Pharmacological properties of indapamide - Rationale for use in hypertension

Indapamide is a thiazide-related diuretic drug with antihypertensive proper ties. Its blood pressure-lowering action has been repeatedly demonstrated i n acute as well as chronic conditions in various genetically and nongenetic ally determined forms of hypertension. In rats, the maximally effective ora l dose is 3 mg/kg/24h. The natriuretic effect of indapamide peaked at 3-fol d at a dose of 1 mg/kg. In accordance with its antihypertensive properties, indapamide was shown to have excellent efficacy in protecting against targ et organ damage (heart, kidneys, brain). In addition to its natriuretic effect, it has been shown in several experim ents that indapamide lowers the response to sympathetic nerve stimulation, exhibits calcium antagonist properties, enhances the production of prostacy clin, and limits the production of free radicals and of endothelium-depende nt vasoconstrictor substances. These effects, even though they are observed at high indapamide concentrations and in a possibly species-dependent mann er, may contribute to the beneficial properties of indapamide. The most rec ent data suggest that low doses of indapamide exert synergistic effects in combination with other antihypertensive drugs such as ACE inhibitors, the e ffects of which are influenced by the sodium status of the organism.