Summary

Commonly reported side effects of indapamide include: hypokalemia. Continue reading for a comprehensive list of adverse effects.

Applies to indapamide: oral tablet.

Serious side effects of Indapamide

Along with its needed effects, indapamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking indapamide:

More common

• Agitation
• anxiety
• black, tarry stools
• chest pain
• cough or hoarseness
• dark urine
• dizziness
• fever or chills
• headache
• irritability
• light-colored stools
• lower back or side pain
• muscle cramps or spasms
• painful or difficult urination
• sneezing
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips
• stuffy or runny nose
• swollen glands
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes and skin

Less common

• Blurred vision
• body aches or pain
• burning, dry, or itching eyes
• change in consciousness
• cold sweats
• confusion
• decreased urine output
• discharge, excessive tearing
• discouragement
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drowsiness
• dry mouth
• dryness or soreness of the throat
• excessive muscle tone
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling sad or empty
• flushed, dry skin
• frequent urination
• fruit-like breath odor
• increased hunger, thirst, and urination
• increased urge to urinate during the night
• increased volume of pale, dilute urine
• joint pain, stiffness, or swelling
• lack of appetite
• loss of interest or pleasure
• lower back, side, or stomach pain
• mood changes
• muscle pain, cramps, tension, stiffness, or tightness
• nervousness
• pain or tenderness around the eyes and cheekbones
• redness, pain, swelling of the eye, eyelid, or inner lining of eyelid
• sugar in the urine
• sweating
• swelling of the face, feet, lower legs, ankles, or hands
• tender, swollen glands in the neck
• tightness in the chest
• trouble breathing
• trouble concentrating
• trouble in swallowing
• trouble sleeping
• voice changes
• waking to urinate at night

Incidence not known

• Change in near or distance vision
• difficulty in focusing the eyes
• eye pain

Other side effects of Indapamide

Some side effects of indapamide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Back pain
• blistering, peeling, loosening of the skin
• diarrhea
• increased sensitivity of skin to sunlight
• red irritated eyes
• red skin lesions, often with a purple center
• redness or other discoloration of the skin
• severe sunburn

Less common

• Acid or sour stomach
• belching
• bloating or swelling of the face, arms, hands, lower legs, or feet
• constipation
• decreased interest in sexual intercourse
• heartburn
• hives or rash
• inability to have or keep an erection
• indigestion
• lack or loss of strength
• loss in sexual ability, desire, drive, or performance
• nausea
• rapid weight gain
• stomach discomfort or upset
• tingling of the hands or feet
• unusual weight gain or loss

For Healthcare Professionals

Applies to indapamide: compounding powder, oral tablet.

General

Most adverse side effects are mild and transient.^[Ref]

Dermatologic

Dermatologic reactions, such as rashes, occur in less than 5% of patients, and comprise up to 36% of all adverse drug reactions associated with indapamide.^[Ref]

Metabolic

Metabolic abnormalities are common, but are rarely clinically significant. Hypokalemia occurs in 15% of patients, although clinically relevant hypokalemia is reported in only 1% and 3% of patients receiving 2.5 and 5.0 mg/day, respectively. Hyponatremia, hyperglycemia, and hyperuricemia are reported in 1% to 5% of patients but are rarely clinically relevant. Unlike the thiazides, indapamide has little or no adverse effect on the lipid profile. Severe cases of hyponatremia, accompanied by hypokalemia have been reported with recommended doses of indapamide in elderly females.^[Ref]

Renal

Renal side effects are unusual, consisting primarily of azotemia.^[Ref]

A case of interstitial nephritis and an urticarial rash associated with indapamide has been reported.^[Ref]

Gastrointestinal

Gastrointestinal side effects include dyspepsia, constipation, diarrhea, flatulence, and dry mouth in less than 5% of patients.^[Ref]

Nervous system

Nervous system side effects include dizziness, lightheadedness, headache, and fatigue in 5% of patients.^[Ref]

Cardiovascular

Cardiovascular side effects are usually limited to postural hypotension. Indapamide does not affect the heart rate.^[Ref]

Musculoskeletal

Musculoskeletal cramps are reported in about 5% of patients. A single case of skeletal muscle damage has been associated with indapamide.^[Ref]

A 71-year-old woman with a history of psychiatric problems and reflux esophagitis developed chest pain, finger numbness, sweating, and nausea while gardening. Her medications included indapamide, trifluoperazine, oxazepam, and ranitidine. Myocardial infarction was definitively ruled out by ECG and CPK isoenzyme analysis. Interesting laboratory values included a reduced serum sodium (117 mmol/L), elevated LDH and AST enzymes, and elevated CPK-MM isoenzymes. There was no history of muscular trauma, and thyroid function tests were normal. The hyponatremia and elevated CPK-MM fractions fell precipitously upon hydration with normal saline. A definite causal link between indapamide and rhabdomyolysis could not be made, but thiazide diuretics have been previously implicated in some cases of hypokalemia with subsequent muscle damage.^[Ref]

Genitourinary

Decreased sexual libido is rare, with up to 88% of patients reporting no change and most of the remaining 12% reporting improvement of sexual libido during indapamide therapy.^[Ref]

Genitourinary side effects generally reflect the activity of the drug, with less than 5% of patients reporting polyuria and nocturia.^[Ref]

Hepatic

Hepatic side effects are rare, at least one case of hepatitis has been reported.^[Ref]

A case of reversible hepatitis associated with indapamide has been reported.^[Ref]

Hypersensitivity

Hypersensitivity reactions occur in less than 5% of patients. Cases of severe reactions including toxic epidermal necrolysis, erythema multiforme, and Stevens-Johnson syndrome have been reported. Patients with a sulfa allergy may react to indapamide.^[Ref]

Endocrine

Endocrine side effects include at least one case of indapamide-induced hyperparathyroidism. In one study, indapamide significantly reduced parathyroid hormone levels in all patients.^[Ref]

Hematologic

Hematologic side effects are rare, but have included at least one case of mild thrombocytopenia and mucosal bleeding from the tongue. Bleeding stopped promptly and platelet counts returned to normal following discontinuation of indapamide.^[Ref]