関: Thiazide diuret- ics

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diuretic (trade name Lozal) used in the treatment of hypertension (同)Lozal

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/21 11:21:55」(JST)

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Indapamide is a thiazide-like diuretic^[1] drug marketed by Servier, generally used in the treatment of hypertension, as well as decompensated heart failure. Combination preparations with perindopril (an ACE inhibitor antihypertensive) are also available.

Form and composition

Indapamide is available generically as 1.25 mg and 2.5 mg non-scored tablets.^[2] It is now also available in SR (sustained release) form.

Indications

Hypertension and edema due to congestive heart failure. Indapamide has been proven in the HYVET trial to reduce stroke and all cause mortality when given with or without perindopril to people over the age of 80 for the treatment of hypertension.^[3]

Dosage and administration

The adult dosage is 1.25 to 5 mg, orally and once daily, usually in the morning.

Contraindications

Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level.

There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding.

Interactions

Caution is advised in the combination of indapamide with lithium and nonantiarrhythmic drugs causing wave-burst arrhythmia (astemizole, bepridil, IV erythromycin, halofantrine, pentamidine, sultopride, terfenadine, vincamine).

Precautions

Monitoring of potassium and uric acid serum levels is recommended, especially in subjects with a predisposition or a sensitivity to hypokalemia and in patients with gout.

Adverse effects

Commonly reported adverse events are hypokalemia (low potassium levels), fatigue, orthostatic hypotension (blood pressure decrease on standing up) and allergic manifestations.

Overdosage

Symptoms of overdosage would be those associated with a diuretic effect, i.e. electrolyte disturbances, hypotension, and muscular weakness. Treatment should be symptomatic, directed at correcting electrolyte abnormalities.

References

^ Indapamide at the US National Library of Medicine Medical Subject Headings (MeSH)
^ http://online.lexi.com/crlsql/servlet/crlonline
^ "HYVET Trial".

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1. 糖尿病患者における高血圧治療 treatment of hypertension in patients with diabetes mellitus
2. 心房細動患者における脳卒中 stroke in patients with atrial fibrillation
3. 高齢者における高血圧、特に収縮期高血圧の治療 treatment of hypertension in the elderly patient particularly isolated systolic hypertension
4. 原発性（本態性）高血圧患者におけるサイアザイド系利尿薬の使用 use of thiazide diuretics in patients with primary essential hypertension
5. 脈圧の上昇 increased pulse pressure

English Journal

Treatment of Hypertensive Patients With Diabetes and Microalbuminuria With Combination Indapamide SR/Amlodipine: Retrospective Analysis of NESTOR.

Hanon O1, Boully C2, Caillard L2, Labourée F2, Cochiello S2, Chaussade E2.
American journal of hypertension.Am J Hypertens.2015 Aug;28(8):1064-71. doi: 10.1093/ajh/hpu297. Epub 2015 Jan 26.
BACKGROUND: Combination treatments for hypertension most often include a renin-angiotensin-aldosterone system (RAAS) inhibitor. However, systolic blood pressure (SBP) remains difficult to control. Non-RAAS-inhibiting strategies such as calcium channel blocker/thiazide-like diuretic combinations may
PMID 25628416

Preconcentration of indapamide from human urine using molecularly imprinted solid-phase extraction.

Yılmaz H1, Basan H1.
Journal of separation science.J Sep Sci.2015 Jul 3. doi: 10.1002/jssc.201500427. [Epub ahead of print]
A simple, sensitive, and selective molecularly imprinted solid-phase extraction and spectrophotometric method has been developed for the clean-up and preconcentration of indapamide from human urine. Molecularly imprinted polymers were prepared by a non-covalent imprinting approach using indapamide a
PMID 26140700

Hydrochlorothiazide is not the most useful nor versatile thiazide diuretic.

Vongpatanasin W1.
Current opinion in cardiology.Curr Opin Cardiol.2015 Jul;30(4):361-5. doi: 10.1097/HCO.0000000000000178.
PURPOSE OF REVIEW: To determine usefulness and versatility of hydrochlorothiazide (HCTZ) relative to other thiazide diuretics in the treatment of hypertension.RECENT FINDINGS: HCTZ was found to be less potent in lowering blood pressure (BP) than other thiazide diuretics, including chlorthalidone (CT
PMID 26049382

Japanese Journal

A case of hypokalemia-induced fatal arrhythmia caused by indapamide in an anorexic elderly patient

OHASHI Naro,MINEMURA Shoko,TOGAWA Akashi,OHYAMA Kunio
Clinical and experimental nephrology 15(5), 761-764, 2011-10-01
NAID 10030341241

Effects of Additional Administration of Low-Dose Indapamide on Patients With Hypertension Treated With Angiotensin II Receptor Blocker

Yamada Hirotsugu,Mishiro Yuichiro,Kusunose Kenya,Sata Masataka
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS 15(2), 145-150, 2010
NAID 120004738249

Combination of an ACE Inhibitor and Indapamide Improves Blood Pressure Control, but Attenuates the Beneficial Effects of ACE Inhibition on Plasma Adiponectin in Patients With Essential Hypertension

HUANG Shao-Sung,WU Tao-Cheng,LIN Shing-Jong,CHEN Jaw-Wen
Circulation journal : official journal of the Japanese Circulation Society 73(12), 2282-2287, 2009-11-20
… Methods and Results: After a 2-week placebo run-in phase, 30 patients with essential hypertension were randomized to receive preterax (2 mg perindopril/0.625 mg indapamide) or cilazapril (2.5 mg) once daily for 12 weeks. … Conclusions: The combination of an ACEI and indapamide improved BP control, but attenuated the beneficial effects of ACE inhibition on plasma adiponectin in patients with essential hypertension. …
NAID 10025938377

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「インダパミド」

Indapamide
Systematic (IUPAC) name
	4-chloro-N-(2-methyl-2,3-dihydroindol-1-yl)-3-sulfamoyl-benzamide
Clinical data
AHFS/Drugs.com	monograph
MedlinePlus	a684062
Pregnancy; category	B(US), C (Aus);
Legal status	POMt;
Routes of; administration	Oral tablet
Pharmacokinetic data
Protein binding	71–79%
Metabolism	Hepatic
Biological half-life	14–18 hours
Identifiers
CAS Registry Number	26807-65-8
ATC code	C03BA11
PubChem	CID: 3702
IUPHAR/BPS	7203
DrugBank	DB00808
ChemSpider	3574
UNII	F089I0511L
KEGG	D00345
ChEMBL	CHEMBL406
Chemical data
Formula	C16H16ClN3O3S
Molecular mass	365.835 g/mol
	SMILES O=S(=O)(N)c1c(Cl)ccc(c1)C(=O)NN3c2ccccc2CC3C ;
	InChI InChI=1S/C16H16ClN3O3S/c1-10-8-11-4-2-3-5-14(11)20(10)19-16(21)12-6-7-13(17)15(9-12)24(18,22)23/h2-7,9-10H,8H2,1H3,(H,19,21)(H2,18,22,23) ; Key:NDDAHWYSQHTHNT-UHFFFAOYSA-N ;
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　　[★]

英: indapamide
商: ナトリックス、テナキシル
関: 降圧薬、利尿薬

Na/Cl cotransporterを阻害しNaClと水の排泄を促進する。チアジド系利尿薬と類似の作用を持ちながら、降圧作用が大きい。

[1] Indapamide at the US National Library of Medicine Medical Subject Headings (MeSH)

[2] ttp://online.lexi.com/crlsql/servlet/crlonline

[3] "HYVET Trial".

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indapamide