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indapamide (indapamide, Douglas)

✓ Approved

Douglas Pharmaceuticals Limited · SLC12A3 · Small Molecule

What is indapamide?

indapamide is a small molecule developed by Douglas Pharmaceuticals Limited. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesindapamide, Douglas
CompanyDouglas Pharmaceuticals Limited
Drug ClassSmall Molecule
Molecular TargetSLC12A3
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Douglas Pharmaceuticals Limited

Mechanism of Action

Molecular Targets

indapamide acts on 1 molecular target:

SLC12A3solute carrier family 12 member 3 (NCCT, NCC)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

indapamide is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Vascular disordersHypertension✓ Approved

Related Research Articles

PubMedEuropean heart journal. Cardiovascular pharmacotherapy2026-09-15

Real-world analysis of adherence, persistence, and outcomes in patients receiving four-drug antihypertensive therapy.

Mancia Giuseppe G, Brouwers Sofie S, Calabria Silvia S, Leogrande Melania M et al.

Describe real-world use, adherence, persistence, and risk of non-fatal cardiovascular events (CVE) and mortality among patients receiving four-drug antihypertensive therapy. This was a retrospective, longitudinal cohort study of Italian administrative healthcare databases (N=7,160,298). Eligible patients were ≥18 years and received four-drug therapy between 2018 and 2022. Class- and molecule-level subcohort analyses required data for ≥1 year either side of four-drug therapy identification. Adherence and persistence were based on prescription availability. A Cox proportional hazards model was used for risk assessment.Among 228,594 eligible patients, 113,755 received either an angiotensin-converting enzyme inhibitor (ACEi; n=57,473) or angiotensin II receptor blocker (n=56,282), thiazide/thiazide-like diuretic (DIU), calcium channel blocker (CCB), and a fourth class (mostly beta-blockers [BBs]; n=87,022).In the Class subcohort (ACEi+DIU+CCB+BB; n=41,903), high adherence was more frequent among patients receiving two (52.1%) versus three (40.2%) or four (25.0%) pills (global P<0.001); persistence was also improved (P<0.02 from 6 months). Adherence and persistence were significantly higher with two versus three pills in the Molecule subcohort (perindopril, indapamide, amlodipine, and bisoprolol; n=8007). For persistent versus non-persistent patients, there was a risk reduction for CVE (12.4%; P<0.001) and mortality (16.4%; P<0.001) in the Class subcohort, with similar findings in the Molecule subcohort (20.9% [P=0.003] and 20.9% [P=0.002], respectively). In patients receiving four-drug antihypertensive therapy, adherence and persistence were significantly improved with lower pill burden. Persistence was associated with lower risks of CVE and mortality.

PMID 42736626
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PubMedInternational journal of general medicine2026-09-06

Thiazide Diuretics Are Associated with a Higher Triglyceride-Glucose Index Than Calcium Channel Blockers in Hypertensive Patients.

Erarslan Sertas S, Acet Aycan A, Karagoz Osman Nurullah ON, Erkan Bugrahan B et al.

Hypertension is frequently accompanied by metabolic abnormalities that increase cardiovascular risk. The triglyceride-glucose (TyG) index is a practical surrogate marker of insulin resistance. This study aimed to compare TyG index values and related metabolic parameters between patients receiving RAAS blockers plus thiazide/thiazide-like diuretics and those receiving RAAS blockers plus calcium channel blockers (CCBs) as antihypertensive regimens. In this retrospective observational study, 157 of 189 screened patients met eligibility criteria and were included (RAAS blocker plus thiazide/thiazide-like diuretic, n=95; RAAS blocker plus CCB, n=62). Multivariable linear regression models and inverse probability of treatment weighting (IPTW) analyses were performed to assess the independence of findings from clinical confounders. The TyG index was significantly higher in the diuretic group than in the CCB group [9.21 (9.01-9.73) vs 8.95 (8.66-9.40); p<0.001], as were triglyceride [186.00 vs 142.35 mg/dL; p<0.001] and uric acid levels [5.70 vs 5.00 mg/dL; p=0.004]. Blood pressure control rates were similar. The treatment group effect remained significant across all adjusted models, including IPTW-weighted regression (β=0.385, p=0.0003). A significant treatment group × diabetes mellitus interaction was observed (p=0.042), suggesting a stronger association in diabetic patients. A dose-stratified analysis within the diuretic group showed a significant dose-response relationship: higher hydrochlorothiazide (25 vs 12.5 mg/day) and indapamide (2.5 vs 1.25 mg/day) doses were both associated with significantly higher TyG index, fasting glucose, and uric acid levels. In an exploratory diuretic subgroup analysis, urea and BUN levels were higher with hydrochlorothiazide than indapamide; however, this analysis was underpowered (indapamide n=24) and should be interpreted with caution. RAAS blocker plus thiazide/thiazide-like diuretic regimens were associated with a significantly higher TyG index and a less favorable metabolic profile than RAAS blocker plus CCB regimens, independent of multiple clinical confounders. Metabolic risk profiles should be considered when selecting antihypertensive combination therapy; prospective studies are needed to establish causality.

PMID 42701822
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PubMedAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2026-08-07

Adherence and Healthcare Costs Associated with Single-vs Free-Pill Combination of Perindopril-Based Antihypertensive Medications: An 11-Year Follow-Up, Real-World Evidence.

Savarese Gianluigi G, Vintila Ana-Maria AM, Degli Esposti Luca L, Dovizio Melania M et al.

Short-term studies have demonstrated that single-pill combinations (SPCs) improve adherence, reduce hypertension-related complications, and lower costs; however, long-term benefits remain unclear. This study compared adherence, healthcare resource utilization (HCRU), and costs over 11 years in patients treated with SPCs versus free-pill combinations (FPCs) of antihypertensive drugs in routine Italian practice. We analyzed a large administrative dataset (2010-2022) covering approximately 7 million Italian citizens. Adults initiating perindopril (PER)-based SPC or FPC with amlodipine and/or indapamide were included. PER-based therapies were selected because their SPCs were among the first marketed in Italy, allowing for extended follow-up. Adherence was measured by proportion of days covered (PDC), with high adherence defined as PDC ≥ 80%. Among 24,476 patients (mean age: 64.6 years; 59.7% male), 92.6% received SPCs, and 6.0% FPCs. High adherence was observed in 75.5% of SPC users compared with 32.0% of FPC users. SPC users had fewer all-cause hospitalizations and outpatient visits (both p < 0.001). Average annual healthcare costs were €242.96 lower for SPC users (95% CI €55.03-€430.89; p < 0.05), with significant reductions in costs related to all-cause and cardiovascular-related hospital admissions (p < 0.001). In this long-term, real-world study, SPC use was associated with better adherence, reduced HCRU, and lower healthcare costs compared with FPC regimens. These economic benefits were evident within 1 year and may yield substantial long-term savings for national health systems, given the high prevalence and chronic nature of hypertension.

PMID 42566123
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PubMedInternational journal of hypertension2026-07-15

Real-World Effectiveness and Safety of Ramipril/Indapamide Combination Therapy in Essential Hypertension: A Retrospective Study on UK Primary Care Records.

Mogielnicki Mariusz M, Płaszczyca Marian M, Leary Andrew A, Piechaczek Mateusz M et al.

This study aimed to evaluate the patient characteristics, effectiveness, safety, adherence, and persistence of ramipril/indapamide (R/I) free combination therapy in patients with essential hypertension inadequately controlled with monotherapy. This retrospective observational cohort study used anonymized UK primary care electronic health records from IQVIA's Medical Research Database (IMRD), incorporating "The Health Improvement Network" (THIN), a Cegedim Database. Adults with essential hypertension who switched from ramipril or indapamide monotherapy to R/I between database inception and January 1, 2021, were enrolled. Outcomes included changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), proportions achieving BP < 140/90 mmHg or SBP ≥ 20 mmHg/DBP ≥ 10 mmHg decrease, proportion of days covered (PDC), persistence, and adverse events (AEs) over 12 months. A total of 1089 patients met inclusion criteria (mean age 63.5 years; 55.6% female). Mean baseline BP on monotherapy was 156.0/89.1 mmHg. Over 12 months, mean SBP decreased by 18.7 mmHg and DBP by 8.9 mmHg (both p < 0.001); 54.3% of patients achieved BP < 140/90 mmHg, and 61.6% met the predefined BP decrease threshold. A dose-response relationship was observed for BP outcomes. Mean PDC was 92.4% at 3 months and 86.2% at 12 months; persistence was 87.7% and 81.5%, respectively. The most frequent AE was cough (10.38%); gout occurred in 0.73%, exclusively in indapamide-naïve patients. The outcomes remained consistent across sensitivity and subgroup analyses. Switching from ramipril or indapamide monotherapy to their free combination was associated with clinically meaningful BP decreases, high adherence and persistence, and a favorable safety profile in routine practice. These findings are consistent with current therapeutic guidelines that endorse its use in essential hypertension management.

PMID 42453630
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PubMedFrontiers in pharmacology2026-07-14

Impact of the national centralized volume-based procurement policy on antihypertensive drug procurement, price, and volume in Guangxi: an interrupted time series analysis of procurement data.

Liang Shuang S, Zhang Shuang S, Li Ling L, Luo Jing J et al.

The impact of China's national centralized volume-based procurement (NVBP) policy on antihypertensive drug procurement in underdeveloped, multi-ethnic regions remains understudied. This study evaluated changes in procurement prices, volumes, and costs for four antihypertensive drugs following the second NVBP batch in Guangxi, an economically disadvantaged region in southwestern China. Monthly procurement data for four NVBP antihypertensive drugs (Olmesartan Medoxomil, Candesartan Cilexetil, Terazosin Hydrochloride, and Indapamide) were collected from January 2019 to April 2021, covering 16 months before and 12 months after policy implementation (May 1, 2020). Interrupted time series (ITS) analysis with Newey-West standard errors was used to assess immediate and sustained changes in log-transformed defined daily doses (DDDs) and defined daily dose costs (DDDc). Sensitivity analyses examined robustness to a January 2021 procurement spike. Following policy implementation, the average unit price of the four drugs decreased by 81.52%, and median DDDc dropped by 96.88% to 99.78%. ITS models showed significant immediate increases in DDDs for all four drugs (all p < 0.001), but no significant sustained long-term trend (all β 3 not significant, p > 0.05). A sharp DDDs spike occurred in January 2021, followed by a decline. Sensitivity analyses confirmed that the spike did not affect the direction or significance of the main estimates. The second NVBP batch was associated with substantial and sustained reductions in procurement prices and costs for these four antihypertensive drugs in Guangxi. However, procurement volumes showed marked volatility without stable long-term growth. These findings, based on procurement records rather than patient-level data, suggest that price reductions alone may not ensure consistent procurement patterns. Strengthening supply chain resilience and aligning procurement schedules with clinical demand may support more stable drug supply in disadvantaged regions.

PMID 42445249
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PubMedThe Journal of urology2026-06-30

Urinary Supersaturation in a Randomized Trial Among Individuals with Recurrent Nephrolithiasis Comparing Empiric Versus Selective Preventive Therapy: The URINE Trial.

Hsi Ryan S RS, Lee Aaron X AX, Koyama Tatsuki T, Widmer Annaliese A et al.

To compare a strategy using testing to guide treatment, also known as selective therapy, with a strategy of initiating interventions without testing, termed empiric therapy, on urinary supersaturation of calcium oxalate and calcium phosphate. In this single-center trial, adult individuals with recurrent idiopathic calcium stone disease were randomized to either an empiric or selective strategy. Participants received 24-hour urine testing at baseline, 4 weeks, and 8 weeks. Treatment in the empiric arm comprised dietary and fluid counseling and pharmacologic treatment with indapamide and potassium citrate irrespective of 24-hour urine results. For the selective arm, diet, and pharmacologic treatments, which included indapamide, potassium citrate, and/or allopurinol, were tailored based on urine testing at baseline and 4 weeks. The primary outcome was urinary supersaturation of calcium oxalate and calcium phosphate at 8 weeks. The analytic sample included 56 participants (mean [SD] age, 44.5 [13.2] years; 30 women [54%]), with 29 randomized to the empiric and 27 to the selective groups. At week 8, there were no significant differences comparing the empiric and selective arms with respect to mean [SD] urinary supersaturation of calcium oxalate (4.7 [2.9] vs 5.0 [2.9], respectively, P = .81) or calcium phosphate (1.3 [0.9] vs 1.4 [1.1], respectively, P = .58). Similarly, there were no significant differences at 8 weeks in urine volume and pH or in excretion of calcium, oxalate, citrate, uric acid, and sodium. In this short-term trial among individuals at high risk for stone recurrence, there was no statistically significant difference in the urinary stone risk comparing an empiric vs selective strategy for kidney stone prevention.

PMID 42378339
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