Drug reference

Xipamide

Thiazide Diuretic · Antihypertensive

Thiazide DiureticAntihypertensive

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

5 major

incl. contraindicated

PREGNANCY

May lower fetal heart rate. Avoid oral use

FDA category + note

Top interactionssee all 12 →

Arsenic TrioxideContraindicatedTextbookG&G 14e · p567
DofetilideContraindicatedTextbookG&G 14e · p567
QuinidineContraindicatedTextbookG&G 14e · p567
AllopurinolSevereTextbookG&G 14e · p849

Mechanism

Xipamide is a medium efficacy diuretic that works by inhibiting the Na+-Cl¯ symport in the renal tubules. This action reduces the reabsorption of sodium and chloride ions, leading to increased excretion of water and electrolytes.

Indications

HypertensionEdemaEdema associated with heart failureEdema associated with liver cirrhosisEdema associated with chronic kidney diseaseEdema associated with nephrotic syndromeNephrogenic diabetes insipidusKidney stones caused by Ca2+ crystalsEdema (mild-to-moderate, maintenance in cardiac edema)Diabetes insipidus (nephrogenic and pituitary origin)Hypercalciuria with recurrent calcium stones

Dosing

Adult: after any change in dose or during intercurrent illness. Other drugs used for Hypertension Amiloride hydrochloride, p. 243 . Chlortalidone, p. 244 . Cotriamterzide, p. 245 . Metolazone, p. Torasemide, p. 242 . Triamterene with chlortalidone, p. Xipamide, p. 245 ANTIHYPERTENSIVES, CENTRALLY ACTING Clonidine hydrochloride ▶ ▶ BY MOUTH ▶ Adult: Initially 50 micrograms twice daily for 2 we...
Max dose: 80 mg/day

Pharmacokinetics

Onset

within 1 hour

Duration

12 hours

Contraindications

Toxaemia of pregnancy

Side effects

Common

Increased K+ excretionIncreased HCO3¯ excretionIncreased PO43¯ excretionReduced g.f.r.Decreased renal Ca2+ excretionIncreased Mg2+ excretionGreater reduction in urate excretion than furosemideSlowly developing fall in BP (in hypertensives)Elevation of blood sugar (due to decreased insulin release/hypokalaemia)HypokalaemiaWeaknessFatigueMuscle crampsNauseaVomitingDiarrhoeaHeadacheGiddinessParesthesiasImpotenceAlkalosis (with hypokalaemia)Magnesium depletion

Serious

Severe hypokalemia with ventricular arrhythmias
Cardiac arrhythmias (due to hypokalaemia)
Acute saline depletion (dehydration, marked fall in BP, haemoconcentration, peripheral venous thrombosis)
Dilutional hyponatraemia
Rashes
Photosensitivity
Blood dyscrasias
Aggravated renal insufficiency
Mental disturbances and hepatic coma (in cirrhotics)

Pregnancy & lactation

Pregnancy

May lower fetal heart rate. Avoid oral use

Drug interactions

Arsenic Trioxide

Contraindicated

Textbook

Fatal ventricular arrhythmias.

Avoid coadministration or ensure strict potassium management.

Source: G&G 14e · p567

Dofetilide

Contraindicated

Textbook

Fatal ventricular arrhythmias.

Avoid coadministration or ensure strict potassium management.

Source: G&G 14e · p567

Quinidine

Contraindicated

Textbook

Fatal ventricular arrhythmias.

Avoid coadministration or ensure strict potassium management.

Source: G&G 14e · p567

Allopurinol

Severe

Textbook

Hypersensitivity reactions reported in patients with compromised renal function.

Source: G&G 14e · p849

Lithium

Severe

Textbook

Increased lithium levels and risk of toxicity.

Must be avoided.

Source: G&G 14e · p378

Aceclofenac + Paracetamol

Moderate

Textbook

Diminished diuretic and antihypertensive effects of thiazides.

Not explicitly stated, but suggests caution or avoiding concomitant use.

Source: G&G 14e · p567

Aceclofenac

Moderate

Textbook

Diminished diuretic and antihypertensive effects of thiazides.

Not explicitly stated, but suggests caution or avoiding concomitant use.

Source: G&G 14e · p567

Amiloride

Moderate

Textbook

Reduced K+ loss and risk of ventricular arrhythmias from thiazides. However, combining K+-sparing agents with each other or with K+ supplementation requires great caution.

This combination is effective for preventing hypokalemia. Use great caution and monitor K+ if combining multiple K+-sparing agents or supplements.

Source: G&G 14e

Amphotericin B

Moderate

Textbook

Increased risk of hypokalemia.

Not explicitly stated, but implies careful monitoring of potassium levels.

Source: G&G 14e · p567

Anesthetics

Moderate

Textbook

Enhanced anesthetic effects.