Quinidine
Contraindicated
Textbook
Fatal ventricular arrhythmias.
Avoid coadministration or ensure strict potassium management.
Source: G&G 14e · p567
Drug reference
Indapamide
Thiazide-like diuretic (indoline) · Antihypertensive
START
1.25–1.5 mg PO once daily (low dose maximises BP benefit, minimises metabolic effects)
TYPICAL MAX
2.5 mg/day IR (1.5 mg MR)
STOP IF
Severe hyponatraemia/hypokalaemia, gout flare/AKI, sulfonamide hypersensitivity
WATCH
Electrolytes (Na/K) + renal function at 1–2 weeks then periodically, uric acid, glucose
CDSCO approvedATC C03BA11
KDIGO 2024 + manufacturer label
- ONSET
- 1.5h · diuresis onset
- PEAK
- 2h · Cmax
- t½
- 16h · plasma t½
- DURATION
- 1d · once-daily
EXCRETION
Hepatic metabolism; ~70% renal metabolites
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Avoid — not first-line; risk of reduced placental perfusion, neonatal electrolyte/thrombocytopenia
FDA category + note
Top interactionssee all 12 →
- QuinidineContraindicatedTextbookG&G 14e · p567
- CotrimoxazoleSevereTextbook-citedKDT 7e · p948
- SulfonamidesSevereTextbook-citedKDT 7e · p948
- Aminolevulinic AcidSevereDatabaseDDInter
Available in India
31 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Inhibits Na+/Cl- reabsorption in the distal convoluted tubule (thiazide-like) and has direct vasodilatory/antihypertensive action at low (sub-diuretic) doses; effective antihypertensive with relatively favourable metabolic profile.
Indications
Essential hypertensionOedema associated with heart failure (less common use)
Dosing
- Adult
- 1.25–2.5 mg PO once daily (immediate-release); 1.5 mg modified-release once daily.
- Pediatric
- Not established.
- Renal adjustment
- Ineffective and avoid if CrCl <30 mL/min (use loop diuretic).
- Hepatic adjustment
- Avoid in severe hepatic impairment (encephalopathy risk).
- Geriatric
- Start low; hyponatraemia/hypokalaemia risk.
- Max dose
- 2.5 mg/day (IR); 1.5 mg/day (MR) — higher doses add toxicity not efficacy
Pharmacokinetics
Onset
1–2 h (diuresis); antihypertensive over 1–2 weeks
Peak effect
~2 h Cmax; BP weeks
Duration
~24 h (longer for MR)
Half-life
~14–18 h
Bioavailability
~93%
Protein binding
~71–79% (also binds erythrocytes)
Metabolism
Extensive hepatic
Excretion
Renal (~70%, mostly metabolites) and faecal
Contraindications
- Anuria/severe renal failure
- Severe hepatic impairment/hepatic encephalopathy
- Symptomatic hyponatraemia/hypokalaemia
- Sulfonamide hypersensitivity
- Pregnancy (not first-line; reduced placental perfusion)
Side effects
Common
HypokalaemiaHyponatraemiaHyperuricaemia/goutDizziness, fatigueMild glucose/lipid changes (less than thiazides)
Serious
- Severe hyponatraemia/hypokalaemia → arrhythmia
- QT prolongation/torsades (electrolyte-mediated)
- Severe sulfonamide reactions (SCAR, photosensitivity)
- Acute kidney injury (volume depletion); pancreatitis (rare)
Pregnancy & lactation
Pregnancy
Avoid — not first-line; risk of reduced placental perfusion, neonatal electrolyte/thrombocytopenia
Lactation
Avoid — may suppress lactation; thiazide-like in milk
Drug interactions
Cotrimoxazole
Severe
Textbook-cited
Increased incidence of thrombocytopenia
Avoid concurrent use
Source: KDT 7e · p948
Sulfonamides
Severe
Textbook-cited
Increased incidence of thrombocytopenia
Avoid concurrent use
Source: KDT 7e · p948
Aminolevulinic Acid
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amiodarone
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Arsenic Trioxide
Severe
Database
Fatal ventricular arrhythmias.
Avoid coadministration or ensure strict potassium management.
Source: DDInter
Cisapride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Dofetilide
Severe
Database
Fatal ventricular arrhythmias.
Avoid coadministration or ensure strict potassium management.
Source: DDInter
Dolasetron
Severe
Database
Clinical effect not specified
Source: DDInter
Dronedarone
Severe
Database
Clinical effect not specified
Source: DDInter
Droperidol
Severe
Database
Clinical effect not specified
Source: DDInter
Levacetylmethadol
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Indapamide
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19