Drug General Information (ID: DDIQSNDEXV)
Drug Name			Indapamide		Drug Info		Calcium citrate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Minerals And Electrolytes
Structure

Mechanism of Indapamide-Calcium citrate Interaction (Severity Level: Moderate)
Increased risk of hypercalcemia Click to Show/Hide Mechanism Graph
Drug Name		Indapamide				Calcium citrate
Mechanism		Hypercalcemia				Hypercalcemia
Key Mechanism Factor 1
		Factor Name		Hypercalcemia
		Factor Description		Hypercalcemia is a condition in which the calcium level in your blood is above normal. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work.
Mechanism Description		Increased risk of hypercalcemia by the combination of Indapamide and Calcium citrate

Recommended Action
Management		Patients receiving thiazide diuretic therapy should be cautioned against self-treatment with calcium and vitamin D supplements without first talking to their healthcare provider. Serum calcium should be monitored if thiazide diuretics are coadministered with high dosages of calcium and/or vitamin D. Patients should be advised to seek medical attention if they experience signs and symptoms of hypercalcemia such as dizziness, weakness, lethargy, headache, myalgia, anorexia, nausea, vomiting, and seizures.

References
1	Santos F, Smith MJ, Chan JC "Hypercalciuria associated with long-term administration of calcitriol (1,25-dihydroxyvitamin D3). Action of hydrochlorothiazide." Am J Dis Child 140 (1986): 139-42
2	Drinka PJ, Nolten WE "Hazards of treating osteoporosis and hypertension concurrently with calcium, vitamin D, and distal diuretics." J Am Geriatr Soc 32 (1984): 405-7
3	Duarte CG, Winnacker JL, Becker KL, Pace A "Thiazide-induced hypercalcemia." N Engl J Med 284 (1971): 828-30