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[Pharmacology](https://durgical.com/en/pharmacology/) · [Thiazide and thiazide-like diuretics](https://durgical.com/en/pharmacology/classes/thiazide-and-thiazide-like-diuretics/)

# Indapamide

A thiazide-like diuretic used mainly for high blood pressure. It lowers vascular resistance with little effect on heart output.

Updated 2026-11-01

- Class: [Thiazide and thiazide-like diuretics](https://durgical.com/en/pharmacology/classes/thiazide-and-thiazide-like-diuretics/)
- Transporter: Na⁺-Cl⁻ cotransporter (NCC) of the distal convoluted tubule
- ATC code: C03BA11

⇄**Na⁺-Cl⁻ cotransporter (NCC) of the distal convoluted tubule**Indapamide

ⓘ The figure shows one of indapamide's two mirror-image forms (the S form) bound to the human NCC; the medicine is a mixture of both.

**Target in 3D:** Na⁺-Cl⁻ cotransporter (NCC) of the distal convoluted tubule. PDB structure 8VPN (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8VPN) · Drag to rotate · pinch to zoom

## Mechanism of action

Indapamide, an indoline sulfonamide, blocks the Na⁺-Cl⁻ cotransporter (NCC) in the distal convoluted tubule, so more sodium and chloride are lost in the urine and potassium is lost downstream. It lowers peripheral vascular resistance with little change in cardiac output, rate or rhythm.

- Indapamide blocks NCC in the distal tubule
- More Na⁺ and Cl⁻ lost; K⁺ lost downstream
- Peripheral vascular resistance falls
- Blood pressure falls with little change in cardiac output

## Pharmacokinetics

**Metabolism**
Extensively metabolised; little is excreted unchanged

**Elimination**
Urine and probably the bile

**Half-life**
About 14 hours in whole blood

## Indications

- High blood pressure, alone or combined [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)
- Salt and fluid retention in heart failure [Heart failure →](https://durgical.com/en/conditions/heart-failure/)

## Adverse effects

### Common

- Hypokalaemia
- Hyponatraemia
- Headache and dizziness
- Muscle cramps
- High uric acid

### Serious (rare, important)

- Severe hyponatraemia with low potassium
- Arrhythmias from low potassium, especially with digoxin
- Severe skin reactions (rare)

## Contraindications

- Anuria
- Hypersensitivity to indapamide or other sulfonamide-derived drugs

## Key interactions

**Lithium**
Less lithium clearance and risk of toxicity

**Digoxin**
Hypokalaemia increases digoxin toxicity

**Other antihypertensives**
Additive lowering of blood pressure

## What is monitored

- Sodium and potassium
- Blood pressure
- Uric acid and glucose

## Nursing care

- Before giving: blood pressure, sodium and potassium.
- Watch for confusion, weakness or cramps (low sodium or potassium), especially in older adults.
- Teach: take in the morning, rise slowly, report muscle weakness or confusion.

## Pregnancy and breastfeeding

Used only for oedema from pathological causes, not for ordinary oedema of pregnancy.

## Memory aid

INDApamide «INDicates» pressure: a thiazide-like drug used mostly to bring blood pressure down.

## Test yourself

Think of the answer, then tap the question to see it.

## Which transporter does indapamide block?

The Na⁺-Cl⁻ cotransporter (NCC) of the distal convoluted tubule, like thiazides.

## Which electrolyte problems are linked to indapamide?

Hypokalaemia and hyponatraemia; the risk rises with higher exposure.

## Why is indapamide avoided in sulfonamide allergy?

It is a sulfonamide derivative, and hypersensitivity to other sulfonamide-derived drugs is a contraindication.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/indapamide/)

## Related drugs

- [Chlortalidone](https://durgical.com/en/pharmacology/chlortalidone/)
- [Hydrochlorothiazide](https://durgical.com/en/pharmacology/hydrochlorothiazide/)

## Related conditions

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Heart failure](https://durgical.com/en/conditions/heart-failure/)

[← Back to the class: Thiazide and thiazide-like diuretics](https://durgical.com/en/pharmacology/classes/thiazide-and-thiazide-like-diuretics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - INDAPAMIDE tablet, film coated](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=59cd3331-7afe-432a-8b50-39533fd5f392) (DailyMed (U.S. National Library of Medicine), 2026); [Indapamide: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a684062.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C03BA11) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [RCSB PDB - 8VPN: Phosphorylated human NCC in complex with indapamide](https://www.rcsb.org/structure/8VPN) (RCSB Protein Data Bank, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/indapamide/
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