Vazamide SR

Management of mild to moderate HTN & edema including that associated w/ heart failure.

1 tab once daily.

May be taken with or without food: Preferably taken in the morning. Swallow whole w/ water, do not chew/crush.

Hypersensitivity to indapamide or other sulphonamides. Hypokalaemia. Severe hepatic failure or hepatic encephalopathy. Severe renal failure w/ CrCl <30 mL/min.

Discontinue use immediately in case of hepatic encephalopathy, particularly in case of electrolyte imbalance; photosensitivity (protect exposed areas to the sun or artificial UVA if use is necessary). Regularly monitor plasma Na especially in the elderly & cirrhotic patients. Frequently monitor plasma K in the elderly, malnourished, polymedicated patients, cirrhotic patients w/ edema & ascites, & CAD & cardiac failure patients. May decrease urinary Ca elimination & may cause slight transitory rise in plasma Ca. W/draw treatment before investigating parathyroid functions. Frequently monitor blood glucose in diabetic patients for presence of hypokalemia. May increase tendency of gout attacks in hyperuricemic patients. Hypovolemia due to diuretic-induced loss of water & Na may cause reduction in the glomerular filtration leading to an increase in blood urea & plasma creatinine. Transitory functional renal insufficiency may worsen in patients w/ preexisting renal insufficiency. May render +ve reaction in doping test. Not recommended in patients w/ galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May impair ability to drive vehicles or to operate machinery. Avoid use in pregnant women & should never be used to treat physiological edema of pregnancy. Lack of studies on possible excretion in human milk; risk to infant cannot be excluded.

Giddiness, diarrhea, headache, anorexia, gastric irritation, nausea, vomiting, abdominal pain. Electrolyte imbalances including hypochloraemic alkalosis, hyponatraemia, hypokalaemia, & hyperuricaemia. Hypersensitivity reactions which include skin rashes, pulmonary edema, pneumonitis, cholestatic jaundice, pancreatitis & blood dyscrasias including thrombocytopenia.

Concomitant use w/ lithium is not recommended. Increased risk of ventricular arrhythmias particularly torsades de pointes w/ class Ia (quinidine, hydroquinidine, & disopyramide) & class III (amiodarone, sotalol, dofetilide, & ibutilide) antiarrhythmics, & antipsychotics [phenothiazines (chlorpromazine, cyamemazine, levomepromazine, thioridazine, & trifluoperazine), benzamides (amisulpride, sulpiride, sultopride, & tiapride), & butyrophenones (droperidol & haloperidol)]. Antihypertensive effect may be decreased w/ NSAIDs (systemic) including COX-2 selective inhibitors, high-dose salicylic acid (≥3 g/day). Risk of sudden hypotension &/or acute renal failure w/ ACE inhibitors in presence of preexisting Na depletion (particularly in patients w/ renal artery stenosis). Risk of hypokalemia may be increased w/ K-depleting drugs eg, amphotericin B (IV), gluco- & mineralocorticoids (systemic), stimulant laxatives, & tetracosactide. Antihypertensive effect may be increased w/ baclofen. Hypokalemia may increase risk to exposure of toxic effects of digitalis. May increase incidence of hypersensitivity reactions to allopurinol. Increased occurrence of hypokalemia/hyperkalemia w/ K-sparing diuretics (amiloride, spironolactone, & triamterene) particularly in patients w/ renal failure or diabetes. Increased risk of metformin-induced lactic acidosis. Additive antihypertensive effects w/ imipramine-like antidepressants (neuroleptics). Decreased urinary elimination of Ca may increase risk of hypercalcemia. Risk of increased plasma creatinine w/ ciclosporin. May lead to decreased antihypertensive effect w/ corticosteroids.

Diuretics

C03BA11 - indapamide ; Belongs to the class of low-ceiling sulfonamide diuretics.

Rx