|AHFS/Drugs.com||International Drug Names|
|Elimination half-life||5.8 to 8.2 hours|
|Excretion||renal (1/3) and biliary (2/3)|
|Chemical and physical data|
|Molar mass||354.80 g/mol|
|3D model (JSmol)|
Mechanism of action
Like the structurally related thiazide diuretics, xipamide acts on the kidneys to reduce sodium reabsorption in the distal convoluted tubule. This increases the osmolarity in the lumen, causing less water to be reabsorbed by the collecting ducts. This leads to increased urinary output. Unlike the thiazides, xipamide reaches its target from the peritubular side (blood side).
Additionally, it increases the secretion of potassium in the distal tubule and collecting ducts. In high doses it also inhibits the enzyme carbonic anhydrase which leads to increased secretion of bicarbonate and alkalizes the urine.
Unlike with thiazides, only terminal renal failure renders xipamide ineffective.
After oral administration, 20 mg of xipamide are resorbed quickly and reach the peak plasma concentration of 3 mg/l within an hour. The diuretic effect starts about an hour after administration, reaches its peak between the third and sixth hour, and lasts for nearly 24 hours.
One third of the dose is glucuronidized, the rest is excreted directly through the kidney (1/3) and the faeces (2/3). The total plasma clearance is 30-40 ml/min. Xipamide can be filtrated by haemodialysis but not by peritoneal dialysis.
- more than 1/10 of all patients
- 1/100 to 1/10
- 1/1000 to 1/10,000
- allergic reactions of the skin
- less than 1/10,000
Not recommended combinations
- Xipamide lowers the renal clearance of lithium which can lead to lithium intoxication. (This interaction is classified as medium.)
Combinations requiring special precautions
- The antihypertensive effect can be increased by ACE inhibitors, barbiturates, phenothiazines, tricyclic antidepressants, alcohol, etc. (Classified as minor.)
- NSAIDs can reduce the antihypertensive and diuretic effects. Xipamide increases the neurotoxicity of high doses of salicylates. (Classified as minor.)
- Toxicity of cardiac glycosides is increased due to hypokalemia and hypomagnesemia.(Classified as minor.)
- Antiarrhythmic agents (classes Ia and III), phenothiazines and other antipsychotics increase the risk of torsades de pointes due to hypokalemia.
Interactions not included in the product information
- Xipamide can reduce the effect of antidiabetics. (Classified as minor.)
Banned use in sport
- Jasek, W, ed. (2007). Austria-Codex (in German). 1 (2007/2008 ed.). Vienna: Österreichischer Apothekerverlag. pp. 600–603. ISBN 978-3-85200-181-4.
- Dinnendahl, V; Fricke, U, eds. (2007). Arzneistoff-Profile (in German). 10 (21 ed.). Eschborn, Germany: Govi Pharmazeutischer Verlag. ISBN 978-3-7741-9846-3.
- Klopp, T, ed. (2007). Arzneimittel-Interaktionen (in German) (2007/2008 ed.). Arbeitsgemeinschaft für Pharmazeutische Information. ISBN 978-3-85200-184-5.
- Richard Williams in Pau (17 July 2012). "Frank Schleck tests positive for banned diuretic and is out of Tour". London: The Guardian. Retrieved 2012-07-18.