LORVACS XL

Posology One tablet per 24 hours, preferably in the morning, to be swallowed whole with water and not chewed. At higher doses the antihypertensive action of indapamide is not enhanced but the saluretic effect is increased. 4): In severe renal failure (creatinine clearance below 30 ml/min), treatment is contraindicated.

Thiazide and related diuretics are fully effective only when renal function is normal or only minimally impaired. 4): In severe hepatic impairment, treatment is contraindicated. 4): In the elderly, the plasma creatinine must be adjusted in relation to age, weight and gender.

5 mg when renal function is normal or only minimally impaired. 5 mg in children and adolescents have not been established. No data are available. Method of administration Oral use

Summary of safety profile The most commonly reported adverse reactions are hypokalaemia, hypersensitivity reactions, mainly dermatological, in subjects with a predisposition to allergic and asthmatic reactions and maculopapular rashes.

2 mmol/l in 4% of patients after 4 to 6 weeks treatment. 23 mmol/l. 2 mmol/l in 10 % of patients after 4 to 6 weeks treatment. 41 mmol/l. Tabulated summary of adverse reactions The following undesirable effects have been observed with indapamide during treatment ranked under the following frequency: Very common (≥ 1/10); common (≥ 1/100 to <1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥1/10,000 to <1/1,000); very rare (≥1/100,000 to <1/10,000), not known (cannot be estimated from the available data).

4) Not known Investigations Elevated liver enzyme levels Not known Muscle spasms Not known Muscular weakness Not known Myalgia Not known Musculoskeletal and Connective Tissue Disorders Rhabdomyolysis Not known Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Special warnings When liver function is impaired, thiazide-related diuretics may cause, particularly in case of electrolyte imbalance, hepatic encephalopathy which can progress to hepatic coma. Administration of the diuretic must be stopped immediately if this occurs.

8). If photosensitivity reaction occurs during treatment, it is recommended to stop the treatment. If a re- administration of the diuretic is deemed necessary, it is recommended to protect exposed areas to the sun or to artificial UVA.

Special precautions for use - Water and electrolyte balance: • Plasma sodium:

This must be measured before starting treatment, then at regular intervals subsequently. 9). Any diuretic treatment may cause hyponatraemia, sometimes with very serious consequences. Hyponatraemia with hypovolaemia may be responsible of dehydration and orthostatic hypotension.

Concomitant loss of chloride ions may lead to secondary compensatory metabolic alkalosis: the incidence and degree of this effect are slight. • Plasma potassium: Potassium depletion with hypokalaemia is the major risk of thiazide and related diuretics.

Hypokalaemia may cause muscle disorders. e. the elderly, malnourished and/or polymedicated, cirrhotic patients with oedema and ascites, coronary artery disease and cardiac failure patients. In this situation, hypokalaemia increases the cardiac toxicity of digitalis preparations and the risks of arrhythmias.

Individuals with a long QT interval are also at risk, whether the origin is congenital or iatrogenic. Hypokalaemia, as well as bradycardia, is then a predisposing factor to the onset of severe arrhythmias, in particular, potentially fatal torsades de pointes.

More frequent monitoring of plasma potassium is required in all the situations indicated above. The first measurement of plasma potassium should be obtained during the first week following the start of treatment. Detection of hypokalaemia requires its correction.

1. - Severe renal failure. - Hepatic encephalopathy or severe impairment of liver function. - Hypokalaemia.