Indapamide or Hypothiazide, drug choice

Indapamide differs from Hypothiazide not only in its chemical composition. Is he:

  1. It has a vasodilating effect, affecting not only the systemic, but also directly the renal arteries.
  2. It provides a vasoprotective effect, which in practice is expressed, among other things, in that it prevents platelet aggregation (this reduces the risk of clogging of vessels and the development of a heart attack).
  3. It does not affect the processes of carbohydrate metabolism, does not affect glucose tolerance in people with hypertension and diabetes mellitus.

That is why Indapamide compares favorably with all traditional thiazide diuretics, including Hypothiazide (in about 30% of cases they have such a side effect as a violation of carbohydrate metabolism and a decrease in glucose tolerance).

Indapamide also has a high antihypertensive activity, that is, it reduces pressure. But at the same time, it is a safe drug, since its diuretic effect does not violate normal kidney function. It accelerates glomerular filtration, while hypothiazide slows it down. The last drug has other disadvantages.

In particular, studies have shown that Hypothiazide:

  • More side effects and higher incidence. This is a digestive disorder, cholecystitis, deterioration of lipid metabolism (fats are less absorbed), allergic reactions, etc.
  • Lower performance in relation to pressure reduction (per day, systolic pressure decreases by about 8 mm Hg. And diastolic – by 5 mm). Moreover, in the most dangerous hours – at night and before dawn – the drug practically does not control the indicators.
  • All the results obtained in medical research regarding antihypertensive properties were correct for a dosage of 50 mg, while due to the large number of side effects, the drug is usually prescribed in a much lower dosage.

However, despite these shortcomings, hypothiazide is still prescribed by many doctors if there are no significant contraindications. Moreover, it has a wider scope. It is prescribed not only for arterial hypertension, but also for nephrotic syndrome, polyuria, some diseases of the bladder.

Indapamide and Hypothiazide are drugs that belong to the same group of drugs ( thiazide and thiazide-like diuretics ), which are widely used in the treatment of arterial hypertension, that is, a disease associated with high blood pressure.

The first drugs from this group appeared on the market in the mid-1950s. The diuretic hydrochlorothiazide (trade name – Hypothiazide) was developed in 1957, and quickly replaced all other means. The thiazide-like diuretic Indapamide appeared only in 1974. It would seem that the new drug should be much more effective than its predecessors, but not so simple.

Indapamide: Key Features

Indapamide is a thiazide-like diuretic. Its active ingredient is indapamide, which has antihypertensive properties. The drug is released in tablets at a dosage of 1.5 and 2.5 mg


A feature of this tool is that it acts on calcium channels selectively, blocking only the “slow” ones. At the same time, it improves the elasticity of arterial walls, which allows to reduce peripheral vascular resistance and, accordingly, pressure. The antihypertensive effect of this agent tends to accumulate. It reaches its maximum value a week after the start of administration. But even a single dose of the tablet gives a pronounced result that persists for a day.

Hypothiazide: Key Features

Hypothiazide is a thiazide diuretic, its active substance is hydrochlorothiazide. Release it in tablets with a dosage of 25 mg and 100 mg. Its diuretic effect occurs approximately two hours after the time of administration, and its peak is observed after four hours.


It reduces pressure due to the fact that it removes excess fluid from the body in the most safe way, so that it does not even affect the pH of urine. With normal blood pressure, hypothiazide will not affect this indicator in any way.

The drug is excreted in the urine through the kidneys. It is proved that its active substance can penetrate the placental barrier during pregnancy.

What is common between indapamide and hypothiazide

In addition to the fact that both drugs belong to the group of thiazide diuretics, that is, they have some diuretic effect, they also have other common characteristics. For example, these are indications for use – in both cases, drugs are used to lower blood pressure in hypertension. Moreover, they can be prescribed both in monotherapy and in combination with other antihypertensive drugs.

Contraindications for the drugs are also very similar in many respects. This is an increased sensitivity to the active substance, severe impaired renal function (anuria), liver disease, as well as hypokalemia. Both drugs are not prescribed during pregnancy and lactation.

Which of these two drugs and in what cases is recommended

Based on the described properties of Indapamide and Hypothiazide, it should be noted that the choice of one option or another largely depends on concomitant diseases. For example, Indapamide is the best choice in cases such as:

  • The presence of arterial hypertension in a patient with diabetes mellitus.
  • Moderate hypertension in a patient suffering from chronic kidney disease.
  • The elderly patient, since this drug better reduces diastolic pressure.

Hypothiazide in diabetes is simply contraindicated. However, it can be used to control pressure in patients with mild or moderate arterial hypertension, if they do not have concomitant diseases. It is also used in the presence of diabetes insipidus, with swelling caused by heart or kidney failure, premenstrual syndrome or corticosteroids. And often it is prescribed because it is about 10-15% cheaper than Indapamide.

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