Dinapres

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Dinapres

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Dinapres

Dinapres: Identity and Pharmacological Classification

Property Description
Active ingredients Delapril, Indapamide
Form Oral Tablet
Pharmacological Class Antihypertensive Agent
Common Use Essential Hypertension
Origin Synthetic

Dinapres is classified as an antihypertensive agent, a synthetic medicine used to manage the chronic condition of high blood pressure, medically termed essential hypertension. This product is delivered as an oral tablet and is characterized as a fixed-dose combination product, containing two distinct active ingredients combined into a single pharmaceutical form. It is typically prescribed to adult patients whose blood pressure is not adequately controlled by a single medication.

The composition utilizes two established pharmacological classes for pressure control. The first component is Delapril, classified as an Angiotensin-Converting Enzyme (ACE) inhibitor, and the second is Indapamide, a thiazide-like diuretic. The use of this fixed combination aims to improve the efficacy of blood pressure control compared to single-agent therapy.

Composition and General Therapeutic Purpose

The core purpose of Dinapres is to provide effective, simultaneous control over high blood pressure via the synergistic action of its components. Delapril primarily promotes vascular relaxation, which helps to widen blood vessels, while Indapamide supports fluid management by promoting the excretion of excess salt and water.

The combined strategy is particularly valuable for patients requiring a multi-faceted approach to hypertension. This dual mechanism—which simultaneously addresses resistance in the blood vessels and total fluid volume—is intended to decrease the sustained pressure exerted on the arterial walls, which is the defining objective of antihypertensive therapy. Analogous fixed combinations, such as Perindopril and Indapamide, share this dual-action strategy, underscoring the role of combining an ACE inhibitor with a diuretic for management.

Regulatory References

  1. High blood pressure medications - MedlinePlus

What side effects are possible with Dinapres?

Dinapres: Possible Side Effects and Safety Information

This section describes the adverse reactions and safety characteristics of Dinapres, as classified and documented in official government regulatory sources.


Official Adverse Reactions and Frequency

The documented safety profile is structured by System-Organ Class (SOC) and incidence categories. Common effects primarily reflect the actions of the thiazide-like diuretic and ACE inhibitor components.

Common Adverse Reactions documented in regulatory safety data include headache, dizziness, fatigue or weakness, and metabolic disturbances. The most notable metabolic effect is Hypokalemia (low potassium), a common outcome associated with diuretics, alongside changes in blood chemistry like elevated uric acid (Hyperuricemia).

Rare and Serious Adverse Reactions

Certain reactions, though rare, are considered serious and require particular attention in official labeling. These include Angioedema (rapid swelling of the face, lips, tongue, or throat) and severe Symptomatic Hypotension (abnormally low blood pressure), especially at the initiation of treatment. Severe dermatological reactions (e.g., Stevens-Johnson Syndrome) and acute ocular events such as angle-closure glaucoma are also documented.


Population-Specific Safety Notes

The medicine is subject to specific constraints based on certain patient populations and pre-existing conditions:

  • Pregnancy: The use of drugs acting on the Renin-Angiotensin System is associated with fetal injury and death during the second and third trimesters, leading to a mandatory contraindication in these stages.
  • Severe Organ Impairment: The medicine is strictly contraindicated in patients with severe renal impairment or severe hepatic impairment (due to the risk of precipitating hepatic encephalopathy).
  • Electrolyte Status: It is also contraindicated in patients with pre-existing, severe, uncorrected Hypokalemia.

Time-Related Patterns and Safety Constraints

Some effects, such as dizziness and a noticeable drop in blood pressure, are more likely to be reported after the initiation of treatment or following a dose increase. The safety profile necessitates periodic monitoring of serum electrolytes (potassium and sodium) and renal function (creatinine) throughout the duration of use.

Overdose and Emergency Response

Dinapres Overdose and when to seek help

The official overdose information, as documented in authoritative regulatory sources, describes the potential consequences and required actions if Dinapres (Indapamide) is taken in excess.

Documented Overdose Manifestations

Overdose presentations are primarily linked to an exaggerated pharmacological effect, leading to severe fluid and electrolyte disturbances. Symptoms may include nausea, vomiting, gastrointestinal disorders, and weakness.

Serious, life-threatening outcomes documented in regulatory texts include severe hypotension, respiratory depression, and, particularly in patients with pre-existing liver impairment, the precipitation of hepatic encephalopathy that can progress to coma.

Required Emergency Action

Immediate medical attention is required for any suspected overdose or upon the appearance of signs such as severe hypotension, respiratory difficulty, or clinical evidence of profound fluid and electrolyte imbalances.

Management of Dinapres overdose is primarily supportive, focusing on correcting the resulting physiological disturbances. Officially stated treatment measures may include stopping drug administration, implementing supportive care interventions, and close monitoring of fluid and electrolyte levels.

Measures to reduce absorption, such as gastric lavage, may be considered, but continuous monitoring remains essential to manage the consequential risk of severe hypovolemia and hypokalemia.

Therapeutic Uses of Dinapres

What Dinapres Treats: Main Uses and Benefits

Dinapres's primary therapeutic application is in the domain where additional symptomatic support is needed for managing elevated blood pressure. It is applied in addressing the need to manage fluid balance in the body. This medication is commonly used to help with conditions characterized by periods of heightened symptoms such as high blood pressure (hypertension). It is also considered relevant for easing symptoms related to physical discomfort associated with fluid retention, also known as oedema, which may be part of managing conditions like certain presentations of heart failure.

The supportive effect may assist patients during phases when symptoms become more noticeable. This support helps ease the overall symptom burden and assists with maintaining general well-being during symptomatic periods. In this context, the medicine plays a role in managing **conditions presenting with systemic or localized discomfort.


Quick Fact: May assist with easing symptoms related to physical discomfort


Eligibility and Restrictions for Use

Dinapres is officially approved for use in adults with essential hypertension whose blood pressure is not adequately controlled on a single medication. The use of this fixed-dose combination in children and adolescents is officially not recommended, as its safety and efficacy in this age group have not been established by regulatory authorities.

The medicine is contraindicated and must not be used in several populations. These include:

  • Patients with known hypersensitivity to any ACE inhibitor, Indapamide, or other sulfonamide derivatives.
  • Those with a history of angioedema related to prior ACE inhibitor therapy.
  • Individuals with severe organ impairment such as severe renal failure (creatinine clearance below 30 mL/min), anuria, severe hepatic impairment, or hepatic encephalopathy.
  • Patients with uncorrected hypokalaemia or those concurrently taking sacubitril/valsartan.

Furthermore, Dinapres is contraindicated in the second and third trimesters of pregnancy, and its use is not recommended during the first trimester or while breastfeeding. Use is also advised against for patients undergoing dialysis or those with untreated decompensated heart failure due to limited data.

What should I know about interactions with other medicines?

Dinapres Interactions with other medicines and products

Dinapres, a combination of Delapril (ACE inhibitor) and Indapamide (diuretic), has officially documented interactions primarily concerning blood pressure, electrolyte balance, and kidney function, as stated in regulatory prescribing information.

Documented Pharmacodynamic and Exposure-Related Interactions

Interacting Product Category Interaction Summary (Official Regulatory Statement)
Lithium Reduces the clearance of Lithium, leading to higher serum levels and risk of toxicity.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Increased risk of renal impairment and hyperkalemia; may cause a loss of antihypertensive effect.
Potassium-Sparing Diuretics/Potassium Supplements Increased risk of hyperkalemia (high potassium levels).
Other Antihypertensives Additive effect, which increases the risk of hypotension (low blood pressure).

Formal Restrictions and Specific Constraints

Co-administration with Aliskiren is formally contraindicated in patients with a diagnosis of diabetes or moderate-to-severe renal impairment. This restriction reflects a heightened risk of hypotension and kidney-related complications.

For certain procedures, a timing-based constraint applies: Dinapres must be withheld 24 hours prior to the administration of chemotherapeutic doses of Amifostine to mitigate the risk of severe hypotension.

Diet, Lifestyle, and Population Notes

The official label cautions that excessive sodium intake (including from salt-containing medicines) can prevent the Indapamide component from working effectively. Alcohol consumption may increase the risk of drowsiness. Specific caution is noted for Geriatric Patients (ge 65 years) who have a heightened reported risk for severe electrolyte disturbances, such as hyponatremia and hypokalemia.

Mechanism of Action

Dinapres is a combination formulation containing Delapril and Indapamide. Its pharmacodynamics derive from the synergistic activity of these two distinct components.

Delapril, an angiotensin-converting enzyme (ACE) inhibitor, acts predominantly on the systemic Renin-Angiotensin-Aldosterone System (RAAS). It competitively inhibits the ACE enzyme, primarily localized in the vascular endothelium, thereby preventing the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This inhibition reduces angiotensin II levels, leading to decreased systemic vascular resistance and reduced aldosterone secretion. This mechanism also decreases the degradation of bradykinin, an endogenous vasodilator peptide, contributing to its systemic effects.

Indapamide is a thiazide-like diuretic that targets the Solute Carrier Family 12 Member 3 (SLC12A3), specifically the sodium-chloride cotransporter (NCC), located on the apical membrane of epithelial cells in the distal convoluted tubules of the kidney. Indapamide acts as an inhibitor of this cotransporter, reducing the reabsorption of sodium and chloride ions. This action promotes an increase in the excretion of sodium and water into the urine (natriuresis and diuresis), resulting in a decrease in extracellular fluid volume and consequently a reduction in plasma volume and cardiac output. Indapamide also possesses ancillary vascular effects, including a reduction of calcium flux in vascular smooth muscle, which decreases pressor sensitivity and contributes to systemic vasodilation. The combination modulates both fluid volume and vascular tone, leading to a system-level decrease in total peripheral resistance.

Dosage and Administration Information

Dinapres is a fixed-dose combination product administered exclusively via the oral route as a tablet. The medicine is intended for long-term chronic therapy, requiring consistent daily use.

The dosage schedule typically begins with a lower strength combination, such as Delapril 30 mg and Indapamide 1.25 mg, taken as a single tablet once daily. A critical instruction regarding the timing of administration is that the tablet must be taken in the morning and before a meal to support the defined use pattern.

For proper administration, the tablet must be swallowed whole and should not be crushed, broken, or chewed. The dose is not fixed indefinitely; if the initial strength does not achieve the necessary control, the regimen can be adjusted. The dose may be escalated to the higher strength combination (e.g., Delapril 30 mg and Indapamide 2.5 mg) following an assessment period, usually ranging from two to four weeks.

Regarding patient populations, the use of this fixed combination is strictly constrained by renal function. The medicine is characterized by a contraindication in cases of severe renal impairment (e.g., creatinine clearance below 30 ml/min), reflecting a necessary condition for its administration. For other adult patients, no specific dose modification is mandated solely based on advanced age.

Recent Clinical Evidence

Research evidence / Overview of studies for Dinapres


Evidence for Use in Essential Hypertension

This section summarizes the design and structure of the Randomized Controlled Trials (RCTs) and meta-analyses that form the core evidence base for using this combination medicine to manage high blood pressure. It will describe the types of outcomes measured, such as changes in blood pressure and surrogate markers like Left Ventricular Mass Index (LVMI).

The research on this dual-component combination primarily was studied for its use in managing high blood pressure, medically termed essential hypertension. Studies have included robust Randomized Controlled Trials (RCTs), where patients were randomly assigned to different treatment groups. The research also includes systematic reviews that aggregate data from multiple individual trials. These studies generally included adult patients with high blood pressure that was classified as mild to moderate.

Investigators in these trials research examined how blood pressure changed from the beginning of the study. This involved both in-office measurements and the use of 24-hour monitoring to understand the pressure patterns throughout a full day. Research describes patterns related to changes in blood pressure measurements during the study period.

Outcomes Examined in Clinical Trials

Beyond the direct measurement of blood pressure, researchers also monitored outcomes monitoring physiological strain or stress on the cardiovascular system. For example, some trials monitored changes in the Left Ventricular Mass Index (LVMI), a marker used in studies to describe the structure of the heart muscle. This research highlights changes measured during the study period for groups of patients, offering insight into short-term changes in these outcomes.

Comparative Studies and Context

This part will outline the studies that compared the Dinapres combination against single-drug treatments and against other established two-drug regimens for hypertension, without stating or interpreting any comparative findings or effectiveness claims.

The combination of the two medicines was studied for how it compared to giving patients only one of the active ingredients, which is known as monotherapy. These comparative studies were designed to see if using both components together was observed in trials to relate to different BP patterns than using just one. Additionally, the research was evaluated in studies that used other standard two-drug regimens as comparators.

Long-term Studies and Follow-up

Most primary short-term symptom changes were tracked over relatively defined time intervals, often lasting around 12 weeks. While some studies studies monitored patients for treatment maintenance over intermediate periods, up to six months or a year, the follow-up durations were limited for the initial assessments of BP change. As a result, long-term effects are not fully established regarding the impact on definitive clinical events like stroke or heart attack risk for this specific combination.

Frequently Asked Questions (FAQ)

Common questions about Dinapres (FAQ)

Q: Is Dinapres the same kind of medicine as other blood pressure drugs?

A: Dinapres is a combination medicine that falls into two established classes of medicines used for blood pressure management: an ACE inhibitor and a thiazide-like diuretic. Official regulatory documents describe this composition as distinct from other types of blood pressure medication, such as calcium channel blockers or beta-blockers.


Q: Does Dinapres cause weight gain?

A: Official regulatory documents and safety data do not specifically list weight gain or weight loss as a common or frequent adverse reaction associated with Dinapres. If changes in body weight are experienced, patients are advised to consult a healthcare provider.


Q: Can Dinapres be taken with pain relievers like ibuprofen?

A: Regulatory documents warn that using Dinapres with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), which includes common pain relievers like ibuprofen, is associated with a heightened risk of adverse outcomes. This combination may increase the potential for kidney function problems and can also reduce the blood pressure lowering effect of Dinapres.


Q: How long does it typically take for Dinapres to start working?

A: The initial blood pressure reduction may be observed within several hours of administration. However, official information indicates that the full, stable therapeutic benefit is generally assessed by clinicians after several weeks, corresponding to the time frame required for dose adjustment.


Q: Is it normal to feel tired after taking Dinapres?

A: According to official safety information, feeling fatigue or weakness is classified as a common adverse reaction documented with Dinapres. If this feeling is severe or persistent, patients are advised to consult a healthcare professional.


Q: What happens if I miss a dose of Dinapres?

A: Official patient information typically instructs that if a dose is missed, it should be skipped entirely. The recommended procedure is to take the next dose at the regularly scheduled time and avoid taking two doses at once to compensate.


Q: Does Dinapres interact with common herbal supplements?

A: Official drug labels primarily detail known interactions with prescription medicines and specific foods. There are generally no specific data listed in regulatory documents regarding interactions with common herbal supplements. Patients are advised to disclose any herbal supplements being used to a healthcare provider.


Q: Is Dinapres safe to use long-term?

A: Dinapres is officially indicated for the long-term chronic therapy of essential hypertension. While the short-term effects are documented, official research evidence summaries noted that the long-term effects regarding definitive clinical events like stroke or heart attack risk are not fully established for this specific combination.


Q: Can I drive or operate machinery while on Dinapres?

A: Official labeling includes a caution that side effects such as dizziness or fatigue may impair the ability to drive or operate machinery. This risk is particularly noted during the initiation of treatment or following a dosage increase.


Q: Is Dinapres used for anything other than blood pressure?

A: Dinapres is officially approved for use in adults solely to manage essential hypertension (high blood pressure). Regulatory documents do not list any other conditions for which this combination medicine is specifically approved.


Q: What should I do if I think I'm having a side effect from Dinapres?

A: Patient guides typically recommend consulting a medical professional for any severe or persistent side effects. For rare but serious events documented in the safety profile, such as angioedema (rapid swelling of the face, lips, or throat), immediate emergency medical attention is required.


Q: How long does the effect of one Dinapres dose last?

A: Dinapres is designed to be taken as a single tablet once daily. This dosing schedule indicates that the medicine's pharmacological effect is intended to last for approximately 24 hours, providing continuous coverage.


Q: Can Dinapres cause problems with kidney function?

A: Yes, the medicine is contraindicated (advised against) in cases of severe kidney impairment. Furthermore, official labeling mandates the periodic monitoring of renal function throughout use, indicating that the medicine may affect kidney function.


Q: What should I avoid eating or drinking while on Dinapres?

A: Official labels advise against excessive sodium intake, as high salt levels can prevent the Indapamide component from working effectively. Caution regarding alcohol consumption is also advised, as it may increase the risk of drowsiness.


Q: Can I take Dinapres at the same time as other medications?

A: While many medications can be co-administered, the official interactions section details certain medicines, like Lithium or Aliskiren, that require specific timing, monitoring, or are strictly contraindicated. Patients are advised that all other medications being taken should be reviewed by a prescribing professional.


Q: Does Dinapres affect sleep?

A: While general central nervous system effects like fatigue are documented, official safety data does not specifically list insomnia or other sleep disorders as a common adverse reaction for Dinapres.


Q: Does Dinapres have any effect on heart rate?

A: Official regulatory documents do not list significant changes in heart rate (like an abnormally fast or slow rate) as a common adverse reaction. The primary effect is on blood pressure, though low blood pressure (hypotension) is a documented possibility.


Q: Is Dinapres known to cause headaches?

A: Yes, regulatory data classify headache as a common adverse reaction documented in the official safety information for Dinapres.


Q: Are there any major diet restrictions while using Dinapres?

A: Official regulatory documents specifically caution against excessive sodium intake and advise caution with alcohol consumption. No other major diet restrictions are typically listed in the product labeling.


Q: Does Dinapres interact with birth control pills?

A: Official regulatory documents for the Delapril/Indapamide combination do not typically list specific interactions with hormonal contraceptives (birth control pills).


Q: Are there different strengths of Dinapres available?

A: Yes, official prescribing information defines the available fixed-dose strengths of Dinapres. This typically includes a lower and a higher strength combination of Delapril and Indapamide for adjustment based on patient need.


Q: What is the risk of stopping Dinapres suddenly?

A: Official labeling may include general advice recommending against abrupt cessation of antihypertensive therapy. This potential is related to the risk of rebound blood pressure elevation when the medication is stopped quickly.


Q: Is Dinapres a controlled substance?

A: Official regulatory classifications indicate that the medicine Dinapres (Delapril/Indapamide) is not classified as a controlled substance in the US or in most major international jurisdictions.


Q: Why do doctors check my blood pressure often when I start Dinapres?

A: Official labeling mandates periodic monitoring of blood pressure, serum electrolytes (like potassium), and kidney function, especially when starting treatment. This monitoring is performed to assess the therapeutic response and to detect any potential early adverse reactions.


Q: Are there any specific warning signs I should look for when starting Dinapres?

A: Official labeling details serious but rare warning signs. These include symptoms of angioedema (swelling of the face, lips, tongue, or throat) and signs of severe hypotension (feeling very dizzy or fainting).


Q: Is it normal for my blood pressure to go down very fast when I start Dinapres?

A: The label notes the risk of severe symptomatic hypotension (abnormally low blood pressure), particularly when starting treatment or after a dose increase. This indicates that a significant or rapid drop in blood pressure is a possibility documented in the safety profile.


Q: How does Dinapres affect my liver?

A: Dinapres is contraindicated (advised against) in cases of severe hepatic impairment (severe liver problems) due to the risk of precipitating hepatic encephalopathy. This establishes a documented risk for patients with pre-existing liver conditions.


Q: Are there known issues using Dinapres with grapefruit or grapefruit juice?

A: Official regulatory documents detailing drug-food interactions for this combination do not typically list a specific issue with grapefruit or grapefruit juice.


Q: What is the half-life of Dinapres?

A: Official regulatory documents contain specific pharmacokinetic data for the active ingredients. This includes the reported half-lives of both Delapril and Indapamide, which describe how long it takes the body to eliminate half of the substance.


Q: Does Dinapres need to be taken with food?

A: Official prescribing information specifically states the tablet must be taken before a meal in the morning. This is to support the defined use pattern and ensure proper absorption and effectiveness.

How should Dinapres be stored and disposed of?

Dinapres (Delapril/Indapamide) oral tablets must be stored according to label instructions to maintain product stability and safety.

Storage Requirements

Condition Requirement
Temperature Store at controlled room temperature, typically 20 C to 25 C (68 F to 77 F).
Protection Keep the container tightly closed and protect from excess heat, moisture, and freezing.
Safety Keep the medicine out of the sight and reach of children and lock safety caps.

Tablets should remain in their original container. Do not use the medicine if the tablets appear broken, crumbling, or discoloured.

Disposal

Consult a pharmacist or local waste disposal company for guidance on the proper disposal of any unused or expired Dinapres. Do not simply throw away outdated medicine.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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