Indapamide belongs to the family of medications called diuretics ("water pills"). It is used alone or in combination with other medications to treat mild-to-moderate high blood pressure. This medication works by making the body lose excess water and salt.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended starting dose of indapamide is 1.25 mg once daily in the morning. After 4 to 8 weeks, your doctor may increase this to 2.5 mg once daily, depending on the effect of the medication. If a dose of 2.5 mg daily does not reduce your blood pressure sufficiently, your doctor will likely add another blood-pressure-lowering medication that is not a diuretic or may try a different diuretic. Do not take more than 2.5 mg daily.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

1.25 mg
Each orange, round, biconvex, film-coated tablet, engraved "1.25" on one side and "APO" on the other contains 1.25 mg indapamide. Nonmedicinal ingredients: croscarmellose sodium, hydroxyethyl cellulose, lactose, magnesium stearate, polyethylene glycol, titanium dioxide, FD&C Yellow No. 6 Aluminum Lake 40%, and D&C Yellow No. 10 Aluminum Lake 14-18%.

2.5 mg
Each pink, round, biconvex, film-coated tablet, engraved "2.5" on one side and "APO" on the other contains 2.5 mg indapamide. Nonmedicinal ingredients: croscarmellose sodium, hydroxyethyl cellulose, lactose, magnesium stearate, polyethylene glycol, titanium dioxide, D&C Red No. 30 Aluminum Lake 30%.

Do not take indapamide if you:

• are allergic to indapamide or any ingredients of this medication
• are allergic to sulfa (sulfonamide) medications (e.g., sulfamethoxazole)
• are breast-feeding
• are pregnant
• are taking certain medications that can increase the risk of a type of abnormal heart rhythm called torsades de pointes
• have low levels of potassium in your blood
• have severe kidney failure
• have severe liver impairment, including possible brain involvement
• have lactose or galactose intolerance or malabsorption

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• cough
• diarrhea
• dizziness or lightheadedness, especially when rising from a lying or sitting position
• dry mouth
• headache
• nausea
• sensation of spinning
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• faster, slower, or irregular heartbeat
• flu-like symptoms (e.g., sudden lack of energy, fever, cough, sore throat)
• increased infections
• unexplained muscle cramps or pain
• pain in the stomach, back, or chest
• rash or itching
• sensation of burning or prickling in arms, hands, legs, or feet
• signs and symptoms of imbalance of water, sodium, or potassium in the body (e.g., muscle pain or cramps, weakness, irregular heart beat)
• signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• signs of gout (e.g., joint pain, swelling and warmth of joints)
• signs of high blood calcium levels (e.g., loss of appetite, nausea, vomiting, constipation or stomach pain)
• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, swelling, fatigue, abdominal pain)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of muscle damage (e.g., unexplained muscle pain, tenderness or weakness, or brown or discoloured urine)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• unusual tiredness or weakness
• vision changes (e.g., sudden nearsightedness, blurred vision, eye pain, blind spots)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• symptoms of irregular heart beat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, pimozide, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, probucol, tacrolimus) can increase the risk of a type of abnormal heart rhythm called torsades de pointes and should be used with caution with indapamide.

If you are taking medication for abnormal heart rhythms, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Allergy: Some people who are allergic to sulfonamides also experience allergic reactions to indapamide, as it has a sulfonamide component. Before you take indapamide, tell your doctor about any previous adverse reactions you have had to medications, especially sulfonamide (sulfa) antibiotics. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Diabetes: Although indapamide has very little effect on blood sugar control, people with diabetes may need additional insulin to keep blood sugar levels steady. High blood sugar and sugar in the urine may occur for people who have risk factors for developing diabetes.

If you have diabetes, or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Dizziness: Indapamide can cause severe dizziness, especially when rising from a sitting or lying position. This is more likely to occur when starting to take indapamide or increasing the dose being taken, particularly when other medications with similar side effects are being taken. If you are taking medications that can cause dizziness, rise slowly from sitting or lying down to reduce the possibility of severe dizziness or fainting.

Electrolytes: Changes in the blood levels of electrolytes such as potassium and magnesium become severe at doses above 2.5 mg per day. Do not take more than 2.5 mg per day.

Abnormally low blood potassium levels may occur at all doses causing weakness, cramps, and abnormal heart rhythms. The warning signs of electrolyte imbalance are:

• drowsiness
• dry mouth
• frequent urination
• low blood pressure
• muscle fatigue
• muscle pains or cramps
• racing heartbeat
• restlessness
• stomach problems (e.g., nausea, vomiting)
• thirst
• tiredness
• weakness

Galactose intolerance: Indapamide medications are prepared with lactose. If you have lactose or galactose intolerance you should not take these medications.

Gout: Indapamide may increase the level of uric acid in the body. If you develop painful, warm and swollen joints contact your doctor as soon as possible. If you have a history of gout, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: This medication is not helpful for people with severely reduced kidney function. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience a decrease in the amount of urine your body is producing, contact your doctor as soon as possible.

Liver function: If you have liver disease or reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you have severely reduced liver function you should not take indapamide because this increases the risk for developing liver-caused brain disease.

Sun sensitivity: Like other sulfonamide medications, indapamide may cause increased sensitivity to the effects of exposure to the sun. If you experience a severe sunburn-like reaction while taking indapamide, contact your doctor immediately. Regardless, you should take measures to protect yourself from the sun, such as use of an appropriate sunscreen and keeping exposed skin covered, while taking indapamide.

Systemic lupus erythematosus: This medication can worsen or activate the symptoms of lupus. If you experience swollen and painful joints, fever, fatigue, or rash on the nose and cheeks while taking this medication, contact your doctor.

Vision changes: Although rare, indapamide can cause vision changes, including increased eye pressure, myopia (nearsightedness), or an abnormal buildup of fluid in the eye. If you experience any eye symptoms, such as pain, blind spots or changes in vision, contact your doctor as soon as possible. A history of allergy to sulfonamides may increase the risk of developing eye problems from this medication.

Pregnancy: In general, diuretics should not be used during pregnancy, due to the risk of reducing the growth of the fetus. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding and are taking indapamide, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of indapamide for use by children have not been established.

Seniors: Seniors may be at an increased risk of developing side effects to indapamide. Lower doses may be appropriate when using this medication to treat high blood pressure for seniors.

There may be an interaction between indapamide and any of the following:

• aclidinium
• alcohol
• aldesleukin
• allopurinol
• alpha-blockers (e.g., alfuzosin, tamsulosin)
• amiodarone
• amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; e.g., captopril, lisinopril, ramipril)
• antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., cariprazine, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• apomorphine
• atropine
• barbiturates (e.g., butalbital, phenobarbital)
• benztropine
• beta2-agonists (e.g., formoterol, indacaterol, salbutamol, salmeterol)
• bortezomib
• brigatinib
• brimonidine
• bromocriptine
• buprenorphine
• butorphanol
• calcium supplements (e.g., calcium carbonate, calcium citrate)
• cholestyramine
• clidinium
• colesevelam
• colestipol
• oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• cyclobenzaprine
• cyclophosphamide
• darifenacin
• desmopressin
• diabetes medications (e.g., acarbose, canagliflozin, dulaglutide, gliclazide, insulin, metformin, sitagliptin)
• diazoxide
• digoxin
• dimenhydrinate
• disopyramide
• diuretics (e.g., bumetanide, furosemide)
• duloxetine
• fesoterodine
• general anesthetics (medications used to put people to sleep before surgery)
• glycopyrrolate
• ipratropium
• ivabradine
• ketotifen
• levodopa
• licorice
• lithium
• methadone
• methylphenidate
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• multiple vitamins/minerals
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone, tramadol)
• nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., celecoxib, ibuprofen, ketorolac, naproxen)
• obinutuzumab
• orphenadrine
• oxybutynin
• pentoxifylline
• pergolide
• phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
• pramipexole
• propiverine
• primidone
• riociguat
• ropinirole
• rotigotine
• sacubitril
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline, vortioxetine)
• sodium phosphates
• solifenacin
• sotalol
• tiotropium
• tizanidine
• tolterodine
• topiramate
• tretinoin
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine)
• trihexyphenidyl
• trospium
• vitamin D analogues (e.g., alfacalcidol, calcitriol, cholecalciferol)
• yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.