Indapamide

Indapamide is a type of medicine called a diuretic.

Diuretics are sometimes called "water pills/tablets" because they make you pee more.

Indapamide is used to treat high blood pressure (hypertension). It's also sometimes used to treat heart failure.

Indapamide is only available on prescription.

It comes as tablets and slow-release ("modified-release") tablets.

Indapamide sometimes comes mixed with perindopril to also treat high blood pressure.

• It's usual to take indapamide once a day, in the morning.
• You can take indapamide with or without food.
• The most common side effect of indapamide is a skin rash.
• Indapamide is not usually recommended during pregnancy.
• Indapamide is also called by the brand names Natrilix, Indipam XL, Rawel XL, Tensaid XL and Alkapamid XL.

Indapamide can be taken by adults aged 18 and over.

Indapamide isn't suitable for some people. Tell your doctor if you:

• have had an allergic reaction to indapamide or any other medicine in the past
• are pregnant or breastfeeding
• have liver disease
• have kidney disease
• have low levels of calcium, potassium or sodium in your blood
• have gout
• have diabetes
• have an inflammatory condition called systemic lupus erythematosus
• have heart rhythm problems
• have underactive adrenal glands (Addison's disease)
• have a rare blood disease called porphyria

It's usual to take it once a day, in the morning.

Do not take indapamide too late in the day (after 4pm) or at night, otherwise you may have to wake up to go to the toilet.

How much will I take?

The usual dose to treat:

• heart failure is 2.5mg to 5mg once a day
• high blood pressure is 2.5mg once a day – but if you're taking slow-release indapamide, you'll take a lower dose of 1.5mg

If you have trouble swallowing pills, ask your pharmacist or doctor for advice. Do not crush or chew slow-release tablets, as this stops them from working properly.

How to take it

Swallow the tablets whole with a drink of water. You can take indapamide with or without food.

What if I forget to take it?

If you usually take your dose in the morning, take your forgotten dose as soon as you remember, unless it's after 4pm. In this case, skip the missed dose and take your next dose as usual.

Do not take a double dose to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicines.

What if I take too much?

Accidentally taking an extra dose of indapamide is unlikely to harm you.

If you have accidentally taken too much, you may:

• feel sick (nausea) or be sick (vomit)
• feel very thirsty
• have diarrhoea
• feel faint, dizzy or weak
• feel sleepy
• have muscle cramps

If you take too much indapamide by accident, contact your doctor and have the packet with you.

In serious cases you can have fits (seizures) and may need emergency treatment in hospital.

Go to A&E straight away if you take too much indapamide and feel unwell

Like all medicines, indapamide can cause side effects, although not everyone gets them. Side effects often get better as your body gets used to the medicine.

Common side effects

These common side effects of indapamide happen in more than 1 in 100 people. They include:

• peeing more than normal – most people need to pee a couple of times within a few hours of taking indapamide, and you may also lose a bit of weight as your body loses water
• mild skin rash
• feeling or being sick
• feeling dizzy or faint

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Tell your doctor straight away if you get:

• a severe skin reaction including swelling, itching blistering and flu-like symptoms with a high temperature (38C and above)
• a severe stomach pain that develops suddenly, feeling or being sick, diarrhoea, indigestion, a high temperature, yellowing of your skin or the whites of your eyes and tenderness or swelling of your stomach – these could be signs of pancreatitis
• feeling or being sick, confusion, yellow skin or eyes, dark pee, pale poo, tiredness and loss of appetite – these could be signs of liver disease

Serious allergic reaction

In rare cases, indapamide may cause a serious allergic reaction (anaphylaxis).

Call 999 or go to A&E if:

These are not all the side effects of indapamide. For a full list, see the leaflet inside your medicine packet.

You can report any suspected side effect to the UK safety scheme.

What to do about:

• peeing more than normal – it's nothing to worry about but, if it's inconvenient for you, change the time you take indapamide to one that better suits you, provided it's no later than 4pm. If peeing a lot is still a problem for you, talk to your pharmacist or doctor.
• mild skin rash – it may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you. If your skin rash does not go away, speak to your doctor. They may suggest a change of treatment.
• feeling or being sick – try taking indapamide after a meal. Try to stick to simple foods and avoid rich or spicy meals. Drink water or squash in small, frequent sips so you don't get dehydrated (ask your doctor how much fluid you can drink). Speak to your doctor if your symptoms continue for more than a week.
• feeling confused or dizzy – try sitting or lying down until you feel better. If you begin to feel dizzy, lie down so that you don't faint, then sit until you feel better. Do not drive or use tools or machinery while you're feeling dizzy or shaky.

Indapamide isn't normally recommended in pregnancy. However, your doctor may prescribe it if they think the benefits of the medicine outweigh the risks.

If you're trying to get pregnant or already are pregnant, talk to your doctor about the benefits and possible harms of taking indapamide.

It will depend on how many weeks pregnant you are and why you're taking the medicine. There may be other treatments that are safer for you.

Indapamide and breastfeeding

Indapamide isn't normally recommended when breastfeeding. It can reduce the amount of breast milk you produce.

Talk to your doctor, as other medicines might be better while you're breastfeeding.

Tell your doctor if you’re:

Some medicines can interfere with the way indapamide works.

If you're taking these medicines, tell your doctor before starting indapamide:

• medicines that treat, or might give you, an irregular heartbeat – including amiodarone, digoxin and sotalol
• other medicines that treat high blood pressure – like ACE inhibitors such as ramipril, angiotensin receptor blockers such as candesartan, or calcium channel blockers such as amlodipine
• medicines that decrease blood pressure, including baclofen, levodopa or clonidine
• medicines used to treat mental health problems, including amisulpride, lithium, pimozide and risperidone
• medicines that can change the level of potassium in your blood, such as potassium supplements, steroids or other diuretics
• painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), including diclofenac, ibuprofen and naproxen

Mixing indapamide with herbal remedies and supplements

Some supplements, such as calcium, can cause side effects if taken with indapamide.

There's very little other information about taking herbal remedies and supplements with indapamide.

Important

For safety, tell your pharmacist or doctor if you're taking any other medicines, including herbal remedies, vitamins or supplements.