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Xipamide oral


Oral formulations containing xipamide

Drugs List

  • DIUREXAN 20mg tablets
  • xipamide 20mg tablets
  • Therapeutic Indications





    Treatment of hypertension
    20 mg daily as a single early morning dose.

    Treatment of oedema
    Initially 40 mg daily as a single early morning dose.
    The dose may be reduced to 20 mg daily if sufficient control of oedema has been achieved.
    Higher doses of up to 80 mg daily may be employed in resistant cases.


    Children under 18 years
    Long QT syndrome
    Pre-coma associated with hepatic cirrhosis
    Severe electrolyte imbalance
    Severe hepatic impairment
    Severe renal impairment
    Symptomatic hyperuricaemia
    Torsade de pointes
    Uncontrolled Addison's disease

    Precautions and Warnings

    Family history of long QT syndrome
    Benign prostatic hyperplasia
    Cerebral arteriosclerosis
    Coronary arteriosclerosis
    Diabetes mellitus
    Electrolyte imbalance
    Hepatic cirrhosis
    History of torsade de pointes
    Ischaemic heart disease
    Mild hepatic impairment
    Nephrotic syndrome
    Systemic lupus erythematosus

    Advise patient to protect skin if restarting following photosensitivity
    Correct electrolyte disorders before treatment
    May decrease glucose tolerance in patients with diabetes mellitus
    Advise ability to drive/operate machinery may be affected by side effects
    Consider monitoring ECG in patients at risk of QT prolongation
    Monitor blood glucose closely in patients with diabetes mellitus
    Monitor elderly receiving therapeutic doses
    Monitor fluid and electrolyte status
    Monitor serum urate levels in patients with gout
    Discontinue if acute cholecystitis occurs
    Discontinue if central nervous disturbances occur
    Discontinue if distinct gastrointestinal symptoms occur
    Discontinue if existing myopia is aggravated
    Discontinue if orthostatic regulatory disorders occur
    Discontinue if vasculitis occurs
    Excess consumption of liquorice may increase the risk of hypokalaemia
    Potassium supplements may be required
    Prolonged use may cause fluid/electrolyte imbalance and hypokalaemia
    Discontinue before parathyroid function tests
    Discontinue at once if hepatic encephalopathy occurs
    Discontinue if blood dyscrasia develops
    Discontinue if hypersensitivity reactions occur
    Discontinue if pancreatitis occurs
    Discontinue if photosensitivity occurs
    Discontinue if signs of fluid or electrolyte imbalance occur
    Advise patient that photosensitivity possible

    In cases of diuretic abuse, pseudo Bartter's may occur.

    In patients with prostatic hypertrophy, there is an increased risk of developing urinary retention.

    A decrease in sodium plasma level is a serious complication of diuretic therapy and may initially be asymptomatic. Therefore, regular control is advisable, especially in elderly patients and patients with liver cirrhosis.

    During therapy with thiazide diuretics, calcium plasma level may increase and its excretion via urine is temporarily decreased. Hypercalcaemia may occur due to a previous undiagnosed hyperparathyroidism.

    Thiazide diuretics are only fully effective in patients with normal or only mildly impaired renal function (creatinine serum level less than 25 mg/litre). In elderly patients, the serum creatinine value has to be adjusted according to age, weight and sex of the patient.

    Pregnancy and Lactation


    Xipamide is contraindicated in pregnancy.

    Diuretics pass the placenta and can reduce the plasma volume, lead to electrolyte disturbances and cause hypoglycaemia, haemolytic anaemia and thrombocytopenia in the unborn or newborn infant. Diuretics are not to be used under any circumstances for the treatment if pregnancy-related oedemas or physiological oedemas. This is because diuretics may cause foetoplacental ischaemia and foetal growth disturbances. Thiazides should also not be used to treat hypertension as they may cause neonatal thrombocytopenia, bone marrow suppression, jaundice, electrolyte disturbances and hypoglycaemia. Stimulation of labour, uterine inertia and meconium staining has also been reported.

    Hydrochlorothiazide is the thiazide diuretic of choice during pregnancy as it is the best studied. Use of xipamide, however, does not require a risk-based termination of the pregnancy, nor invasive diagnostic interventions (Schaefer, 2015).

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Xipamide is contraindicated during breastfeeding.

    It is not known if xipamide is expressed in breast milk.

    If a diuretic is urgently needed whilst breastfeeding, hydrochlorothiazide may be considered in moderate doses. Due to limited experience, xipamide should not be used, but single doses will not require limitation of breastfeeding (Schaefer, 2015).

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Abdominal discomfort
    Aggravation of pre-existing myopia
    Anaphylactoid reaction
    Aplastic anaemia
    Diabetes mellitus
    Dry mouth
    ECG changes
    Fluid and electrolyte disturbances
    Hypochloraemic alkalosis
    Increase in serum glucose
    Interstitial nephritis
    Muscle hypotonia
    Muscle spasm
    Muscular cramps
    Orthostatic hypotension
    Pseudo Barrter's syndrome
    Serum uric acid disturbances
    Skin reactions
    Visual disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: June 2017

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Summary of Product Characteristics: Diurexan Tablets. Meda Pharmaceuticals. Revised December 2016.

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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