Xipamide

It's primary site of action is the cortical diluting segment or the early distal tubule. Here it inhibits sodium reabsorption, chlorine and water are retained in the tubule secondarily. It does not affect the corticomedullary osmotic gradient. The extra renal actions consist of a slowly developing relaxant effect on arterioles (specially in hypertensives) and elevation of blood sugar, probably due to decreased insulin release.

Indications

Oedema due to renal, hepatic, cardiac or with rheumatoid arthritis. Oedema of pregnancy. Peripheral oedema due to venous insufficiency.

Dosage

20-60 mg daily as single early morning dose. Initial dose should not exceed 20 mg if combined with other antihypertensive agents.

Contra-Indications

Renal impairment. Acute electrolyte deficiency. Precomatose states associated with cirrhosis.

Special Precautions

Avoid admin. during Ist trimester of pregnancy. Renal or hepatic dysfunction. Diabetes, gout, prostatic hypertrophy. Potassium supplements may be required during therapy. Paediatrics: Not recommended. Pregnancy: Unsafe in toxaemia of pregnancy. Lactation: To be used if clearly indicated.

Side Effects

Weakness, fatigue, muscle cramps, cardiac arrhythmias. Hypokalemia. Hyponatremia. G.I. disturbances. Hearing loss.

Drug Interactions

Potentiates anti-hypertensives, increases serum lithium, probenecid competitively inhibits tubular secretion