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Updated: Jul 6, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
[Hyponatremia with somnolence due to indapamide]
Tadanori Hamano1, Tomoko Yamamoto, Isamu Miyamori
1Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui.
Rinsho Shinkeigaku = Clinical Neurology
|April 5, 2008
Summary
Indapamide, a diuretic, may cause severe hyponatremia and hypokalaemia in elderly women, leading to somnolence and hypotension. Discontinuation of indapamide rapidly reversed these adverse effects.
Area of Science:
- Nephrology
- Neurology
- Geriatrics
Background:
- Hypertension management often involves diuretics like indapamide.
- Elderly patients may be more susceptible to adverse drug reactions.
Observation:
- An 83-year-old woman developed somnolence, nausea, vomiting, and hypotension after starting indapamide for hypertension.
- She presented with severe hyponatremia (115 mEq/l) and hypokalaemia (2.8 mEq/l).
Findings:
- Neurological examination revealed somnolence and hyperreflexia.
- Brain MRI showed multiple lacunar infarctions.
- Discontinuation of indapamide led to rapid normalization of consciousness and serum electrolytes.
Implications:
- Indapamide can induce significant electrolyte imbalances and neurological symptoms, particularly in elderly women.
- Clinicians should monitor electrolyte levels and neurological status in patients receiving indapamide.
- Awareness of these risks is crucial, especially when indapamide is co-prescribed with ACE inhibitors or ARBs.
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