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Indapamide

Also indexed as: Lozol®

Indapamide is a thiazide-like diuretic used, either alone or in combination with other drugs, to treat high blood pressure and to prevent salt and fluid retention associated with heart failure. Indapamide may interact with nutrients and herbs in ways similar to interactions described for thiazide diuretics, such as hydrochlorothiazide. However, research has not investigated these interactions specifically for indapamide.

Interactions with Dietary Supplements

Potassium and Sodium
Taking indapamide may result in sodium and potassium loss, which may cause dry mouth, thirst, fatigue, drowsiness, or muscle cramps.1 Doctors may suggest supplements or foods high in potassium to prevent unwanted side effects.

Calcium
Slight increases in blood calcium levels may occur in people taking indapamide, which could be aggravated by calcium supplementation.2 Therefore, people taking both calcium supplements and indapamide should have their blood calcium levels monitored by their healthcare practitioner, and it may be necessary to avoid calcium supplementation.

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression. Taking indapamide may elevate blood levels of lithium, resulting in unwanted side effects such as diarrhea, nausea, and drowsiness.3 It is unknown whether people taking small amounts of supplemental lithium will experience adverse reactions.

Vitamin D
Thiazide diuretics enhance the actions of vitamin D;4 however, it is unknown whether indapamide has the same effect. Until more is known, people taking indapamide should supplement vitamin D only under the supervision of a health practitioner.

Summary of Interactions for Indapamide

Depletion or interference Calcium
Lithium
Potassium
Sodium
Vitamin D*
Adverse interaction None known
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1969–71.

2. Threlkeld DS, ed. Diuretics and Cardiovasculars, Diuretics, Thiazides and Related Diuretics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1999, 704–16.

3. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1969–71.

4. Threlkeld DS, ed. Diuretics and Cardiovasculars, Diuretics, Thiazides and Related Diuretics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1999, 704–16.