Indapamide is a thiazide-like diuretic commonly used to treat high blood pressure (hypertension) and sometimes fluid retention (edema) associated with heart failure. Though chemically distinct from thiazide diuretics, it has similar effects and is often grouped with them.

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### 🔬 Mechanism of Action Indapamide works on the distal convoluted tubules of the kidney by: - Inhibiting sodium reabsorption, - Leading to increased excretion of sodium and water, - Reducing blood volume and peripheral resistance, → Resulting in lower blood pressure.

Over time, its vasodilatory effect becomes more prominent than its diuretic action.

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### 💊 Clinical Uses - Primary hypertension (as monotherapy or in combination with other antihypertensives, like ACE inhibitors) - Heart failure (off-label or supportive use) - May be used in stroke prevention, as shown in the PROGRESS trial when combined with perindopril.

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### 📚 Evidence: The PROGRESS Trial In the PROGRESS trial, the combination of perindopril + indapamide significantly reduced the risk of recurrent stroke compared to placebo or perindopril alone. This supports the idea that blood pressure reduction is key in stroke prevention, regardless of initial BP levels.

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### ⚠️ Common Side Effects - Hypokalemia (low potassium) - Hyponatremia (low sodium) - Dizziness or fatigue - Elevated uric acid or glucose levels - Muscle cramps

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### 🩺 Monitoring - Regular checks of blood electrolytes and kidney function are recommended. - Usually taken once daily, preferably in the morning to avoid nocturia.