Natrilix SR
Generic Name
Indapamide SR
Manufacturer
Servier
Country
France (Originator)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| natrilix sr 15 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Natrilix SR is a sustained-release tablet containing Indapamide, a thiazide-like diuretic used primarily for the treatment of essential hypertension. It helps lower blood pressure by increasing the excretion of sodium and water from the body.
Uses & Indications
Dosage
Adults
1.5 mg once daily, preferably in the morning. Swallow the tablet whole with water, do not chew or crush.
Elderly
Same as adults. Renal function should be monitored.
Renal_impairment
Mild to moderate renal impairment: 1.5 mg once daily. Severe renal impairment (CrCl < 30 ml/min): Contraindicated.
How to Take
Take one tablet orally once daily in the morning, swallowed whole with water. Do not chew or crush the tablet.
Mechanism of Action
Indapamide acts on the cortical diluting segment of the nephron, increasing the excretion of sodium and chloride, and secondarily, water. It also possesses a direct vascular effect, leading to a reduction in peripheral vascular resistance.
Pharmacokinetics
Onset
Antihypertensive effect typically observed within a few days, maximum effect after 2-4 weeks.
Excretion
Mainly via urine (about 70%) and feces (about 22%).
Half life
Approximately 14-24 hours.
Absorption
Well absorbed from the gastrointestinal tract. Food does not significantly affect absorption. Sustained release provides prolonged plasma levels.
Metabolism
Extensively metabolized in the liver, primarily by hydroxylation and glucuronidation.
Side Effects
Contraindications
- Severe renal impairment (creatinine clearance <30 ml/min)
- Hepatic encephalopathy or severe hepatic impairment
- Hypersensitivity to indapamide or sulfonamides
- Hypokalaemia
Drug Interactions
NSAIDs
Reduced antihypertensive effect; risk of acute renal failure in dehydrated patients.
Lithium
Increased plasma lithium levels, leading to toxicity. Monitor lithium levels.
Metformin
Risk of lactic acidosis, especially with renal impairment.
Cardiac glycosides (e.g., Digoxin)
Increased risk of digitalis toxicity due to hypokalaemia.
Potassium-depleting drugs (e.g., corticosteroids, other diuretics)
Increased risk of hypokalaemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include electrolyte disturbances (hypokalaemia, hyponatremia), hypotension, nausea, vomiting, dizziness. Management involves gastric lavage, correction of fluid and electrolyte balance, and supportive measures.
Pregnancy & Lactation
Pregnancy: Not recommended unless clearly necessary. Lactation: Excreted in breast milk, discontinue breastfeeding or the drug.
Side Effects
Contraindications
- Severe renal impairment (creatinine clearance <30 ml/min)
- Hepatic encephalopathy or severe hepatic impairment
- Hypersensitivity to indapamide or sulfonamides
- Hypokalaemia
Drug Interactions
NSAIDs
Reduced antihypertensive effect; risk of acute renal failure in dehydrated patients.
Lithium
Increased plasma lithium levels, leading to toxicity. Monitor lithium levels.
Metformin
Risk of lactic acidosis, especially with renal impairment.
Cardiac glycosides (e.g., Digoxin)
Increased risk of digitalis toxicity due to hypokalaemia.
Potassium-depleting drugs (e.g., corticosteroids, other diuretics)
Increased risk of hypokalaemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include electrolyte disturbances (hypokalaemia, hyponatremia), hypotension, nausea, vomiting, dizziness. Management involves gastric lavage, correction of fluid and electrolyte balance, and supportive measures.
Pregnancy & Lactation
Pregnancy: Not recommended unless clearly necessary. Lactation: Excreted in breast milk, discontinue breastfeeding or the drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generics available (Patent expired)
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of indapamide SR in essential hypertension, including trials like ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation).
Lab Monitoring
- Serum potassium levels
- Sodium levels
- Uric acid levels
- Blood glucose levels
- Renal function tests (creatinine, BUN)
Doctor Notes
- Regularly monitor patient's electrolyte levels, especially potassium.
- Advise patients on dietary potassium intake.
- Caution in patients with hepatic or renal impairment.
Patient Guidelines
- Take medicine at the same time each day, preferably in the morning.
- Do not stop taking the medicine without consulting your doctor.
- Inform your doctor about all other medications you are taking.
- Report any unusual side effects immediately.
Missed Dose Advice
If a dose is missed, take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose.
Driving Precautions
May cause dizziness, especially at the start of treatment or when changing dosage. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet low in sodium.
- Engage in regular physical activity.
- Avoid excessive alcohol consumption.
- Quit smoking.
- Monitor blood pressure regularly.
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