Medicine Information

Indimide-SR

Name: Indimide-SR
Brand: Indimide-SR
Rating: 4.5 (117 reviews)

Tablet15 mgAntihypertensive, DiureticATC: C03BA11

Generic Name

Indapamide (Sustained Release)

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
indimide sr 15 mg tablet	৳ 6.50	৳ 65.00

Description

Overview of the medicine

Indimide-SR 15 mg Tablet is a sustained-release formulation containing Indapamide, a thiazide-like diuretic. It is primarily used to treat essential hypertension. *Note: The standard sustained-release dose for Indapamide is typically 1.5 mg. A 15 mg SR dose is highly unusual and generally not recommended due to potential for severe side effects.*

Uses & Indications

Treatment of essential hypertension

Treatment of edema associated with congestive heart failure

Dosage

Adults

For essential hypertension, the usual dose of Indapamide SR is 1.5 mg once daily, preferably in the morning. A 15 mg dose is significantly higher than recommended and carries increased risk of adverse effects.

Elderly

No specific dosage adjustment is generally required in elderly patients, but renal function should be monitored.

Renal_impairment

Use with caution in patients with mild to moderate renal impairment. Contraindicated in severe renal impairment (creatinine clearance <30 ml/min).

How to Take

Take orally, once daily in the morning, with or without food. Swallow the tablet whole; do not chew or crush it.

Mechanism of Action

Indapamide acts by inhibiting the reabsorption of sodium and chloride in the cortical diluting segment of the renal tubules. This increases the excretion of sodium, chloride, and water, leading to a reduction in extracellular fluid volume and consequently, blood pressure. It also has direct vasodilatory effects on peripheral blood vessels.

Pharmacokinetics

Onset

Diuretic effect onset within 2 hours. Antihypertensive effect may take several days to weeks to fully develop.

Excretion

Approximately 70% eliminated via the kidneys and 20% via the gastrointestinal tract (feces).

Half life

Approximately 14-24 hours for Indapamide, allowing for once-daily dosing.

Absorption

Well absorbed from the gastrointestinal tract (approximately 93%). Peak plasma concentrations are reached within 12 hours for sustained-release formulations.

Metabolism

Extensively metabolized in the liver to inactive metabolites.

Side Effects

Contraindications

Hypersensitivity to Indapamide or other sulfonamide derivatives
Severe renal impairment (creatinine clearance <30 ml/min)
Severe hepatic impairment or hepatic encephalopathy
Hypokalemia
Anuria

Drug Interactions

Digoxin

Increased risk of digitalis toxicity due to hypokalemia.

Lithium

Increased plasma lithium levels and toxicity due to reduced renal clearance. Concurrent use is generally not recommended.

Metformin

Increased risk of lactic acidosis with concurrent use in patients with renal impairment (rare for 1.5mg, but consider for 15mg if renal function is suboptimal).

ACE inhibitors/ARBs

Increased risk of first-dose hypotension when initiating these agents in diuretic-treated patients.

Corticosteroids/Stimulant Laxatives

Increased risk of hypokalemia.

NSAIDs (e.g., Ibuprofen, Indomethacin)

May reduce the antihypertensive and diuretic effects of Indapamide.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms may include electrolyte disturbances (hypokalemia, hyponatremia), hypotension, nausea, vomiting, dizziness, drowsiness, and muscle cramps. In severe cases, profound diuresis may lead to dehydration and circulatory collapse. Management is symptomatic and supportive, including correction of fluid and electrolyte imbalances.

Pregnancy & Lactation

Not recommended during pregnancy due to potential for placental ischemia and fetal growth retardation. Excreted in breast milk; avoid during breastfeeding or discontinue breastfeeding if use is essential.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets30 tablets

Shelf Life

36 months from manufacturing date.

Availability

Available in pharmacies and hospitals

Approval Status

Approved by DGDA (Bangladesh)

Patent Status

Off-patent (generic available)

WHO Essential Medicine

Yes

Clinical Trials

Clinical trials have established the efficacy and safety of Indapamide 1.5 mg SR for essential hypertension. Data for a 15 mg SR dose is not widely available, as it is outside standard therapeutic recommendations.

Lab Monitoring

Serum electrolytes (especially potassium, sodium, magnesium, calcium) at regular intervals
Renal function (creatinine, BUN) periodically
Blood glucose levels (especially in diabetic patients)
Uric acid levels

Doctor Notes

Monitor serum potassium closely, especially during initial therapy and in patients at risk of hypokalemia.
Assess renal function before and during treatment.
Educate patients on symptoms of electrolyte imbalance.
Consider potential drug interactions, especially with lithium and NSAIDs.
Emphasize that 15 mg SR is an atypical dose and risks may outweigh benefits.

Patient Guidelines

Take your medicine regularly as prescribed, even if you feel well.
Do not stop taking the medicine without consulting your doctor.
Report any unusual side effects, especially muscle weakness or severe dizziness.
Maintain a balanced diet and stay hydrated.
Avoid excessive salt intake.

Missed Dose Advice

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

May cause dizziness or fatigue, especially at the start of treatment or when the dose is changed. Exercise caution when driving or operating machinery.