwal, R. Thiazide diuretics in chronic kidney disease. Current hypertension reports. 2015; 17(3): 1-6.
  • Waeber B, Rotaru C, Feihl F. Position of indapamide, a diuretic with vasorelaxant activities, in antihypertensive therapy. Expert Opin Pharmacother. 2012 Jul;13(10):1515-26.
  • WANG, C. P., & GUO, G. B. F. Indapamide induced syncope in a patient with long QT syndrome. Pacing and clinical electrophysiology. 2002; 25(9): 1397-1399.

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