Generic
Indapamide+Amlodipine
2 brands available in the market
At a glance
Indapamide + Amlodipine combination tablet is used as substitution therapy for treatment of essential hypertension in patients already controlled with indapamide and amlodipine given concurrently at the same dose level.
Description
Indapamide + Amlodipine is a combination medicine used for essential hypertension. Indapamide is a thiazide-like diuretic that inhibits sodium reabsorption in the cortical diluting segment, increasing sodium and chloride excretion. Amlodipine is a dihydropyridine calcium ion influx inhibitor that lowers blood pressure through a direct relaxant effect on vascular smooth muscle.
Indications
- Essential hypertension (substitution therapy - in patients already controlled with indapamide and amlodipine at the same dose level)
Therapeutic class
Combined antihypertensive preparations
Pharmacological class
Thiazide-like Diuretic + Dihydropyridine Calcium Channel Blocker
Pharmacology
Indapamide is a sulphonamide derivative related to thiazide diuretics that inhibits sodium reabsorption in the cortical dilution segment, increasing urinary excretion of sodium and chlorides. Amlodipine is a calcium ion influx inhibitor of the dihydropyridine group that inhibits transmembrane influx of calcium ions into cardiac and vascular smooth muscle. Its antihypertensive action is due to a direct relaxant effect on vascular smooth muscle.
Mechanism of action
Indapamide removes excess water by inhibiting sodium reabsorption in the distal tubule; Amlodipine lowers blood pressure by relaxing vascular smooth muscle.
Dosage
Adult Dose (Oral):
- One tablet daily as single dose in the morning
- Swallow whole with water, do not chew
- Fixed dose combination is not suitable for initiation therapy
Renal Impairment: Contraindicated in severe renal impairment (CrCl <30 mL/min); no dose adjustment needed in mild-moderate
Hepatic Impairment: Contraindicated in severe hepatic impairment; caution and start at lower end in mild-moderate
Child Dose: Safety and efficacy not established
Administration
Take one tablet daily in the morning; swallow whole with water; do not chew; if dose change needed, titrate with individual components.
Missed dose
If you miss a dose, take it as soon as possible; if it is almost time for your next dose, skip the missed dose and go back to regular schedule; do not double the dose.
Side effects
Most Common:
- Somnolence
- Dizziness
- Headache
- Palpitations
- Flushing
- Abdominal pain
- Nausea
- Ankle swelling
- Edema
- Fatigue
Precautions & warnings
Precautions:
- Caution in recent heart attack, heart failure, arrhythmias, coronary artery disease
- Caution in kidney problems
- Caution in hypertensive crisis
- Caution in elderly when dose needs to be increased
- Caution in malnutrition, liver problems, diabetes, gout
- Caution before parathyroid function tests
- Caution if history of photosensitivity reactions
Contraindications
Contraindications:
- Hypersensitivity to active substances, other sulphonamides, dihydropyridine derivatives or excipients
- Severe renal failure (CrCl <30 mL/min)
- Hepatic encephalopathy or severe impairment of liver function
- Hypokalemia
- Lactation
- Severe hypotension
- Shock (including cardiogenic shock)
- Obstruction of left ventricular outflow tract (e.g., high-grade aortic stenosis)
- Hemodynamically unstable heart failure after acute myocardial infarction
Drug interactions
No significant drug interactions reported.
Food interactions
No food interaction found/established.
Use in pregnancy
Use in Pregnancy: Not recommended during pregnancy; switch to alternative treatment as soon as pregnancy is planned or confirmed.
Use in lactation
Use in Lactation: Must not take this medicine if breastfeeding; tell doctor immediately if breastfeeding or about to start breastfeeding.
Pediatric use
Safety and efficacy in children and adolescents have not been established; no data available.
Geriatric use
Elderly patients can be treated according to renal function; caution when dose needs to be increased.
Renal / hepatic impairment
Renal Impairment: Contraindicated in severe renal impairment (CrCl <30 mL/min); no dose adjustment needed in mild-moderate renal impairment.
Hepatic Impairment: Contraindicated in severe hepatic impairment; dose selection should be cautious and start at lower end in mild-moderate hepatic impairment.
Overdose effects
Overdose: Expected symptoms: excessive peripheral vasodilation, reflex tachycardia, hypotension; gastric lavage, activated charcoal; cardiovascular support; vasopressors and calcium gluconate may be effective; hemodialysis not effective.
Storage conditions
Keep below 30°C temperature, away from light & moisture; keep out of reach of children.
Chemical structure
Indapamide + Amlodipine