Lozide
Lozide Medication Information:
Lozide medication comes in several different strengths; click on the strength you need to view prices from pharmacies competing to earn your business.
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Lozide 1.250 mg
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Lozide 2.500 mg
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Pharmacology
Pharmacokinetics
Indapamide is rapidly and completely absorbed after oral administration. Peak blood levels are obtained after 1 to 2 hours. Indapamide is concentrated in the erythrocytes and is 79% bound to plasma proteins and to erythrocytes.
It is taken up by the vascular wall in smooth vascular muscle according to its high lipid solubility. Seventy per cent of a single oral dose is eliminated by the kidneys and 23% by the gastrointestinal tract. Indapamide is metabolized to a marked degree, the unchanged product representing approximately 5% of the total dose found in the urine during the 48 hours following administration. Elimination of indapamide from the plasma is biphasic with half-lives of 14 and 25 hours respectively.
Indications
The management of essential hypertension. It may be tried as a sole therapeutic agent in the treatment of mild to moderate hypertension. Normally indapamide, as other diuretics, is used as the initial agent in multiple drug regimens.
Precautions
Lactation
It is unknown whether or not indapamide appears in breast milk. Indapamide should not be administered to nursing mothers. If use of the drug is deemed essential, the patient should stop nursing.
Children
The safety and effectiveness have not been established.
Pregnancy
Since indapamide has not been studied in human pregnancy, the drug should not be given to pregnant women. The use in patients of childbearing potential requires that the anticipated benefit be weighed against possible hazards.
Supplied
2.5 mg
Each pink, sugar-coated tablet contains: indapamide hemihydrate 2.5 mg. Nonmedicinal ingredients: colloidal silica, corn starch, ethylcellulose, FD&C Red No. 3 lake, FD&C Yellow No. 6 lake, glycerol monooleate, lactose, magnesium stearate, polysorbate, povidone, pregelatinized corn starch, sodium benzoate, sodium carboxymethylcellulose, sucrose, talc, titanium dioxide and white beeswax. Blister-packs of 30 and 100.
Store at room temperature (15-30°C).
1.25 mg
Each round, orange, film-coated tablet, with S embossed on one side, contains: indapamide hemihydrate 1.25 mg. Nonmedicinal ingredients: glycerol, hydroxypropylmethyl cellulose, lactose monohydrate, macrogol 6000, magnesium stearate, maize starch, microcrystalline cellulose, pregelatinized starch, sunset yellow S aluminium lake, talc and titanium dioxide. Blister-packs of 30 and 100.
Contraindications
Anuria, progressive and severe oliguria, hepatic coma. Known hypersensitivity to indapamide or to other sulfonamide derivatives.
Warnings
Electrolyte changes observed with indapamide become severe at doses above 2.5 mg/day. Therefore the maximum daily dose should not exceed this dose.
Hypokalemia may occur at all doses with consequent weakness, cramps, and cardiac dysrhythmias. Hypokalemia is a particular hazard in digitalized patients; dangerous or fatal arrhythmias may be precipitated.
Hypokalemia occurs commonly with diuretics; electrolyte monitoring is essential particularly in patients who would be at increased risk from hypokalemia, such as patients with cardiac arrhythmias or those who are receiving concomitant cardiac glycosides.
Patients with renal insufficiency receiving indapamide should be carefully monitored. If increasing azotemia and oliguria occur during treatment, the diuretic should be discontinued.
Hyperuricemia may occur during administration of indapamide. Rarely gout has been reported. Blood uric acid levels should be monitored, particularly in patients with a history of gout who should continue to receive appropriate treatment.
Adverse Effects
Gastrointestinal
increased appetite, dry mouth, GI carcinoma, GI disorders, duodenitis, dysphagia, esophagitis, flatulence, gastritis, gastroenteritis, oral moniliasis, proctitis, rectal disorders, rectal hemorrhoids, stomatitis, tooth disorders and vomiting.
Central Nervous
agitation, amnesia, anxiety, ataxia, coordination abnormality, depression, dream abnormality, hyperesthesia, insomnia, migraine, paresthesia, somnolence, twitching and vertigo.
Musculoskeletal
arthralgia, arthritis, bone disorders, joint disorders, bone fracture, bone pain, chondrodystrophy, myalgia, myasthenia and myopathy.
Urogenital
dysmenorrhea, dysuria, impotence, urinary tract infection, nocturia, oliguria, urinary frequency or urgency, renal pain or calculus, prostate disorders and vaginitis.
Special Senses
amblyopia, ear disorders, ear pain, otitis, photophobia, taste perversion, tinnitus and vision abnormality.
Endocrine
gout.
Other
thyroid disorder, ecchymosis, allergic reaction, edema face, fever, hernia, malaise and monilia.
Metabolic and Nutritional
diabetes mellitus and gout.
Respiratory
bronchitis, dyspnea, laryngitis, lung disorder and sputum increase.
Dermatological
acne, application site reaction, exfoliative dermatitis, nail disorder, skin nodule, rash, bullous eruption and sweat.
Postmarketing Experience
Among the less common suspected adverse reactions reported, the following, which are not included elsewhere in the product monograph, have been published in the medical literature and/or are classified as serious or potentially serious: Stevens-Johnson syndrome, bullous eruption, photosensitivity with bullae, erythroderma, purpura, epidermal necrolysis, erythema multiforme, angioedema, cataract, acute myopia, optic neuritis, ventricular arrhythmia, torsades de pointe, stroke, acute hypersensitivity reaction leading to interstitial nephritis and renal failure, anemia, agranulocytosis, metabolic alkalosis, hyperosmolar coma, dehydration, hepatitis, pancreatitis, lithium toxicity, rhabdomyolysis, vasculitis, fever.
One case of synergetic effect of clofibrate with indapamide leading to hyponatremia, hypokalemia, hypoosmolarity, nausea and progressive loss of consciousness.
Relationship with the administration of indapamide has not been proved in all cases.
Cardiovascular
angina pectoris, bundle branch block, ventricular extrasystoles, atrial fibrillation, atrial flutter, hypertension, postural hypotension, palpitations, syncope, supraventricular tachycardia and vasodilation.
Overdose
Symptoms
There have been no reports of overdosage. Based on the pharmacological activities of indapamide, overdosage may lead to excessive diuresis with electrolyte depletion. In cirrhotic patients, overdosage might precipitate hepatic coma.
Treatment
There is no specific antidote. Treatment is symptomatic and supportive. Discontinue drug. Induce emesis or perform gastric lavage. Correct dehydration, electrolyte imbalance, hepatic coma and hypotension by established procedures.
Dosage
One 1.25 mg tablet/day taken in the morning as a single dose. If the response is not satisfactory after 4 to 8 weeks, the dose may be increased to a maximum of 2.5 mg as a single dose taken in the morning. If the antihypertensive response to indapamide is insufficient, an increase in dosage is not recommended (see Warnings).
Instead a nondiuretic antihypertensive agent should be added to the drug regimen. Alternatively if in the opinion of the physician, an important diuretic effect is desirable for the patient's control, a different diuretic which allows for dose titration could be tried instead of indapamide.
