Effect of indapamide on phosphate metabolism and vascular reactivity

Plante, Gérard E.; Lafreniere, Marie-Chantal; Tam, Pham Thi; Sirois, Pierré

doi:10.1016/s0002-9343(88)90993-x

Cited by 11 publications

(3 citation statements)

References 19 publications

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“…Mok et al reported a unique cardiac case of acquired Brugada syndrome and prolonged QT interval that developed polymorphic ventricular arrhythmia and cardiac arrest due to severe hyponatremia and severe hypokalemia secondary to indapamide [11]. In addition to this, indapamide is reported to alter phosphate metabolism and hypophosphatemia, which is presumed to be mainly due to renal phosphorus loss [12]. Also, indapamide is reported to cause a direct acute kidney injury and renal failure; a study in French National Pharmacovigilance Database has reported 11 patients who developed acute kidney injury secondary to indapamide, where two of them required renal replacement therapy [13].…”

Section: Discussionmentioning

confidence: 99%

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Alamin

Ahmed

Suliman

2020

Cureus

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Indapamide is one of the most effective and well-known anti-hypertensive medications. Electrolyte disturbances have been classically recognized as a typical side effect profile of indapamide. The most common electrolyte imbalance described with indapamide was hypokalemia; however, hyponatremia is being increasingly reported. In this case, we report a unique form of severe electrolytes derangement (hyponatremia, hypokalemia, hypophosphatemia, and hypocalcemia), which was complicated by seizures, rhabdomyolysis, and acute kidney injury that occurred within only 10 days of indapamide initiation. The patient was admitted to the medical intensive care unit for prompt electrolyte replacement and close monitoring. With the discontinuation of indapamide and the prompt replacement of the deficient electrolytes, the patient's condition has improved dramatically, and he was discharged in a good state of health. Electrolyte disturbances are expected to be seen with indapamide usage, and it might be associated with severe consequences like arrhythmias and seizures. This case report would raise awareness and add to the importance of closely following patients after prescribing indapamide.

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Section: Discussionmentioning

confidence: 99%

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Alamin

Ahmed

Suliman

2020

Cureus

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“…Hypokalaemia Diuretic therapy may lead to potassium, magnesium and phosphate depletion as a result of urinary losses, which reflect a direct effect of diuretics on the homeostasis of these electrolytes (40)(41)(42). Furthermore, experimental and clinical observations have demonstrated a close link among potassium, magnesium and phosphate concentrations (43)(44)(45)(46).…”

Section: Potassium Homeostasismentioning

confidence: 99%

“…Hypophosphataemia because of renal losses is observed after inhibition of carbonic anhydrase with acetazolamide. Thiazides and indapamide can produce an increase in the renal clearance of inorganic phosphate and hypophosphataemia (41,42). The underlying mechanisms may involve a direct effect of the diuretic on distal renal tubular reabsorption of phosphate, as well changes in potassium and ⁄ or magnesium homeostasis.…”

Section: Disorders Of Magnesium Phosphate and Calciummentioning

confidence: 99%

Blood pressure drug therapy and electrolyte disturbances

Liamis

Milionis

Elisaf

2008

International Journal of Clinical Practice

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Antihypertensive pharmacologic treatment may be associated with diverse disturbances of electrolyte homeostasis. These drug-induced disorders are relatively common, typically including hyponatraemia, hypokalaemia, hyperkalaemia, hypomagnesaemia, hypophosphataemia and hypercalcaemia. Diuretics, beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are particularly likely to cause these complications. Recognised risk factors include high-dosage regimens (especially diuretics), old age, diabetes and impairment of renal function. Strategies to prevent these adverse drug reactions involve careful consideration of risk factors and clinical and laboratory evaluation in the course of treatment.

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Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

Poulsen

Friberg

Noer

et al. 1989

Cardiovasc Drug Ther

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In a randomized, double-blind crossover trial, indapamide (IND) 2.5 mg and hydrochlorothiazide 25 mg + amiloride 2.5 mg (HCTZ + A) were found to be equally effective in reducing blood pressure (BP) in 13 patients with moderate to severe hypertension already receiving chronic treatment with a beta blocker and a vasodilatator (supine BP during run-in: 169/103 +/- 21/5 mmHg; on IND: 149/91 +/- 21/14 mmHg; on HCTZ + A 144/88 +/- 23/5 mmHg). Both drugs induced insignificant reductions in body weight, and no change in plasma volume was seen. Serum potassium was significantly reduced on both regimens--the values recorded on IND being significantly lower than those seen on HCTZ + A. Values below 3.0 mmol/l were found in two patients receiving IND, but no subjective side effects were reported. Hyperuricemia occurred with the same frequency on both regimens. It is concluded that IND, just like the thiazide diuretics, is useful as the third drug in patients needing triple drug therapy to control BP, but metabolic adverse effects are not avoided by the choice of this drug.

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Effect of indapamide on phosphate metabolism and vascular reactivity

Cited by 11 publications

References 19 publications

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Severe Electrolyte Disturbances Complicated by Seizures and Acute Kidney Injury Within 10 Days of Starting Indapamide

Blood pressure drug therapy and electrolyte disturbances

Comparison of indapamide and hydrochlorothiazide plus amiloride as a third drug in the treatment of arterial hypertension

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