Indapamide tablets

Indapamide is a diuretic (a water tablet).

It is best taken in the morning.

Any side-effects are usually mild. The most common are feeling sick, feeling dizzy and a skin rash.

Type of medicine Diuretic
Used for High blood pressure
Also called Standard-release tablets: Natrilix®
Modified-release tablets: Ethibide XL®; Indipam® XL; Natrilix SR®; Rawel® XL; Tensaid XL®; Varbim® XL
Tablets of indapamide with perindopril arginine: Coversyl® Arginine Plus
Available as Tablets
Modified-release tablets (indapamide is released more slowly to give an even effect)

Indapamide belongs to a group of medicines called diuretics. A diuretic is a medicine which increases the amount of urine that you pass out from your kidneys. They are often referred to as water tablets. Diuretics are a common treatment for hypertension (high blood pressure).

Diuretics like indapamide work by interfering with the transport of salt and water across certain cells in your kidneys. The effect of this is to make your kidneys pass out more urine. They also widen (dilate) blood vessels. A combination of these two effects reduces high blood pressure.

Indapamide can be used on its own or alongside other medicines which reduce blood pressure. It is also available as a combination tablet with a medicine called perindopril arginine.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking indapamide it is important that your doctor or pharmacist knows:

  • If you are pregnant or breast-feeding.
  • If you have kidney or liver problems.
  • If you have gout, diabetes, or systemic lupus erythematosus (SLE). These conditions may be made worse by diuretics.
  • If you have been told by a doctor that you have low sodium or potassium levels in your blood, or high calcium levels in your blood.
  • If you have a problem with your adrenal glands, called Addison's disease.
  • If you have a rare inherited blood disorder called porphyria.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have had an unusual reaction to a medicine known as a 'sulfonamide'.
  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about indapamide and a full list of side-effects which you may experience from taking it.
  • Take indapamide exactly as your doctor has told you. The usual dose is one tablet daily. Your doctor is likely to recommend that you take it in the morning.
  • Swallow the tablet with a drink of water. You can take it before or after your meals.
  • If you have been prescribed a modified-release tablet (these have 'SR' or 'XL' after the brand name), these tablets should be swallowed whole. Do not break, crush or chew them.
  • If you forget to take a tablet, take it as soon as you remember. However, if it is after 6 pm in the evening, you should skip the forgotten dose and continue as usual the next day. Do not take two doses at the same time to make up for a missed dose.
  • Treatment for high blood pressure is usually long-term. Although many people with high blood pressure do not feel unwell, if left untreated, high blood pressure can harm your heart and damage your blood vessels. This damage may later result in a heart attack, stroke, or kidney problems, so it is important that you continue to take these tablets regularly to help reduce the risk of this.
  • Try to keep your regular appointments with your doctor. This is so your doctor can monitor your blood pressure and check on your progress. Also, the salt balance in your bloodstream may be upset by indapamide and your doctor may want you to have a blood test from time to time to check for this.
  • You may be given some lifestyle or dietary advice by your doctor, such as stopping smoking, reducing the amount of salt in your diet and taking some regular exercise. Following this advice will also help to reduce the risk of damage to your heart and blood vessels.
  • Diuretics like indapamide help you to lose water. Occasionally you may lose too much and become dehydrated. Let your doctor know if you feel constantly thirsty, your mouth is dry, or your skin looks and feels dry.
  • Drinking alcohol while you are on indapamide may make you feel dizzy. Ask for your doctor's advice about whether you should avoid alcohol.
  • If you buy any medicines, check with a pharmacist that they are suitable to take alongside indapamide.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • If you are an athlete, you should be aware that indapamide may give a positive reaction in doping tests.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common indapamide side-effects - these affect less than 1 in 10 people who take this medicine
What can I do if I experience this?
A rash, or an increased sensitivity to sunlight If this becomes troublesome, speak with your doctor for advice
Feeling or being sick, stomach upset Stick to simple foods - avoid rich or spicy meals
Feeling dizzy, particularly when you stand up (due to low blood pressure) Getting up and moving more slowly should help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few minutes before you try standing up again

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Natrilix®; Servier Laboratories Limited, The electronic Medicines Compendium. Dated November 2011.
  • British National Formulary; 64th Edition (Sep 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (links to current BNF)
Original Author: Helen Allen Current Version: Peer Reviewer: Dr John Cox
Last Checked: 10/12/2012 Document ID: 3296  Version: 27 © EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.