Lozol (indapamide) is a thiazide-like diuretic medication specifically engineered for the management of essential hypertension and the treatment of salt and fluid retention associated with congestive heart failure. As a first-line or adjunctive therapeutic option, it functions by promoting the excretion of sodium and water from the body, thereby reducing blood volume and peripheral vascular resistance. Its unique pharmacological profile offers effective 24-hour blood pressure control with a favorable side effect spectrum, making it a cornerstone in cardiovascular risk management protocols. Clinicians value Lozol for its proven efficacy in long-term hypertension regimens and its utility in reducing edema in cardiac patients.

Features

• Active Ingredient: Indapamide 1.25 mg or 2.5 mg per tablet
• Pharmacological Class: Thiazide-like diuretic/sulfonamide
• Dosage Form: Oral tablet
• Mechanism of Action: Inhibition of sodium reabsorption in the cortical diluting segment of the distal tubule
• Onset of Action: Within 2 hours of administration
• Duration of Effect: Up to 24 hours, allowing for once-daily dosing
• Bioavailability: Approximately 93% following oral administration
• Protein Binding: 79% bound to plasma proteins
• Metabolism: Hepatic, primarily via CYP450 enzymes
• Elimination Half-Life: 14-18 hours
• Excretion: Primarily renal (60-70%) and fecal (20-23%)

Benefits

• Provides sustained 24-hour blood pressure reduction with single daily dosing
• Effectively reduces peripheral edema and pulmonary congestion in heart failure
• Demonstrates a lower risk of hypokalemia compared to conventional thiazide diuretics
• Shows potential pleiotropic effects including vasodilation and antioxidant properties
• Compatible with most antihypertensive regimens including ACE inhibitors and beta-blockers
• Cost-effective therapeutic option with established long-term safety data

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) in patients with congestive heart failure. Off-label uses may include the treatment of nephrogenic diabetes insipidus and reduction of calcium excretion in recurrent calcium nephrolithiasis. The medication is particularly valuable in elderly hypertensive patients and those with comorbid conditions where volume overload contributes to cardiovascular compromise.

Dosage and direction

The recommended initial dosage for hypertension is 1.25 mg once daily in the morning. This may be increased to 2.5 mg once daily after 4 weeks if blood pressure response is inadequate. For edema in congestive heart failure, the initial dose is 2.5 mg once daily. Tablets should be taken with a glass of water, preferably at the same time each day, with or without food. Dosage adjustment is necessary in patients with renal impairment (creatinine clearance <30 mL/min) and hepatic impairment. Elderly patients may require lower initial doses due to age-related changes in pharmacokinetics.

Precautions

Patients should maintain adequate hydration but avoid excessive fluid intake. Regular monitoring of serum electrolytes (particularly potassium, sodium, and magnesium), blood urea nitrogen, creatinine, and uric acid is recommended, especially during initial therapy and after dosage adjustments. Caution is advised in patients with history of gout, diabetes mellitus, systemic lupus erythematosus, and photosensitivity reactions. Patients should be advised to rise slowly from sitting or lying positions to minimize orthostatic hypotension. Regular blood pressure monitoring is essential to assess therapeutic response.

Contraindications

Lozol is contraindicated in patients with known hypersensitivity to indapamide, other sulfonamide-derived drugs, or any component of the formulation. Additional contraindications include anuria, severe renal impairment (creatinine clearance <30 mL/min), severe hepatic impairment, and pre-existing significant hypokalemia. The medication is contraindicated in pregnancy due to potential fetal harm and should not be used during breastfeeding. Concurrent use with lithium is contraindicated due to increased risk of lithium toxicity.

Possible side effect

Common adverse reactions (≥1%) include headache, dizziness, fatigue, muscle cramps or spasms, orthostatic hypotension, and nausea. Less frequent side effects include hypokalemia (3-9%), hyperuricemia (2-6%), hyperglycemia (1-3%), and photosensitivity reactions. Rare but serious adverse effects include severe electrolyte imbalances (hyponatremia, hypochloremia), pancreatitis, hepatic dysfunction, blood dyscrasias, and allergic reactions including Stevens-Johnson syndrome. Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment.

Drug interaction

Lozol may potentiate the effects of other antihypertensive medications and increase the risk of orthostatic hypotension. Concurrent use with corticosteroids, amphotericin B, or stimulant laxatives may exacerbate potassium depletion. NSAIDs may reduce the antihypertensive effect of indapamide. The diuretic effect may be diminished when used with cholestyramine or colestipol. Indapamide may enhance the neurotoxic effects of lithium and increase serum lithium concentrations. Caution is advised with digoxin due to increased risk of digitalis toxicity secondary to hypokalemia. The medication may alter the response to oral hypoglycemic agents and insulin.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed dose. Consistent daily administration is important for maintaining stable blood pressure control. Healthcare providers should educate patients about the importance of adherence to prescribed dosing regimens.

Overdose

Symptoms of overdose include profound electrolyte disturbances (particularly hypokalemia and hyponatremia), dehydration, hypotension, weakness, dizziness, confusion, gastrointestinal disturbances, and impaired renal function. Severe overdose may lead to circulatory collapse and cardiac arrhythmias. Management involves gastric lavage or activated charcoal if ingestion was recent, along with aggressive electrolyte replacement and fluid resuscitation. Hemodialysis is not effective due to high protein binding. Treatment should focus on symptomatic and supportive care with continuous cardiac and electrolyte monitoring.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in the original container with the lid tightly closed. Protect from light, moisture, and excessive heat. Keep out of reach of children and pets. Do not use tablets that show signs of discoloration, cracking, or other physical deterioration. Properly discard any unused medication after the expiration date printed on the packaging. Do not flush medications down the toilet or pour them into drainage unless instructed to do so.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Individual patient responses to Lozol may vary based on specific health conditions, concomitant medications, and other factors. Healthcare professionals should exercise clinical judgment when prescribing this medication. Patients should consult their healthcare provider before starting, stopping, or changing any medication regimen. The complete prescribing information should be reviewed before administration.

Reviews

Clinical studies demonstrate that Lozol achieves blood pressure control in 60-70% of patients with mild to moderate hypertension. The NESTOR study showed comparable efficacy to enalapril with better preservation of potassium levels. Long-term extension studies indicate maintained efficacy over 12-24 months of treatment. Patient satisfaction surveys report appreciation for once-daily dosing and generally good tolerability. Some studies note improved vascular compliance and reduced left ventricular mass index with long-term use. Real-world evidence supports its position as a valuable option in hypertension management algorithms.