Generic Name:  Indapamide.

Trade Name    : Natrilix.

Drug Class      :  Thiazide Diuretics.

Forms of The Drug

  • Tablets: 1.25mg – 2.5mg.

Mechanism of Action

The mechanism of action of Natrilix involves its effects on the kidneys and blood vessels. It works by increasing the excretion of sodium and chloride ions from the body, thereby promoting diuresis (increased urine production) and reducing fluid volume. This process helps to lower blood pressure and alleviate edema. Natrilix acts primarily on the distal convoluted tubules of the nephrons in the kidneys. The nephrons are the functional units responsible for filtering blood and forming urine. Within the distal convoluted tubules, Natrilix inhibits the reabsorption of sodium ions. By blocking the sodium-chloride symporter, which is a transporter protein, Natrilix prevents the reabsorption of sodium and chloride ions back into the bloodstream. As a result, more sodium and chloride are excreted in the urine, leading to increased urine output and decreased fluid retention.

The increased excretion of sodium and chloride ions also leads to osmotic effects. The presence of these solutes in the urine causes water to follow them, resulting in increased water excretion. This diuretic effect helps to reduce blood volume and subsequently lowers blood pressure. In addition to its diuretic effects, Natrilix also possesses vasodilatory properties. It acts on the smooth muscle cells of blood vessels, causing them to relax and widen. This relaxation of blood vessels reduces peripheral vascular resistance, allowing blood to flow more easily and decreasing the workload on the heart. The vasodilatory effect of Natrilix further contributes to its antihypertensive action.

Indications

  1. Hypertension.
  2. Edema.
  3. Congestive heart failure (CHF).
  4. Renal disorders such as nephrotic syndrome or renal impairment.

Contraindications

  1. Hypersensitivity.
  2. Severe renal impairment.
  3. Severe hepatic impairment.
  4. Hypokalemia.
  5. Severe dehydration.
  6. Pregnancy and breastfeeding.

Side Effects

  1. Hypotension
  2. Palpation
  3. Flushing
  4. Dizziness
  5. Lightheadedness
  6. Vertigo
  7. Headache
  8. Weakness
  9. Restlessness
  10. Drowsiness
  11. Fatigue
  12. Lethargy
  13. Malaise
  14. Anorexia
  15. Nausea/vomiting
  16. Nocturia
  17. Polyuria
  18. Blurred vision
  19. Rhinnorhea
  20. Electrolyte abnormalities
  21. Pruritus
  22. Rash

Drug Interactions

Other drugs that can interact with it.

  1. Diuretics such as loop diuretics (e.g., furosemide) or thiazide diuretics (e.g., hydrochlorothiazide)
  2. Lithium.
  3. NSAIDs such as ibuprofen or naproxen.
  4. Potassium-Sparing Diuretics and Potassium Supplements: (e.g., spironolactone) or potassium supplements may increase the risk of hyperkalemia (high potassium levels).
  5. Antidiabetic medications.
  6. Antihypertensive medications such as beta-blockers, ACE inhibitors, or calcium channel blockers.

Precautions

  1. Pregnancy: Category B.
  2. Lactation: The safety of using Natrilix (indapamide) during lactation is not well-established, and limited data is available regarding the excretion of Natrilix into breast milk. Therefore, it is generally recommended to exercise caution when considering the use of Natrilix while breastfeeding.

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