Lozol (indapamide) is a thiazide-like diuretic antihypertensive agent specifically formulated for the management of essential hypertension and salt/fluid retention-associated edema, such as in cases of congestive heart failure. It functions by promoting the excretion of sodium and water from the body, thereby reducing blood volume and peripheral vascular resistance. This dual-action mechanism provides clinicians with a reliable option for long-term blood pressure control and symptomatic relief of edema. Its well-established efficacy and favorable pharmacokinetic profile make it a cornerstone in many therapeutic regimens.

Features

• Active Ingredient: Indapamide 1.25 mg or 2.5 mg
• Pharmacological Class: Thiazide-like diuretic/sulfonamide
• Dosage Form: Oral tablet
• Onset of Action: Diuretic effect within 1-2 hours; antihypertensive effect may take several days to a week
• Duration of Action: Up to 24 hours, allowing for once-daily dosing
• Bioavailability: Approximately 93% following oral administration
• Protein Binding: 71-79%
• Metabolism: Hepatic, extensive
• Elimination Half-life: 14-18 hours
• Excretion: Primarily renal (60-70%) and fecal (20-30%)

Benefits

• Provides sustained 24-hour blood pressure control with a single daily dose, supporting patient adherence
• Effectively reduces edema and fluid overload in conditions like congestive heart failure
• Demonstrates a favorable metabolic profile with minimal impact on glucose and lipid metabolism compared to some other diuretics
• Offers a well-tolerated side effect profile for most patients when used as directed
• Serves as an effective monotherapy or combination therapy component in hypertension management protocols
• Reduces the risk of long-term cardiovascular complications associated with uncontrolled hypertension

Common use

Lozol is primarily indicated for the treatment of essential hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also approved for the management of salt and fluid retention edema associated with congestive heart failure. Clinicians may prescribe Lozol as part of a comprehensive cardiovascular risk reduction strategy, particularly in patients who require gentle fluid management without significant potassium depletion concerns. The medication is commonly used in adult populations and requires appropriate monitoring in elderly patients due to potential age-related renal function changes.

Dosage and direction

The recommended initial dosage for hypertension is 1.25 mg once daily, preferably taken in the morning. If the response is inadequate after 4 weeks, the dosage may be increased to 2.5 mg once daily, then to 5 mg once daily if necessary. Maximum recommended daily dose is 5 mg. For edema management in congestive heart failure, the initial dose is typically 2.5 mg once daily. Tablets should be swallowed whole with a glass of water, with or without food, though consistent administration relative to meals is recommended. Dosage adjustments are necessary in patients with renal impairment (creatinine clearance below 30 mL/min is generally a contraindication). Regular monitoring of serum electrolytes, particularly potassium, is essential during therapy.

Precautions

Patients should be monitored for electrolyte imbalances, particularly hypokalemia, which may develop especially with brisk diuresis, severe cirrhosis, or concomitant corticosteroid or ACTH therapy. Regular assessment of blood urea nitrogen and creatinine is recommended, as azotemia may occur in patients with impaired renal function. Use with caution in patients with severe hepatic impairment, as minor alterations of fluid and electrolyte balance may precipitate hepatic coma. Photosensitivity reactions may occur; patients should adopt protective measures against UV exposure. Orthostatic hypotension may occur, particularly in elderly patients or those taking other antihpertensive medications. Periodic monitoring of blood glucose is advised, especially in diabetic patients, as hyperglycemia may occur.

Contraindications

Lozol is contraindicated in patients with known hypersensitivity to indapamide or other sulfonamide-derived drugs. It should not be used in patients with anuria, severe renal impairment (creatinine clearance below 30 mL/min), or hepatic encephalopathy. The medication is contraindicated in patients with pre-existing severe hypokalemia or hyponatremia. It should not be administered to patients with Addison’s disease or other conditions associated with adrenal insufficiency. Concurrent use with lithium is contraindicated due to increased risk of lithium toxicity. The safety and effectiveness in pediatric patients have not been established.

Possible side effect

Common side effects (≥1%) include headache, dizziness, fatigue, muscle cramps or spasms, orthostatic hypotension, and nausea. Less frequent adverse reactions (0.1-1%) may include constipation, dry mouth, palpitations, impotence, rash, and photosensitivity. Rare but serious side effects (<0.1%) include severe electrolyte disturbances (hypokalemia, hyponatremia, hypochloremic alkalosis), pancreatitis, hepatic encephalopathy, blood dyscrasias (thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia), and anaphylactic reactions. Patients should report any signs of electrolyte imbalance such as muscle pain or weakness, nausea, vomiting, unusual tiredness, or mental confusion.

Drug interaction

Lozol may potentiate the effects of other antihypertensive medications, requiring dosage adjustment. Concurrent use with corticosteroids, ACTH, amphotericin B, or stimulant laxatives may increase the risk of hypokalemia. NSAIDs may reduce the antihypertensive and diuretic effects of indapamide. The diuretic effect may be decreased when used with cholestyramine or colestipol. Indapamide may enhance the neurotoxic effects of lithium and increase lithium serum levels. It may potentiate the effects of skeletal muscle relaxants and digitalis glycosides (due to hypokalemia). The medication may alter the response to oral anticoagulants and require adjustment of antidiabetic medication dosages.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is near the time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistent daily administration at approximately the same time each day is recommended to maintain stable therapeutic effects. Healthcare providers should educate patients about the importance of adherence while providing clear guidance for handling missed doses to prevent accidental overdose or inconsistent therapy.

Overdose

Symptoms of overdose primarily include effects of excessive pharmacologic action: electrolyte disturbances (particularly hypokalemia and hyponatremia), dehydration resulting from excessive diuresis, hypotension, and possible central nervous system effects such as dizziness, drowsiness, confusion, and gastrointestinal symptoms including nausea and vomiting. There is no specific antidote for indapamide overdose. Treatment is supportive and symptomatic, with primary emphasis on electrolyte replacement and fluid balance restoration. Gastric lavage may be considered if ingestion was recent. Hemodialysis is not effective due to high protein binding. Cardiovascular and respiratory support should be provided as needed, with continuous monitoring of vital signs and electrolyte status.

Storage

Store Lozol tablets at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep the medication in its original container, tightly closed, and protected from light and moisture. Do not store in bathroom cabinets where humidity levels may fluctuate. Keep out of reach of children and pets. Properly discard any medication that is expired or no longer needed through medication take-back programs or according to specific local guidelines. Do not flush medications down the toilet or pour them into drains unless specifically instructed to do so.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Lozol is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual patient responses may vary, and therapeutic decisions should be based on the healthcare provider’s assessment of the specific clinical situation. The prescribing physician should be consulted for complete information regarding indications, dosage, warnings, and precautions. Patients should not alter their treatment regimen without consulting their healthcare provider.

Reviews

Clinical studies and post-marketing surveillance have demonstrated Lozol’s efficacy in hypertension management, with many patients achieving significant blood pressure reduction. The 24-hour duration of action is frequently cited as beneficial for adherence. Some patients report mild side effects during the initial treatment period, which often resolve with continued use. Healthcare providers appreciate its generally favorable metabolic profile compared to some other diuretics. Elderly patients may require more careful monitoring for electrolyte disturbances. Overall, Lozol maintains a positive reputation among clinicians as a well-tolerated and effective option for hypertension and edema management when used appropriately with proper monitoring.