Do not take indapamide if you:

• are allergic to indapamide, any other sulfonamide or to any of the other ingredients of this medicine (listed in section 6)
• have severe kidney disease
• have severe liver disease or suffer from a condition called hepatic encephalopathy (liver problems which affect your brain and central nervous system)
• have low levels of potassium in your blood (hypokalaemia)

Do not take the medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking indapamide.

Warnings and precautions

Talk to your doctor or pharmacist before taking indapamide if you:

• suffer from gout or have diabetes
• have kidney problems
• have heart rhythm problems
• have liver problems
• experience a decrease in vision or eye pain
  These could be symptoms of fluid accumulation in the vascular layer of the eye (choroidal effusion) or an increase of pressure in your eye and can happen within hours to weeks of taking indapamide. This can lead to permanent vision loss, if not treated. If you earlier have had a penicillin or sulfonamide allergy, you can be at higher risk of developing this.
• have muscle disorders including muscle pain, tenderness, weakness or cramps
• need to have a test to check how well your parathyroid gland is working

You should tell your doctor if you have had photosensitivity reactions.

Your doctor may give you blood tests to check for low sodium or potassium levels or high calcium levels.

If you think any of these situations may apply to you or you have any questions or doubts about taking your medicines, you should consult your doctor or pharmacist.

Athletes should be aware that this medicine contains an active ingredient, which may give a positive reaction in doping tests.

Other medicines and indapamide

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines you buy without a prescription, including herbal medicines. This is because indapamide can affect the way some medicines work. Also some medicines can affect the way indapamide works.

In particular, tell your doctor if you are taking any of the following as special care may be required:

• lithium (used to treat depression). You should not take indapamide with lithium due to the risk of increased levels of lithium in the blood
• medicines for heart rhythm problems such as quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, ibutilide, dofetilide or digitalis
• bepridil (used to treat angina pectoris, a condition causing chest pain)
• stimulant laxatives
• medicines used to treat mental disorders such as depression, anxiety or schizophrenia (for example tricyclic antidepressants, antipsychotic drugs, neuroleptics (such as amisulpride, sulpride, sultopride, tiapride, haloperidol, droperidol))
• sparfloxacin, moxifloxacin, erythromycin by injection (antibiotics used to treat bacterial infections)
• vincamine by injection (used to treat symptomatic cognitive disorders in elderly including memory loss)
• pentamidine (used to treat certain types of pneumonia)
• halofantrine (antiparasitic drug used to treat certain types of malaria)
• mizolastine (used to treat allergic reactions, such as hay fever)
• non-steroidal anti-inflammatory drugs for pain relief (e.g. ibuprofen) or high doses of acetylsalicylic acid (aspirin)
• angiotensin converting enzyme (ACE) inhibitors (used to treat high blood pressure and heart failure)
• amphotericin B by injection (anti-fungal medicines)
• oral corticosteroids used to treat various conditions including severe asthma and rheumatoid arthritis
• allopurinol (for the treatment of gout)
• baclofen (to treat muscle stiffness occurring in diseases such as multiple sclerosis)
• potassium-sparing diuretics (amiloride, spironolactone, triamterene)
• metformin (to treat diabetes)
• iodinated contrast media (used for tests involving X-rays)
• calcium tablets or other calcium supplements
• ciclosporin, tacrolimus or other medicines to depress the immune system after organ transplantation, to treat autoimmune diseases, or severe rheumatic or dermatological diseases,
• tetracosactide (to treat Crohn’s disease)
• cisapride (used to treat reduced movement of the gullet and stomach)
• diphemanil (used to treat gastro-intestinal problems such as ulcers, too much acid, overactive digestive system)
• methadone (used to treat addiction)

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking indapamide.

Driving and using machines:

This medicine can cause side effects such as tiredness or dizziness due to lowering of the blood pressure (see section 4). These side effects are more likely to occur after the initiation of the treatment and after dose increases. If this occurs, you should refrain from driving and other activities requiring alertness. However, under good control, these side effects are unlikely to occur.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Indapamide is not recommended during pregnancy. When a pregnancy is planned or confirmed, the switch to an alternative treatment should be initiated as soon as possible.

Do not use this medicine if you are breast-feeding or planning to breast-feed. The active ingredient is excreted in milk.

Important information about the ingredients of indapamide

Indapamide contains lactose.

If you have been told by your doctor that you have an intolerance to some sugars, talk to your doctor before taking this medicinal product.

Indapamide contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.