Indapamide + Amlodipine: Brands, Price & Uses in Bangladesh

Indapamide + Amlodipine is a fixed-dose combination indicated for the treatment of essential hypertension. It combines a thiazide-like diuretic (indapamide) with a dihydropyridine calcium channel blocker (amlodipine), two agents with complementary mechanisms of blood pressure lowering.

• Established use: As substitution therapy in patients whose blood pressure is already adequately controlled with indapamide and amlodipine given concurrently as separate tablets at the same dose strengths.
• Guideline-supported use: As combination therapy for essential hypertension not adequately controlled on monotherapy with either indapamide or amlodipine alone, when a physician determines that combination treatment is appropriate.
• Not indicated: Indapamide + Amlodipine is not intended for initial titration of therapy; the dose of each component should first be individually titrated before switching to this fixed-dose combination.

Adult Dose (Hypertension)

Administration

• Take once daily, preferably in the morning, with or without food.
• Swallow the tablet whole with a glass of water; do not crush or chew a sustained-release indapamide component unless the specific product is confirmed to be immediate-release.
• Take at approximately the same time each day for consistent blood pressure control.

Renal Impairment

Indapamide + Amlodipine is contraindicated in severe renal impairment (see Contraindications). In mild-to-moderate renal impairment, use with caution and monitor renal function and electrolytes.

Hepatic Impairment

Indapamide + Amlodipine is contraindicated in severe hepatic impairment or hepatic encephalopathy (see Contraindications). Amlodipine should be initiated at the lower end of the dosing range in hepatic impairment; a physician should assess whether the fixed-dose combination is appropriate.

Elderly

No dose adjustment of the combination is generally required in the elderly, but they are at greater risk of electrolyte disturbances and should be monitored closely; see Use in Special Populations.

Side effects of Indapamide + Amlodipine reflect those reported with each component.

Common (Amlodipine-related)

• Peripheral edema (ankle swelling)
• Headache
• Flushing
• Dizziness
• Palpitations
• Fatigue

Common (Indapamide-related)

• Electrolyte disturbances, particularly hypokalemia and hyponatremia (see Precautions and Warnings)
• Hyperuricemia
• Mild gastrointestinal upset (nausea, constipation)
• Dizziness, headache
• Photosensitivity reactions (see Precautions and Warnings)

Less Common / Serious

• Hypotension, especially after the first dose or with volume depletion
• Skin rash, urticaria
• Cardiac arrhythmia related to electrolyte imbalance
• Rarely: angioedema, severe skin reactions, blood dyscrasias, hepatic or renal dysfunction

Patients should seek prompt medical attention for signs of severe allergic reaction, irregular heartbeat, severe dizziness, or unusual muscle weakness/cramping (possible electrolyte disturbance).