Антигипертензивный препарат, диуретик.; Индапамид относится к группе нетиазидных сульфонамидов, по фармакологическим свойствам близок к тиазидоподобным диуретикам. Снижает тонус гладкой мускулатуры артерий, уменьшает ОПСС. Препарат обладает умеренным салуретическим и диуретическим эффектами, которые связаны с блокадой реабсорбции ионов натрия, хлора, водорода и, в меньшей степени, ионов калия в проксимальных канальцах и кортикальном сегменте дистальных канальцев почек. Обладая способностью селективно блокировать "медленные" кальциевые каналы, повышает эластичность стенок артерий и снижает ОПСС. Способствует уменьшению гипертрофии левого желудочка сердца. Не влияет на содержание липидов в плазме (триглицериды, ЛПНП, ЛПВП); не влияет на углеводный обмен (в т.ч. у больных с сопутствующим сахарным диабетом). Уменьшение ОПСС также обусловлено снижением чувствительности адренорецепторов сосудистой стенки к норадреналину и ангиотензину II, повышением синтеза простагландинов, обладающих вазодилатирующей активностью (простагландина PgE2 и простациклина PgI2). Снижает продукцию свободных и стабильных кислородных радикалов. При назначении в высоких дозах не влияет на степень снижения АД, несмотря на увеличение диуреза.; Антигипертензивный эффект проявляется к концу первой недели, сохраняется в течение 24 ч на фоне однократного приема, достигает максимума через 8-12 недель после начала приема препарата.
Показания к применению
— артериальная гипертензия.
Противопоказания
Острое нарушение мозгового кровообращения
Выраженная печеночная (в т.ч. с энцефалопатией) и/или почечная недостаточность, анурия
Непереносимость лактозы, галактоземия, синдром нарушения всасывания глюкозы, галактозы
Беременность
Период лактации (грудного вскармливания)
Возраст до 18 лет (эффективность и безопасность не установлены)
Повышенная чувствительность к индапамиду, другим производным сульфонамидов и компонентам препарата
С осторожностью: сахарный диабет в стадии декомпенсации, гиперурикемия (особенно сопровождающаяся подагрой и уратным нефролитиазом), гипонатриемия и другие нарушения водно-электролитного обмена, умеренная печеночная и/или почечная недостаточность, асцит, ИБС, хроническая сердечная недостаточность, удлинение интервала QT; гиперпаратиреоз.
Применение при беременности и в период грудного вскармливания
Индап; противопоказан к применению при беременности и в период лактации (грудного вскармливания).
Способ применения и дозы
Препарат назначают внутрь, утром, независимо от приема пищи. Капсулу следует проглатывать не разжевывая, запивая водой.; Назначают по 2.5 мг (1 капс.) 1 раз/сут.; Препарат может использоваться в качестве монотерапии или в комбинации с другими антигипертензивными средствами (с бета-адреноблокаторами, блокаторами "медленных" кальциевых каналов, ингибиторами АПФ). Если через 4-8 недель лечения желаемый терапевтический эффект не достигнут, дозу препарата повышать не рекомендуется (возрастает риск побочных эффектов без усиления антигипертензивного эффекта). Вместо этого в схему лечения целесообразно добавить другой антигипертензивный препарат, не являющийся диуретиком. В случаях, когда лечение необходимо начинать с приема 2-х препартов, доза Индапа остается равной 2.5 мг утром 1 раз/сут.
Побочное действие
Со стороны пищеварительной системы: тошнота, рвота, анорексия, сухость во рту, дискомфорт в области живота, гастралгия, запор или диарея, печеночная энцефалопатия (на фоне печеночной недостаточности).; Со стороны ЦНС: астения, головная боль, общая слабость, повышенная утомляемость, летаргия, вялость, недомогацие, вертиго, спазм мышц, нервозность, напряженность, раздражительность, ажитация; тревога, бессонница, депрессия, головокружение, сонливость.; Со стороны органов чувств: конъюнктивит, нарушение зрения.; Со стороны дыхательной системы: ринит, редко - кашель, фарингит, синусит.; Со стороны сердечно-сосудистой системы: ортостатическая гипотензия, аритмия, сердцебиение, изменения на ЭКГ (гипокалиемия).; Со стороны мочевыделительноп системы: никтурия, полиурия, увеличение частоты развития инфекций.; Аллергические реакции: зуд, сыпь, крапивница, геморрагический васкулит.; Со стороны органов кроветворения: тромбоцитопения, лейкопения, агранулоцитоз, аплазия костного мозга, гемолитическая анемия.; Со стороны лабораторных показателей: гиперкальциемия, гиперурикемия, гипохлоремия, гипонатриемия, гипергликемия, гипокалиемия, повышение азота мочевины в плазме крови, гиперкреатининемия, глюкозурия.; Прочие: гриппоподобный синдром, боль в грудной клетке, боль в спине, снижение потенции и/или либидо, ринорея, потливость, снижение массы тела, парестезии в конечностях, обострение системной красной волчанки, панкреатит.
Передозировка
Симптомы: тошнота, рвота, слабость, нарушение функции ЖКТ, водно-электролитные нарушения, в некоторых случаях - чрезмерное снижение АД, угнетение дыхания. У пациентов с циррозом печени возможно развитие печеночной комы.; Лечение: промывание желудка, коррекция водно-электролитного баланса, симптоматическая терапия. Специфического антидота нет.
Особые указания
Индапамид эффективен для лечения больных артериальной гипертензией группы риска, т.е. с сопутствующей патологией (сахарным диабетом легкой и средней степени тяжести или с хронической почечной недостаточностью, пациентов с гиперлипидемиями).; При длительном применении индапамида иногда могут возникать нарушения электролитного обмена, такие как гипонатриемия, гипокалиемия, гиперкальциемия и гипохлоремический алкалоз. Эти нарушения чаще наблюдаются у больных с хронической сердечной недостаточностью, заболеваниями печени, при рвоте и диарее, а также у лиц, находящихся на бессолевой диете, что обуславливает необходимость контроля электролитов крови.; Индапамид увеличивает выделение магния с мочой, что может привести к гипомагниемии.; При применении индапамида также следует систематически контролировать содержание мочевой кислоты и остаточного азота в плазме крови.; Возможно появление ортостатической гипотензии, которая может провоцироваться приемом алкоголя, барбитуратами, опиоидными анальгетиками, а также - другими гипотензивными средствами.; В случае гипокалиемии, вызванной индапамидом, может увеличиваться токсичность сердечных гликозидов. У больных, принимающих сердечные гликозиды, слабительные средства, при гиперальдостеронизме, а также у лиц пожилого возраста показан тщательный контроль содержания калия и креатинина.; Наиболее тщательный контроль показан у больных циррозом печени (особенно с отеками или асцитом - риск развития метаболического алкалоза, усиливающего проявления печеночной энцефалопатии), ИБС, хронической сердечной недостаточностью, а также у лиц пожилого возраста. К группе повышенного риска также относятся больные с увеличенным интервалом QT на ЭКГ (врожденным или развившемся на фоне какого-либо патологического процесса).; Первое измерение концентрации калия в крови следует провести в течение 1 недели лечения.; Гиперкальциемия на фоне приема индапамида может быть следствием ранее недиагностированного гиперпаратиреоза.; У больных сахарным диабетом крайне важно контролировать уровень глюкозы в крови, особенно при наличии гипокалиемии.; Значительная дегидратация может привести к развитию острой почечной недостаточности (снижение клубочковой фильтрации). Больным необходимо компенсировать потерю воды и в начале лечения тщательно контролировать функцию почек.; Индапамид может дать положительный результат при проведении допинг-контроля.; Больным с артериальной гипертензией и гипонатриемией (вследствие приема диуретиков) необходимо за 3 дня до начала приема ингибиторов АПФ прекратить прием диуретиков (при необходимости прием диуретиков можно возобновить несколько позже), либо им назначают начальные низкие дозы ингибиторов АПФ.; Индапамид может ухудшать течение системной красной волчанки.; Несмотря на то, что индапамид практически не влияет на углеводный обмен, у больных с инсулинозависимым сахарным диабетом возможно повышение необходимой дозы инсулина, а при латентном сахарном диабете необходимо осуществлять контроль глюкозы крови.
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2.5 мг; Вспомогательные вещества: целлюлоза микрокристаллическая (гранулированная), лактозы моногидрат, крахмал кукурузный, магния стеарат, кремния диоксид коллоидный, титана диоксид, желатин, краситель индигокармин."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Антигипертензивный препарат, диуретик.; Индапамид относится к группе нетиазидных сульфонамидов, по фармакологическим свойствам близок к тиазидоподобным диуретикам. Снижает тонус гладкой мускулатуры артерий, уменьшает ОПСС. Препарат обладает умеренным салуретическим и диуретическим эффектами, которые связаны с блокадой реабсорбции ионов натрия, хлора, водорода и, в меньшей степени, ионов калия в проксимальных канальцах и кортикальном сегменте дистальных канальцев почек. Обладая способностью селективно блокировать \"медленные\" кальциевые каналы, повышает эластичность стенок артерий и снижает ОПСС. Способствует уменьшению гипертрофии левого желудочка сердца. Не влияет на содержание липидов в плазме (триглицериды, ЛПНП, ЛПВП); не влияет на углеводный обмен (в т.ч. у больных с сопутствующим сахарным диабетом). Уменьшение ОПСС также обусловлено снижением чувствительности адренорецепторов сосудистой стенки к норадреналину и ангиотензину II, повышением синтеза простагландинов, обладающих вазодилатирующей активностью (простагландина PgE2 и простациклина PgI2). Снижает продукцию свободных и стабильных кислородных радикалов. При назначении в высоких дозах не влияет на степень снижения АД, несмотря на увеличение диуреза.; Антигипертензивный эффект проявляется к концу первой недели, сохраняется в течение 24 ч на фоне однократного приема, достигает максимума через 8-12 недель после начала приема препарата."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"— артериальная гипертензия."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["Острое нарушение мозгового кровообращения","Выраженная печеночная (в т.ч. с энцефалопатией) и/или почечная недостаточность, анурия","Гипокалиемия","Одновременный прием препаратов, удлиняющих интервал QT","Непереносимость лактозы, галактоземия, синдром нарушения всасывания глюкозы, галактозы","Беременность","Период лактации (грудного вскармливания)","Возраст до 18 лет (эффективность и безопасность не установлены)","Повышенная чувствительность к индапамиду, другим производным сульфонамидов и компонентам препарата"]}},{"type":"paragraph","data":{"text":"С осторожностью: сахарный диабет в стадии декомпенсации, гиперурикемия (особенно сопровождающаяся подагрой и уратным нефролитиазом), гипонатриемия и другие нарушения водно-электролитного обмена, умеренная печеночная и/или почечная недостаточность, асцит, ИБС, хроническая сердечная недостаточность, удлинение интервала QT; гиперпаратиреоз."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Индап; противопоказан к применению при беременности и в период лактации (грудного вскармливания)."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат назначают внутрь, утром, независимо от приема пищи. Капсулу следует проглатывать не разжевывая, запивая водой.; Назначают по 2.5 мг (1 капс.) 1 раз/сут.; Препарат может использоваться в качестве монотерапии или в комбинации с другими антигипертензивными средствами (с бета-адреноблокаторами, блокаторами \"медленных\" кальциевых каналов, ингибиторами АПФ). Если через 4-8 недель лечения желаемый терапевтический эффект не достигнут, дозу препарата повышать не рекомендуется (возрастает риск побочных эффектов без усиления антигипертензивного эффекта). Вместо этого в схему лечения целесообразно добавить другой антигипертензивный препарат, не являющийся диуретиком. В случаях, когда лечение необходимо начинать с приема 2-х препартов, доза Индапа остается равной 2.5 мг утром 1 раз/сут."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: тошнота, рвота, анорексия, сухость во рту, дискомфорт в области живота, гастралгия, запор или диарея, печеночная энцефалопатия (на фоне печеночной недостаточности).; Со стороны ЦНС: астения, головная боль, общая слабость, повышенная утомляемость, летаргия, вялость, недомогацие, вертиго, спазм мышц, нервозность, напряженность, раздражительность, ажитация; тревога, бессонница, депрессия, головокружение, сонливость.; Со стороны органов чувств: конъюнктивит, нарушение зрения.; Со стороны дыхательной системы: ринит, редко - кашель, фарингит, синусит.; Со стороны сердечно-сосудистой системы: ортостатическая гипотензия, аритмия, сердцебиение, изменения на ЭКГ (гипокалиемия).; Со стороны мочевыделительноп системы: никтурия, полиурия, увеличение частоты развития инфекций.; Аллергические реакции: зуд, сыпь, крапивница, геморрагический васкулит.; Со стороны органов кроветворения: тромбоцитопения, лейкопения, агранулоцитоз, аплазия костного мозга, гемолитическая анемия.; Со стороны лабораторных показателей: гиперкальциемия, гиперурикемия, гипохлоремия, гипонатриемия, гипергликемия, гипокалиемия, повышение азота мочевины в плазме крови, гиперкреатининемия, глюкозурия.; Прочие: гриппоподобный синдром, боль в грудной клетке, боль в спине, снижение потенции и/или либидо, ринорея, потливость, снижение массы тела, парестезии в конечностях, обострение системной красной волчанки, панкреатит."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: тошнота, рвота, слабость, нарушение функции ЖКТ, водно-электролитные нарушения, в некоторых случаях - чрезмерное снижение АД, угнетение дыхания. У пациентов с циррозом печени возможно развитие печеночной комы.; Лечение: промывание желудка, коррекция водно-электролитного баланса, симптоматическая терапия. Специфического антидота нет."}}]},{"id":9,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Индапамид эффективен для лечения больных артериальной гипертензией группы риска, т.е. с сопутствующей патологией (сахарным диабетом легкой и средней степени тяжести или с хронической почечной недостаточностью, пациентов с гиперлипидемиями).; При длительном применении индапамида иногда могут возникать нарушения электролитного обмена, такие как гипонатриемия, гипокалиемия, гиперкальциемия и гипохлоремический алкалоз. Эти нарушения чаще наблюдаются у больных с хронической сердечной недостаточностью, заболеваниями печени, при рвоте и диарее, а также у лиц, находящихся на бессолевой диете, что обуславливает необходимость контроля электролитов крови.; Индапамид увеличивает выделение магния с мочой, что может привести к гипомагниемии.; При применении индапамида также следует систематически контролировать содержание мочевой кислоты и остаточного азота в плазме крови.; Возможно появление ортостатической гипотензии, которая может провоцироваться приемом алкоголя, барбитуратами, опиоидными анальгетиками, а также - другими гипотензивными средствами.; В случае гипокалиемии, вызванной индапамидом, может увеличиваться токсичность сердечных гликозидов. У больных, принимающих сердечные гликозиды, слабительные средства, при гиперальдостеронизме, а также у лиц пожилого возраста показан тщательный контроль содержания калия и креатинина.; Наиболее тщательный контроль показан у больных циррозом печени (особенно с отеками или асцитом - риск развития метаболического алкалоза, усиливающего проявления печеночной энцефалопатии), ИБС, хронической сердечной недостаточностью, а также у лиц пожилого возраста. К группе повышенного риска также относятся больные с увеличенным интервалом QT на ЭКГ (врожденным или развившемся на фоне какого-либо патологического процесса).; Первое измерение концентрации калия в крови следует провести в течение 1 недели лечения.; Гиперкальциемия на фоне приема индапамида может быть следствием ранее недиагностированного гиперпаратиреоза.; У больных сахарным диабетом крайне важно контролировать уровень глюкозы в крови, особенно при наличии гипокалиемии.; Значительная дегидратация может привести к развитию острой почечной недостаточности (снижение клубочковой фильтрации). Больным необходимо компенсировать потерю воды и в начале лечения тщательно контролировать функцию почек.; Индапамид может дать положительный результат при проведении допинг-контроля.; Больным с артериальной гипертензией и гипонатриемией (вследствие приема диуретиков) необходимо за 3 дня до начала приема ингибиторов АПФ прекратить прием диуретиков (при необходимости прием диуретиков можно возобновить несколько позже), либо им назначают начальные низкие дозы ингибиторов АПФ.; Индапамид может ухудшать течение системной красной волчанки.; Несмотря на то, что индапамид практически не влияет на углеводный обмен, у больных с инсулинозависимым сахарным диабетом возможно повышение необходимой дозы инсулина, а при латентном сахарном диабете необходимо осуществлять контроль глюкозы крови."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антигипертензивный препарат, диуретик.; Индапамид относится к группе нетиазидных сульфонамидов, по фармакологическим свойствам близок к тиазидоподобным диуретикам. Снижает тонус гладкой мускулатуры артерий, уменьшает ОПСС. Препарат обладает умеренным салуретическим и диуретическим эффектами, которые связаны с блокадой реабсорбции ионов натрия, хлора, водорода и, в меньшей степени, ионов калия в проксимальных канальцах и кортикальном сегменте дистальных канальцев почек. Обладая способностью селективно блокировать \"медленные\" кальциевые каналы, повышает эластичность стенок артерий и снижает ОПСС. Способствует уменьшению гипертрофии левого желудочка сердца. Не влияет на содержание липидов в плазме (триглицериды, ЛПНП, ЛПВП); не влияет на углеводный обмен (в т.ч. у больных с сопутствующим сахарным диабетом). Уменьшение ОПСС также обусловлено снижением чувствительности адренорецепторов сосудистой стенки к норадреналину и ангиотензину II, повышением синтеза простагландинов, обладающих вазодилатирующей активностью (простагландина PgE2 и простациклина PgI2). Снижает продукцию свободных и стабильных кислородных радикалов. 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