Hyponatraemia and hypokalaemia due to indapamide.
OBJECTIVE
To review Australian adverse drug reaction reports describing hyponatraemia and hypokalaemia attributed to indapamide and compare the characteristics of the patients with those in Australian reports implicating two other diuretic products (hydrochlorothiazide and amiloride hydrochloride; chlorothiazide).


METHODS
Descriptive analysis using reports from the database of the Adverse Drug Reactions Advisory Committee (ADRAC).


METHODS
Numbers of reports of hyponatraemia and hypokalaemia; proportion of such reports in total reports of adverse reactions to each drug; severity of electrolyte disturbances.


RESULTS
Between August 1984 and September 2000, 84 Australian reports of hyponatraemia and 87 reports of hypokalaemia, in which indapamide was the sole suspected drug, were submitted to ADRAC. Most reports involved an indapamide dose of 2.5 mg daily. There was a significantly greater proportion of reports of hyponatraemia with indapamide and with the hydrochlorothiazide and amiloride combination than with chlorothiazide; hypokalaemia was significantly more common for indapamide than for the other two drugs. Of the 87 reports of hypokalaemia with indapamide, 35 patients also had hyponatraemia. For all three drugs, at least 80% of reports of hyponatraemia were in people aged 65 or over, and electrolyte disturbance was most commonly reported in elderly women.


CONCLUSIONS
Hyponatraemia and hypokalaemia have been described in 20.9% and 21.7%, respectively, of reports to ADRAC in which indapamide was the sole suspected drug. The electrolyte disturbances can be severe.
Chapman
Michael D
MD
Department of General Practice, University of Adelaide, SA.
Hanrahan
Ross
R
McEwen
John
J
Marley
John E
JE
D000584:Amiloride / Q000009:adverse effects; D001315:Australia / Q000453:epidemiology; D002740:Chlorothiazide / Q000009:adverse effects; D004232:Diuretics / Q000009:adverse effects*; D004338:Drug Combinations; D004363:Drug Utilization; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects; D007008:Hypokalemia / Q000139:chemically induced* / Q000453:epidemiology; D007010:Hyponatremia / Q000139:chemically induced* / Q000453:epidemiology; D007190:Indapamide / Q000009:adverse effects*; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects
D004232:Diuretics; D004338:Drug Combinations; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D002740:Chlorothiazide; D000584:Amiloride; D007190:Indapamide