Indapamide: a review.

Indapamide (Natrilix; Servier) is an antihypertensive diuretic which is used at a dose of 2.5 mg/d as first-line single-drug treatment of essential arterial hypertension. Indapamide effectively controls blood pressure in about 65% of cases of mild and moderate hypertension. The time-course of the antihypertensive effect of this drug consists of a clinically significant fall in blood pressure after the 1st week of treatment and of a further reduction that follows a decreasing power function of time thereafter. When an epidemiological approach to the mass treatment of hypertension is considered, the time-course of the antihypertensive effect of indapamide constitutes an advantage over diuretics such as the thiazides that lower blood pressure mildly during the 1st week of treatment and then proceed to lower it in a linear pattern thereafter. Indapamide does not increase magnesium excretion when given in single doses to normal volunteers. This distinguishes it from most diuretic formulations in current use, which increase renal magnesium excretion. The difference could be explained by the fact that the dose of indapamide usually employed is devoid of major diuretic activity although it still exhibits power antihypertensive properties. Since magnesium depletion provoked by diuretics seems to be the principal causative factor in the development of sudden cardiac death in patients under treatment with diuretics, indapamide should be regarded as one of the best options from this point of view.(ABSTRACT TRUNCATED AT 250 WORDS)