Common questions about indapamide

Indapamide is a type of medicine called a diuretic.

Most diuretics work on the kidneys to increase the amount of pee (urine) produced, which you then pee out.

This means you have less fluid in your body and blood, which helps reduce blood pressure and relieves symptoms of heart failure caused by too much fluid (oedema).

Indapamide is different to other diuretics, as it only causes a small increase in the amount of pee produced.

The main way indapamide works is by causing blood vessels to widen, which reduces the pressure inside.

Indapamide will start to work within a few hours of taking it. However, it may take a couple of weeks to see an effect on your blood pressure and several months for the full effect to be seen.

Indapamide is safe to take for a long time.

You will occasionally have to see your doctor or nurse to get your blood pressure checked and have blood and urine tests. This is to make sure the salts (calcium, sodium and potassium) in your blood are balanced properly and your kidneys are working well.

How often you'll need these tests will depend on the reason you're taking indapamide, whether your dose has changed recently, whether you get side effects from indapamide, or if you have any other health problems or are taking other medicines.

Indapamide keeps working to reduce your blood pressure for as long as you take it. It stays in the body for about 3 to 4 days after you stop taking it.

If you have high blood pressure, you may not feel ill and taking indapamide will not make you feel any different.

Your doctor will check your blood pressure to make sure the medicine is working. If it's not working well enough, they may add another medicine or switch you to a different one.

There are lots of other medicines that can help treat high blood pressure, including angiotensin converting enzyme (ACE) inhibitors such as lisinopril, or calcium channel blockers such as amlodipine.

If you have high blood pressure, you'll usually need to take more than one medicine to get the best effect.

Speak to your doctor or pharmacist if you think you would like to try a different treatment.

It's usually best to drink normally while you're taking indapamide. A good rule is to drink enough so that you're not thirsty for long periods. Steadily increase the amount you drink when you're exercising and during hot weather.

If your pee is pale or clear, you're probably drinking enough.

However, if you have heart failure or kidney problems, you might need to limit how much fluid you drink. In this case, your doctor or nurse will tell you how much you need to drink each day.

You might lose a bit of weight when taking indapamide, but this is because you're losing fluids, not body fat.

Taking diuretics to try and lose weight might increase your chances of damaging your kidneys.

Only take indapamide if your doctor has prescribed it and only take it at the dose, and for the reason your doctor prescribed it for you.

This will depend on your medical condition and the type of surgery you're having. Tell your doctor that you're taking indapamide and ask them if you need to stop it before surgery.

Indapamide will not affect any type of contraception.

However, some types of hormonal contraception, like the combined pill and contraceptive patch, are not usually recommended if you have high blood pressure.

Talk to your doctor if you're taking or using hormonal contraceptives.

If indapamide makes you vomit, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Indapamide can make you feel dizzy. If this happens to you, do not drive, cycle, or use machinery or tools until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking indapamide. GOV.UK has more information on the law on drugs and driving.

Drinking alcohol with indapamide can lower your blood pressure or cause dehydration and make you feel dizzy or light-headed.

During the first few days of taking indapamide or after increasing the dose, see how the medicine affects you before you drink any alcohol.

If you feel OK, you can drink alcohol. Find out more about the national guidelines.

If you have high blood pressure, it's best not to drink alcohol in large amounts regularly as this can raise your blood pressure further.

There's no specific food or drink you need to avoid, but try to follow a balanced diet to help your blood pressure.

Very strict low-salt (or low-sodium) diets are not recommended when taking indapamide because the medicine can cause low levels of salt in your body.

You can boost your general health and the health of your heart by making some key lifestyle changes. These will also help if you have high blood pressure or heart failure.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke too.
• Cut down on alcohol – drinking too much alcohol raises blood pressure over time and also makes heart failure worse.
• Be more active – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day can help.
• Eat healthily – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products, and lean proteins. It's a good idea to cut down on salt too, however, it's important not to go on a low-salt (or low-sodium) diet while taking this medicine, as that could make your sodium levels too low. People need salt in their diet, but eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year and the pneumococcal vaccine as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS if you have heart failure. Coronavirus (COVID-19) vaccination is recommended for most people. Make sure you've had all the doses that you are eligible for. Talk to your doctor if you think you might be in one of the at risk groups.