Generic Name: Indapamide
Class: Thiazide-like Diuretics
VA Class: CV701
Chemical Name: 3-(Aminosulfonyl)-4-chloro-N-(2,3-dihydro-2-methyl-1H-indol-1-yl)benzamide
Molecular Formula: C16H16ClN3O3S
CAS Number: 26807-65-8
Uses for Lozol
JNC classifies indapamide as a thiazide-like drug with regard to management of hypertension; the drug’s efficacy in hypertensive patients is similar to that of the thiazide diuretics.14 18 21 24 500 501
Thiazide-type diuretics are recommended as one of several preferred agents for the initial management of hypertension; other options include ACE inhibitors, angiotensin II receptor antagonists, and calcium-channel blockers.501 502 503 504 While there may be individual differences with respect to specific outcomes, these antihypertensive drug classes all produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.500 501 502 504 Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).500 501 502 503 504 515
The optimum BP threshold for initiating antihypertensive drug therapy is controversial.501 504 505 506 507 508 515 523 530 Further study needed to determine optimum BP thresholds/goals; individualize treatment decisions.501 503 507 515 526 530
JNC 7 recommends initiation of drug therapy in all patients with uncomplicated hypertension and BP ≥140/90 mm Hg;500 JNC 8 panel recommends SBP threshold of 150 mm Hg for patients ≥60 years of age.501 Although many experts agree that SBP goal of <150 mm Hg may be appropriate for patients ≥80 years of age,502 504 505 530 application of this goal to those ≥60 years of age is controversial, especially for those at higher cardiovascular risk.501 502 505 506 508 511 515
In the past, initial antihypertensive drug therapy was recommended for patients with diabetes mellitus or chronic kidney disease who had BP ≥130/80 mm Hg;500 503 current hypertension management guidelines generally recommend a BP threshold of 140/90 mm Hg for these individuals (same as for the general population of patients without these conditions), although a goal of <130/80 mm Hg may still be considered.501 502 503 504 520 530 535 536 541
Black hypertensive patients generally tend to respond better to monotherapy with thiazide diuretics or calcium-channel blockers than to other antihypertensive drug classes (e.g., ACE inhibitors, angiotensin II receptor antagonists).82 200 500 501 504 However, diminished response to these other drug classes is largely eliminated when administered concomitantly with a thiazide diuretic or calcium-channel blocker.500 504
Thiazide-like diuretics may be preferred in hypertensive patients with osteoporosis. Secondary beneficial effect in hypertensive geriatric patients of reducing the risk of osteoporosis secondary to effect on calcium homeostasis and bone mineralization.
Edema in Heart Failure
Diuretics produce rapid symptomatic benefits, relieving pulmonary and peripheral edema more rapidly (within hours or days) than cardiac glycosides, ACE inhibitors, or β-blockers (in weeks or months).70
Loop diuretics (e.g., bumetanide, ethacrynic acid, furosemide, torsemide) are diuretics of choice for most patients with heart failure.70
Edema in Pregnancy
Diuretics should not be used for routine therapy in pregnant women with mild edema who are otherwise healthy.a
Use of thiazide-like diuretics may be appropriate in the management of edema of pathologic origin during pregnancy when clearly needed; routine use of diuretics in otherwise healthy pregnant women is irrational.21 30
Dependent edema secondary to restriction of venous return by the expanded uterus should be managed by elevating the lower extremities and/or by wearing support hose; use of diuretics in these pregnant women is inappropriate.21 30
In rare cases when the hypervolemia associated with normal pregnancy results in edema that produces extreme discomfort, a short course of diuretic therapy may provide relief and may be considered when other methods (e.g., decreased sodium intake, increased recumbency) are ineffective.21 30 44
No substantial difference in clinical effects or toxicity of comparable thiazide or thiazide-like diuretics, except metolazone may be more effective in edema with renal impairment.a
Lozol Dosage and Administration
BP Monitoring and Treatment Goals
When available, use evidence-based dosing information (i.e., dosages shown in randomized controlled trials to reduce complications of hypertension) to determine target dosages; target dosages usually can be achieved within 2–4 weeks but may take up to several months.501
If adequate BP response not achieved with a single antihypertensive agent, add a second drug with demonstrated benefit; if goal BP still not achieved with optimal dosages of 2 antihypertensive agents, add a third drug.501 May maximize dosage of the first drug before adding a second drug, or add a second drug before maximizing dosage of the initial drug.501
Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies.500 501 (See Hypertension under Uses.)
Individualize dosage according to individual requirements and response.600
JNC 8 expert panel recommends initial dosage of 1.25 mg once daily and target dosage of 1.25–2.5 mg once daily based on dosages used in randomized controlled studies.501
Manufacturer recommends initial dosage of 1.25 mg once daily in the morning; if response is inadequate, dosage may be increased at 4-week intervals to 2.5 mg daily and subsequently to 5 mg daily.83
Dosages >5 mg daily do not appear to result in further improvement in BP and increase the risk of hypokalemia.83 (See Hypokalemia under Cautions.)
If adequate response is not achieved with monotherapy, add another antihypertensive agent.501
If concomitant therapy with other antihypertensive agents is required, the usual dose of the other agent may need to be reduced initially by up to 50%; subsequent dosage adjustments should be based on BP response.44 83 Dosage reduction of both drugs may be required.39
If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class.501
Edema in Heart Failure
Initially, 2.5 mg once daily in the morning.83
Dosages >5 mg daily do not appear to result in further improvement in heart failure or BP and are associated with increased risk of hypokalemia;24 29 39 83 such dosages have been employed only in a limited number of clinical studies.24 29 39 83
No specific dosage recommendations.83 (See Hepatic Impairment under Cautions.)
No specific dosage recommendations.83 (See Geriatric Use under Cautions.)
Cautions for Lozol
Severe hyponatremia (serum sodium concentration <120 mEq/L), accompanied by hypokalemia, occurs rarely.51 52 53 54 55 56 57 58 59 60 61 Do not administer sodium chloride unless the hyponatremia is life threatening or actual sodium depletion is documented.21 If sodium chloride is administered, initially only correct to a state of mild hyponatremia; avoid early overcorrection to normonatremia or hypernatremia (risk of central pontine myelinolysis).52 55 60 62
Possible dilutional hyponatremia; occurs most commonly in patients with edema.21 51 54 Usually asymptomatic and managed by fluid intake restriction (e.g., 500 mL/day)21 and withdrawal of the diuretic.51 54
Hypokalemia occurs commonly.9 21 24 28 47 Increased risk of hypokalemia, especially with brisk diuresis; large dosages (i.e., ≥5 mg daily);21 24 29 39 40 83 inadequate oral electrolyte intake; in presence of severe cirrhosis, hyperaldosteronism, or potassium-losing renal diseases; or during concomitant use of corticosteroids or ACTH.21 24 83
Generally, do not use with lithium salts.21 (See Specific Drugs under Interactions.)
Rash (e.g., erythematous, maculopapular, morbilliform), urticaria, pruritus, and vasculitis reported.21 63 In some cases, rash was accompanied by fever and/or dysuria.63 Rash generally resolves within 2 weeks after drug discontinuance, usually without specific therapy.63 64 May be treated with antihistamines.63
Fluid and Electrolyte Imbalance
Risk of electrolyte disturbances (e.g., hyponatremia, hypokalemia, hypochloremic alkalosis, hypomagnesemia).21 (See Hyponatremia and also Hypokalemia under Cautions.)
Periodic determinations of serum electrolyte concentrations (particularly potassium, sodium, chloride, and bicarbonate) should be performed and are especially important in patients at increased risk from hypokalemia (e.g., geriatric patients, those with cardiac arrhythmias, receiving concomitant cardiac glycosides, and/or with a history of ventricular arrhythmias),21 24 39 and those with diabetes mellitus, vomiting, diarrhea, parenteral fluid therapy, or expectations of other electrolyte imbalance (e.g., heart failure, renal disease, cirrhosis, restricted sodium intake, advanced age).21 83
Observe carefully for manifestations of fluid and electrolyte depletion (e.g., dryness of mouth, thirst, weakness, fatigue, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, GI disturbance).21 83 Measures to maintain normal serum concentrations should be instituted if necessary.21 83
Risk of hyperuricemia, especially in patients with a history of gout, family predisposition to gout, or chronic renal failure.4 10 12 17 25 28 29 39 47 Usually asymptomatic and rarely leads to clinical gout.19 21 24 28 29 39
Risk of increased blood glucose, hyperglycemia, glycosuria, and impaired glucose tolerance;15 21 24 28 precipitation of diabetes mellitus rarely reported in patients with a history of impaired glucose tolerance (latent diabetes).21
Monitor blood glucose concentrations periodically, especially in patients with known or suspected (e.g., marginally impaired glucose tolerance) diabetes mellitus.21
May decrease calcium urinary excretion; slight intermittent serum calcium increases reported;83 clinically important changes in serum total or ionic calcium concentrations have not been reported.20 21 24
Antihypertensive effect may be enhanced after sympathectomy.21
Diuretics are considered second-line agents for control of chronic hypertension in pregnant women;142 500 if initiation of antihypertensive therapy is necessary during pregnancy, other antihypertensives (i.e., methyldopa, nifedipine, labetalol) are preferred.142 540
Safety and efficacy not established.83
Increased risk of hypochloremic alkalosis associated with hypokalemia.21
Increased risk of hypochloremic alkalosis associated with hypokalemia.21
Evaluate renal function (e.g., BUN, Scr) periodically.21
Common Adverse Effects
Hypokalemia,9 21 24 28 47 headache,3 21 24 28 dizziness,3 21 24 28 29 fatigue,3 21 24 weakness,21 29 lethargy,21 tiredness,21 malaise,21 muscle cramps or spasm,3 21 24 29 numbness of the extremities,21 nervousness,21 24 tension, anxiety, irritability, agitation.21 83
Interactions for Lozol
If concomitant therapy with other antihypertensive agents is required, dose of the other agent may need to be reduced initially by up to 50%; subsequent dosage adjustments should be based on BP response;44 83 dosage reduction of both drugs may be required39
Monitor for possible postural hypotension21
Possible electrolyte disturbances (e.g., hypokalemia, hypomagnesemia) may predispose to digitalis toxicity; possibly fatal cardiac arrhythmias21
Monitor electrolytes; correct hypokalemia21
Diuretics, potassium-sparing (e.g., amiloride, triamterene)
Concomitant therapy not fully evaluated40
Safety and efficacy of concurrent use for the prevention of hypokalemia have not been fully determined40
Monitor blood glucose concentrations periodically, especially in patients with known or suspected (e.g., marginally impaired glucose tolerance) diabetes mellitus21
Concomitant use generally contraindicated21
Potassium-depleting drugs (e.g., corticosteroids, corticotropin, amphotericin B)
Additive hypokalemic effects21
Monitor electrolytes; correct hypokalemia83
Vasopressors (e.g., norepinephrine, phenylephrine)
Unlikely to be clinically important21
Plasma Protein Binding
Not removed from circulation by hemodialysis.4
Tight, light-resistant containers at 20–25°C; avoid excessive heat.600
Precise mechanism of hypotensive action has not been determined, but postulated that diuretics lower BP mainly by reducing plasma and extracellular fluid volume41 44 and by decreasing peripheral vascular resistance possibly secondary to sodium depletion43 and/or vascular autoregulatory feedback mechanisms;41 however, part of the hypotensive effect of indapamide may be caused by direct arteriolar dilation.5 6 21 24 25 27 39
Advice to Patients
Importance of informing patients of the signs and symptoms of electrolyte imbalance and instructing them to contact their clinician if dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, oliguria, hypotension, tachycardia, GI disturbance, or muscle pains or cramps occur.21
Importance of informing patients with diabetes mellitus that blood glucose and urine glucose concentrations may increase.83
Advise hypertensive patients of importance of continuing lifestyle/behavioral modifications that include weight reduction (for those who are overweight or obese), dietary changes to include foods that are rich in potassium and calcium and moderately restricted in sodium (adoption of the Dietary Approaches to Stop Hypertension [DASH] eating plan), increased physical activity, smoking cessation, and moderation of alcohol intake.500
Advise that lifestyle/behavioral modifications reduce BP, enhance antihypertensive drug efficacy, and decrease cardiovascular risk and remain an indispensable part of the management of hypertension.500
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.83
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.83
Importance of informing patients of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
AHFS DI Essentials. © Copyright, 2004-2016, Selected Revisions January 23, 2015. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
2. Noveck RJ, Quiroz A, Giles T et al. Hemodynamic effects of a new antihypertensive-diuretic, indapamide in healthy male volunteers. Clin Pharmacol Ther. 1982; 31:257.
3. Passeron J, Pauly N, Desprat J. International multicentre study of indapamide in the treatment of essential arterial hypertension. Postgrad Med J. 1981; 57(Suppl. 2):57-9. [IDIS 173233] [PubMed 7033949]
4. Acchiardo SR, Skoutakis VA. Clinical efficacy, safety, and pharmacokinetics of indapamide in renal impairment. Am Heart J. 1983; 106:237-44. [IDIS 172679] [PubMed 6346847]
5. Mironneau J, Gargouil Y. Action of indapamide on excitation-contraction coupling in vascular smooth muscle. Eur J Pharmacol. 1979; 57:57-67. [PubMed 477742]
6. Mironneau J, Savineau J, Mironneau C. Compared effects of indapamide, hydrochlorothiazide, and chlorthalidone on electrical and mechanical actions in vascular smooth muscle. Eur J Pharmacol. 1981; 75:109-13. [PubMed 7318900]
7. Guidi G, Giuntoli F, Saba G et al. Clinical investigation on efficacy of indapamide as an antihypertensive agent. Curr Ther Res. 1982; 31:601-7.
8. Chalmers JP, Bune AJC, Graham JR et al. Comparison of indapamide with thiazide diuretics in patients with essential hypertension. Med J Aust. 1981; 2:100-1. [IDIS 173240] [PubMed 7300705]
9. Wheeley MSG, Bolton JC, Campbell DB. Indapamide in hypertension: a study in general practice of new or previously poorly controlled patients. Pharmatherapeutica. 1982; 3:143-51. [IDIS 173247] [PubMed 7100225]
10. Weidman P, Meier A, Mordasini R et al. Diuretics, indapamide and serum lipoproteins. Postgrad Med J. 1981; 57(Suppl. 2):73.
11. Haiat R, Lellouch A, Lanfranchi J et al. Continuous electrocardiographic recording (Holter method) during indapamide treatment: a study of 40 cases. Postgrad Med J. 1981; 57(Suppl. 2):68-9. [IDIS 173236] [PubMed 7322960]
12. Horgan JH, O’Donovan A, Teo KK. Echocardiographic evaluation of left ventricular function in patients showing an antihypertensive and biochemical response to indapamide. Postgrad Med J. 1981; 57(Suppl. 2):64-7. [IDIS 173235] [PubMed 7033950]
13. Dunn FG, Hillis WS, Tweddel A et al. Non-invasive cardiovascular assessment of indapamide in patients with essential hypertension. Postgrad Med J. 1981; 57(Suppl. 2):19-22. [IDIS 173222] [PubMed 7322955]
14. Zacharis FJ. A comparative study of the efficacy of indapamide and bendrofluazide given in combination with atenolol. Postgrad Med J. 1981; 57(Suppl. 2):51-2. [IDIS 173231] [PubMed 7033947]
15. Roux P, Courtois H. Blood sugar regulation during treatment with indapamide in hypertensive diabetics. Postgrad Med J. 1981; 57(Suppl. 2):70-2. [IDIS 173237] [PubMed 7322961]
16. Grebow PE, Trectman JA, Barry EP et al. Pharmacokinetics and bioavailability of indapamide—a new antihypertensive drug. Eur J Clin Pharmacol. 1982; 22:295-9. [IDIS 154475] [PubMed 7106164]
17. Van Hee W, Thomas J, Brems H. Indapamide in the treatment of essential arterial hypertension in the elderly. Postgrad Med J. 1981; 57(Suppl. 2):29-33. [IDIS 173225] [PubMed 7033944]
18. James I, Griffith D, Davis J et al. Comparison of the antihypertensive effects of indapamide and cyclopenthiazide. Postgrad Med J. 1981; 57(Suppl. 2):39-41. [IDIS 173228] [PubMed 7322959]
19. Morledge JH. Clinical efficacy and safety of indapamide in essential hypertension. Am Heart J. 1983; 106:229-32. [IDIS 172677] [PubMed 6346846]
20. Caruso FS, Szabadi RR, Vukovich RA. Pharmacokinetics and clinical pharmacology of indapamide. Am Heart J. 1983; 106:212-20. [IDIS 172675] [PubMed 6869203]
21. Rorer Pharmaceuticals. Lozol (indapamide) tablets prescribing information. Fort Washington, PA; 1990 Jul.
22. Kradjan WA, Koda-Kimble MA. Congestive heart failure. In: Katcher BS, Young LY, Koda-Kimble MA, eds. Applied therapeutics: the clinical use of drugs. 3rd ed. San Francisco: Applied Therapeutics, Inc.; 1983:176.
23. Coleman JH, Johnston JA. Affective disorders. In: Katcher BS, Young LY, Koda-Kimble MA, eds. Applied therapeutics: the clinical use of drugs. 3rd ed. San Francisco: Applied Therapeutics, Inc.; 1983:1035-6.
24. Chaffman M, Heel RC, Brogden TM et al. Indapamide, a review of its pharmacodynamic properties and therapeutic efficacy in hypertension. Drugs. 1984; 28:189-35. [IDIS 190031] [PubMed 6489195]
25. Materson BJ. Insights into intrarenal sites and mechanisms of action of diuretic agents. Am Heart J. 1983; 106:188-208. [IDIS 172673] [PubMed 6869201]
26. Pruss T, Wolf PS. Preclinical studies of indapamide, a new 2-methylindoline antihypertensive agent. Am Heart J. 1983; 106:208-11. [IDIS 172674] [PubMed 6869202]
27. Noveck RJ, McMahon FG, Quiros A et al. Extrarenal contributions to indapamide’s antihypertensive mechanism of action. Am Heart J. 1983; 106:221-9. [IDIS 172676] [PubMed 6869204]
28. Beling S, Vukovich RA, Neiss ES et al. Long-term experience with indapamide. Am Heart J. 1983; 106:258-62. [IDIS 172682] [PubMed 6346848]
29. Slotkoff L. Clinical efficacy and safety of indapamide in the treatment of edema. Am Heart J. 1983; 106:233-7. [IDIS 172678] [PubMed 6869205]
30. US Food and Drug Administration. Limited usefulness of diuretics in pregnancy. FDA Drug Bull. 1977; 7:7.
31. Perez-Stable E, Caralis PV. Thiazide-induced disturbances in carbohydrate, lipid, and potassium metabolism. Am Heart J. 1983; 106:245-51. [IDIS 172680] [PubMed 6869206]
32. Grimm RH, Leon AS, Hunninghake DB et al. Effects of thiazide diuretics on plasma lipids and lipoproteins in mildly hypertensive patients. Ann Intern Med. 1981; 94:7-11. [IDIS 126660] [PubMed 7447225]
33. Goldman AI, Steele BW, Schnaper HW et al. Serum lipoprotein levels during chlorthalidone therapy, a Veterans Administration—National Heart, Lung, and Blood Institute cooperative study on antihypertensive therapy: mild hypertension. JAMA. 1980; 244:1691-5. [IDIS 125462] [PubMed 6997522]
34. Helgeland A, Leren P, Foss OP et al. Serum glucose levels during long-term observation of treated and untreated men with mild hypertension. Am J Med. 1984; 76:802-5. [PubMed 6720727]
35. Lott RS. Lithium interactions. Drug Interact Newsl. 1983; 3:17-22.
36. Rowe JW, Tobin JD, Rosa RM et al. Effect of experimental potassium deficiency on glucose and insulin metabolism. Metabolism. 1980; 29:498-502. [PubMed 6991855]
37. Helderman JH, Elahi D, Anderson DK et al. Prevention of glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes. 1983; 32:106-11. [IDIS 165713] [PubMed 6337892]
38. Windholz M, ed. The Merck index. 10th ed. Rahway, NJ: Merck & Co., Inc.: 1983.
39. Mroczek WJ. Indapamide: clinical pharmacology, therapeutic efficacy in hypertension, and adverse effects. Pharmacotherapy. 1983; 3:61-7. [IDIS 169172] [PubMed 6856486]
40. Hansen KB (Revlon Health Care Group Ethical Products Division, Tarrytown, NY): Personal communication; 1984 Oct 1.
41. Freis ED. How diuretics lower blood pressure. Am Heart J. 1983; 106:185-7. [IDIS 172672] [PubMed 6869200]
42. Mudge GH. Drugs affecting renal function and electrolyte metabolism. In: Gilman AG, Goodman L, Gilman A, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 6th ed. New York: Macmillan Publishing Company; 1980:899-903.
43. Blaschke TF, Melmon KL. Antihypertensive agents and the drug therapy of hypertension. In: Gilman AG, Goodman L, Gilman A, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 6th ed. New York: Macmillan Publishing Company; 1980:803-4.
44. Reviewers’ comments (personal observations); 1984 Oct.
45. The United States Pharmacopeial Convention, Inc. Indapamide tablets. Pharmacopeial Forum. 1989; 15:5475-7.
46. Scalabrino A, Galeone F, Giuntoli F et al. Clinical investigation on long-term effects of indapamide in patients with essential hypertension. Curr Ther Res. 1984; 35:17-22.
47. Weidman P, Bianchetti MG, Mordasini R. Effects of indapamide and various diuretics alone or combined with beta-blockers on serum lipoproteins. Curr Med Res Opin. 1983 (Suppl. 3); 8:123-34.
49. Kaplan NM. Initial treatment of adult patients with essential hypertension. Part II: alternating monotherapy is the preferred treatment. Pharmacotherapy. 1985; 5:195-200. [IDIS 394161] [PubMed 4034407]
50. Bauer JH. Stepped-care approach to the treatment of hypertension: is it obsolete? (unpublished observations)
51. Ayus JC. Diuretic-induced hyponatremia. Arch Intern Med. 1986; 146:1295. [IDIS 218029] [PubMed 3718124]
52. Ashouri OS. Severe diuretic-induced hyponatremia in the elderly: a series of eight patients. Arch Intern Med. 1986; 146:1355-7. [IDIS 218034] [PubMed 3718133]
53. Sonnenblick M, Algur N, Rosin A. Thiazide-induced hyponatremia and vasopressin release. Ann Intern Med. 1989; 110:751. [IDIS 254417] [PubMed 2930114]
54. Friedman E, Shadel M, Halkin H et al. Thiazide-induced hyponatremia: reproducibility by single dose rechallenge and an analysis of pathogenesis. Ann Intern Med. 1989; 110:24-30. [IDIS 250001] [PubMed 2491733]
55. Sterns RH. Severe symptomatic hyponatremia: treatment and outcome. Ann Intern Med. 1987; 107:656-64. [PubMed 3662278]
56. Bain PG, Egner W, Walker PR. Thiazide-induced dilutional hyponatremia masquerading as subarachnoid haemorrhage. Lancet. 1986; 2:634. [IDIS 221204] [PubMed 2875352]
57. Booker JA. Severe symptomatic hyponatremia in elderly outpatients: the role of thiazide therapy and stress. J Am Geriatr Soc. 1984; 32:108-13. [IDIS 181829] [PubMed 6693695]
58. Johnson JE, Wright LF. Thiazide-induced hyponatremia. South Med J. 1983; 76:1363-7. [IDIS 178758] [PubMed 6635723]
59. Kone B, Gimenez L, Watson AJ. Thiazide-induced hyponatremia. South Med J. 1986; 79:1456-7. [IDIS 231398] [PubMed 3775478]
60. Mozes B, Pines A, Werner D et al. Thiazide-induced hyponatremia: an unusual neurologic course. South Med J. 1986; 79:629-31. [IDIS 216157] [PubMed 3704734]
61. Oles KS, Denham JW. Hyponatremia induced by thiazide-like diuretics in the elderly. South Med J. 1984; 77:1314-5. [IDIS 193082] [PubMed 6484653]
62. Ayus JC, Krothapalli RK, Arieff Al. Changing concepts in treatment of severe symptomatic hyponatremia: rapid correction and possible relation to central pontine myelinolysis. Am J Med. 1985; 78(6 Part 1):897-902. [IDIS 201191] [PubMed 4014266]
63. Stricker BHC, Biriell C. Skin reactions and fever with indapamide. BMJ. 1987; 295:1313-4. [IDIS 236136] [PubMed 2961407]
64. Kandela D, Guez D. Skin reactions and fever with indapamide. BMJ. 1988; 296:573. [IDIS 238905] [PubMed 2964890]
67. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. [IDIS 365188] [PubMed 8622249]
68. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45. [IDIS 380501] [PubMed 9042847]
69. Whelton PK, Appel LJ, Espeland MA et al. or the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998; 279:839-46. [PubMed 9515998]
70. Anon. Consensus recommendations for the management of chronic heart failure. On behalf of the membership of the advisory council to improve outcomes nationwide in heart failure. Part II. Management of heart failure: approaches to the prevention of heart failure. Am J Cardiol. 1999; 83:9-38A.
71. The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA. 1988; 259:539-44. [IDIS 237362] [PubMed 2447297]
72. Richardson A, Bayliss J, Scriven AJ et al. Double-blind comparison of captopril alone against frusemide plus amiloride in mild heart failure. Lancet. 1987; 2:709-11. [IDIS 234108] [PubMed 2888942]
73. Sherman LG, Liang CS, Baumgardner S et al. Piretanide, a potent diuretic with potassium-sparing properties, for the treatment of congestive heart failure. Clin Pharmacol Ther. 1986; 40:587-94. [IDIS 224725] [PubMed 3533372]
74. Patterson JH, Adams KF Jr, Applefeld MM et al. Oral torsemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Pharmacotherapy. 1994; 14:514-21. [IDIS 336083] [PubMed 7997385]
75. Wilson JR, Reichek N, Dunkman WB et al. Effect of diuresis on the performance of the failing left ventricle in man. Am J Med. 1981;70:234-9.
76. Parker JO. The effects of oral ibopamine in patients with mild heart failure—a double blind placebo controlled comparison to furosemide. Int J Cardiol. 1993; 40:221-7. [PubMed 8225657]
77. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. [PubMed 10818056]
78. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. [PubMed 10818055]
79. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. [IDIS 452007] [PubMed 10977801]
80. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from website.
81. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-42. [IDIS 490723] [PubMed 12479770]
82. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. [IDIS 490721] [PubMed 12479763]
83. Aventis Pharmaceuticals. Lozol (indapamide) tablets prescribing information. Bridgewater, NJ; 2002 Dec.
85. Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs. Lancet. 2000; 356:1955-64. [PubMed 11130523]
86. Cushman WC, Ford CE, Cutler JA, et al. Success and predictors of blood pressure control in diverse North American settings: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich). 2002; 4:393-404. [PubMed 12461301]
87. Black HR, Elliott WJ, Neaton JD et al. Baseline characteristics and elderly blood pressure control in the CONVINCE trial. Hypertension. 2001; 37:12-18. [PubMed 11208750]
88. Black HR, Elliott WJ, Grandits G, et al. Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) trial. JAMA. 2003; 289:2073-2082. [PubMed 12709465]
89. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint Reduction in Hypertension Study (LIFE). Lancet. 2002; 359:995-1003. [PubMed 11937178]
90. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000; 342:145-153. [IDIS 439235] [PubMed 10639539]
91. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001; 358:1033-41. [PubMed 11589932]
92. Wing LMH, Reid CM, Ryan P, et al, for Second Australian National Blood Pressure Study Group. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly. N Engl J Med. 2003; 348:583-92. [PubMed 12584366]
93. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003; 26(Suppl 1):S80-2.
94. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. J Am Coll Cardiol. 2001; 38:2101-2113. [IDIS 474368] [PubMed 11738322]
141. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011:255-8.
142. ACOG task force on hypertension in pregnancy: hypertension in pregnancy. Washington, DC: American College of Obstetricians and Gynecologists; 2013.
200. Douglas JG, Bakris GL, Epstein M et al. Management of high blood pressure in African Americans: Consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003; 163:525-41. [IDIS 494836] [PubMed 12622600]
217. The Guidelines Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension. 1999; 17:392-403.
218. National Kidney Foundation Guideline. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis. 2002; 39(Suppl 2):S1-246.
500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.)
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. [PubMed 24352797]
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. [PubMed 23817082]
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. [PubMed 24243703]
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. [PubMed 24341872]
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. [PubMed 24424788]
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. [PubMed 24549531]
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. [PubMed 24352710]
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. [PubMed 24352759]
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. [PubMed 19139601]
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. [PubMed 24591473]
520. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37 Suppl 1:S14-80. [PubMed 24357209]
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471. [PubMed 23166211]
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. [PubMed 24788967]
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. [PubMed 24641124]
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. [PubMed 23684145]
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.
539. Churchill D, Beevers GD, Meher S et al. Diuretics for preventing pre-eclampsia. Cochrane Database Syst Rev. 2007; :CD004451. [PubMed 17253507]
540. Magee LA, Pels A, Helewa M et al., for the Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014; 4:105-45.
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. [PubMed 22555213]
600. Mylan Pharmaceuticals. Indapamide tablets prescribing information. Morgantown, WV; 2010 Jan.
a. AHFS drug information 2015. McEvoy GK, ed. Thiazides general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2015: .
c. AHFS drug information 2015. McEvoy GK, ed. Indapamide. Bethesda, MD: American Society of Health-System Pharmacists; 2015: .