Lozol vs Other Diuretics Comparison Tool
Select two medications to compare their side effects and benefits:
Lozol (generic name Indapamide) is a thiazide‑like diuretic that lowers blood pressure by increasing sodium and water excretion, typically prescribed at 1.5mg sustained‑release. It’s often chosen for its modest impact on electrolytes and proven cardiovascular benefit.
Why Compare Lozol with Other Options?
Patients and prescribers-whether in primary care or cardiology-need to know when Indapamide shines and when a different agent might be a better fit. The health‑system landscape offers several thiazide‑type and loop diuretics, plus mineral‑corticoid receptor antagonists that can achieve the same end‑point: controlled blood pressure with tolerable side‑effects.
How Indapamide Works
Indapamide blocks the Na⁺/Cl⁻ co‑transporter in the distal convoluted tubule, reducing sodium reabsorption. The reduced intravascular volume triggers a fall in systemic vascular resistance, which in turn lowers systolic and diastolic pressures. Because it also has a direct vasodilatory component via calcium‑channel modulation, the drug often reaches target blood pressure faster than classic thiazides.
Key Alternatives to Lozol
- Hydrochlorothiazide (HCTZ) is a first‑generation thiazide that mainly reduces plasma volume.
- Chlorthalidone is a long‑acting thiazide‑like diuretic with a half‑life of about 40‑50hours.
- Furosemide is a loop diuretic that works in the thick ascending limb of Henle.
- Spironolactone is a potassium‑sparing aldosterone antagonist often added for resistant hypertension.
- Amiloride is a potassium‑sparing diuretic that blocks ENaC channels.
- Lisinopril is an ACE inhibitor frequently used as a first‑line antihypertensive.
Side‑Effect Profiles at a Glance
| Drug | Electrolyte Impact | Metabolic Effects | Typical Dose |
|---|---|---|---|
| Indapamide (Lozol) | ↑Potassium| Neutral on glucose & lipids |
1.5mg SR daily |
|
| Hydrochlorothiazide | ↓Potassium, ↑Sodium | ↑Uric acid, modest ↑glucose | 12.5‑50mg daily |
| Chlorthalidone | ↓Potassium, ↑Sodium | ↑Uric acid, ↑glucose risk | 12.5‑25mg daily |
| Furosemide | ↓Potassium, ↓Magnesium | Can cause ototoxicity at high doses | 20‑80mg daily |
| Spironolactone | ↑Potassium (risk of hyperkalaemia) | May raise testosterone‑related side‑effects | 25‑100mg daily |
When to Choose Indapamide Over the Rest
Clinical guidelines (e.g., NICE 2023) rank Indapamide high for patients who need a thiazide‑like effect but are prone to low potassium or metabolic disturbances. Typical scenarios include:
- Elderly patients with borderline renal function - Indapamide’s milder electrolyte shift makes it safer.
- Individuals with pre‑diabetes - its neutral effect on glucose avoids worsening glycaemic control.
- Those with a history of gout - lower uric‑acid increase compared with HCTZ or chlorthalidone.
When Alternatives May Be Better
Even a well‑balanced drug can miss the mark. Use the alternatives when:
- Rapid fluid removal is needed - Loop diuretics like Furosemide are far more potent for acute pulmonary edema.
- Resistant hypertension - Adding Spironolactone directly blocks aldosterone‑mediated sodium retention.
- Long‑acting control for once‑daily dosing - Chlorthalidone provides 24‑hour coverage, useful in non‑adherent patients.
- Need for synergistic ACE inhibition - Lisinopril can be combined with low‑dose thiazides for additive blood‑pressure reduction.
Practical Switching Guide
If you must move a patient from Lozol to another agent, follow a stepwise plan to avoid abrupt volume shifts:
- Assess current blood‑pressure control and electrolyte panel.
- Choose the target drug based on the clinical scenario outlined above.
- Cross‑taper over 3‑5days: reduce Indapamide by 25% each day while introducing the new agent at a low dose.
- Re‑check BP, serum potassium, creatinine, and uric acid after 1week.
- Adjust dose or consider combination therapy if target BP (<140/90mmHg for most adults) isn’t reached.
Related Concepts and Next Steps
Understanding the broader antihypertensive landscape helps you make smarter swaps. Concepts worth exploring next include:
- Renin‑angiotensin‑aldosterone system (RAAS) blockade - How ACE inhibitors, ARBs and direct renin inhibitors complement diuretics.
- Blood‑pressure phenotypes - Isolated systolic vs combined hypertension and which drug class is most effective.
- Pharmacogenomics - Genetic variants (e.g., CYP2C9) that influence thiazide metabolism.
Delving into these topics will round out your prescribing toolkit and keep you ahead of evolving guidelines.
Frequently Asked Questions
Can I take Lozol with a potassium supplement?
Yes, many clinicians add a low‑dose potassium‑chloride supplement (typically 8‑10mmol) when using Indapamide, especially if the patient has a history of hypokalaemia. Monitor serum potassium after two weeks.
Is Indapamide safe for patients with chronic kidney disease (CKD) stage3?
Generally, Indapamide can be used down to an eGFR of 30mL/min/1.73m², but dosage may need halving and electrolyte monitoring becomes critical. For eGFR<30, switch to a loop diuretic or combine with a low‑dose ACE inhibitor.
How does Lozol compare cost‑wise with generic hydrochlorothiazide?
In the UK, a 28‑day supply of Lozol (1.5mg SR) costs roughly £8‑£10, while generic HCTZ tablets are around £2‑£4. However, if Indapamide prevents a gout flare or a hospital admission, the total cost of care may be lower.
What should I watch for when switching from HCTZ to Indapamide?
Watch for a transient rise in blood pressure during the overlap period, and re‑check potassium and uric acid within 7‑10days. Most patients notice smoother control within two weeks.
Can Indapamide be used in pregnancy?
Indapamide is classified as pregnancy category C in the UK. It should only be used if the benefit outweighs the risk, and only under specialist advice. Alternatives like labetalol are often preferred.
