Lozide , Lozol
Classifications: electrolytic and water balance agent; thiazide diuretic; Therapeutic: thiazide diuretic
Pregnancy Category: B
1.25, 2.5 mg tablets
Sulfonamide derivative which has both diuretic and direct vascular effects. Action mechanism is similar to that of the thiazide
diuretics. Principal site of action is on the proximal portion of the distal renal tubules. Enhances excretion of sodium,
potassium, and water by interfering with sodium transfer across renal epithelium of the tubules.
Hypotensive activity appears to result from a decrease in plasma and extracellular fluid volume, decreased peripheral vascular
resistance, direct arteriolar dilation, and calcium channel blockade.
Alone or with other antihypertensives in the management of hypertension in patients who have failed to respond to diet,
exercise, or weight reduction.
Edema associated with CHF.
Hypersensitivity to indapamide or other sulfonamide derivatives, anuria, renal failure.
Electrolyte imbalance, hypokalemia, severe renal disease; impaired hepatic function or progressive liver disease; prediabetic
and type II diabetic patient, hyperparathyroidism, thyroid disorders; SLE; sympathectomized patient; history of gout; pregnancy
(category B), lactation. Safe use in children is not established.
Route & Dosage
Adult: PO 2.5 mg once/d, may increase to 5 mg/d if needed
- Give with food or milk to reduce GI irritation.
- Administer in a.m. to prevent nocturia. Urge patient to take at least 240 mL (8 oz) of fluid (if allowed) with the medication.
- Store in tight, light-resistant container unless otherwise directed.
Adverse Effects (≥1%)CNS:
Headache, dizziness, fatigue
, weakness, muscle cramps or spasm, paresthesia
, tension, anxiety, nervousness, agitation, vertigo,
, mental depression
, blurred vision, drowsiness. CV:
Orthostatic hypotension, PVCs, dysrhythmias, flushing, palpitation. GI:
Dry mouth, anorexia, nausea, vomiting, diarrhea
, abdominal cramps or pain. Urogenital:
Urinary frequency, nocturia, polyuria, glycosuria, impotence or reduced libido. Skin:
Rash, hives, pruritus, vasculitis, photosensitivity. Metabolic:
Dilutional hyponatremia, hyperuricemia,
exacerbation of gout; hypokalemia,
hyperglycemia, hypochloremia, hypercalcemia, increased BUN or creatinine
, weight loss, exacerbation of SLE; increased cholesterol.
Diagnostic Test Interference
Since indapamide may cause hypercalcemia (and hypophosphatemia), it is generally withheld before tests for parathyroid function are performed.
Effects of diazoxide
and indapamide intensified; increased risk of digoxin toxicity
with hypokalemia; decreased renal lithium
clearance may increase risk of lithium toxicity
Readily from GI tract. Peak:
22.5 h. Duration:
Up to 36 h. Metabolism:
In liver. Elimination:
60% in urine; 1623% in feces. Half-Life:
Assessment & Drug Effects
- Monitor BP periodically throughout therapy.
- Lab tests: Obtain baseline and periodic BUN, serum creatinine, uric acid, blood glucose, serum electrolytes, and fluid balance.
- Monitor for digitalis toxicity with concurrent therapy.
- Note: Electrolyte imbalances may be clinically serious with protracted vomiting and diarrhea, excessive sweating, GI drainage,
- Report promptly signs of hyponatremia or hypokalemia (see Appendix F).
- Monitor diabetics for loss of glycemic control.
Patient & Family Education
- Notify physician of decreased urine output, dizziness, weakness or muscle cramps, nausea, jaundice, or blurred vision.
- Take precautions from sun exposure because of risk of photosensitivity.
- Record weight at least every other day; inspect ankles and legs for edema. Report unexplained, progressive weight gain [e.g.,
11.5 kg (23 lb) in 23 d].