Supplements and Indapamide.
Indapamide, sold under the brand names Natrilix, Natrilix SR, is a thiazide diuretic: it inhibits sodium reabsorption in the distal tubule, a milder diuresis than loop agents.
Indapamide is a thiazide diuretic, or the thiazide-like agents that share the same prescribing space. The class inhibits sodium reabsorption in the distal convoluted tubule. It produces a milder diuresis than loop agents, but with a longer plasma half life suitable for dosing once a day in hypertension. The metabolic profile carries hypokalaemia, hyponatraemia (especially in older patients on combined antihypertensives), hyperuricaemia, and a small impact on glucose control. Supplement-relevant points sit on the electrolyte side. Potassium and magnesium supplementation is often given alongside in patients with low baseline electrolytes. Real liquorice opposes thiazide effect by retaining sodium, driven by glycyrrhizin rather than by aldosterone, which reads low. The combination with NSAIDs is the same as for loop diuretics. Blunted antihypertensive effect and added renal stress. Indapamide sits in the same prescribing space as bendroflumethiazide in current UK practice and shares the profile.
Below are the 10 documented pairs we have explicitly assessed against Indapamide in the Distil database: 10 amber. The pairs cluster around 4 mechanisms: Additive blood-pressure lowering, Hypercalcaemia risk, Reduced renal lithium clearance, and Renal zinc wasting (drug-induced). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive blood-pressure lowering
Amber Does Garlic Extract interact with ?
Garlic supplements have a mild blood-pressure-lowering effect, and indapamide lowers blood pressure as well. The combined effect tends to be slightly larger. Watch for dizziness on standing in the first couple of weeks and tell your GP if symptoms appear.
Evidence: Limited human data, based on case reports and a known mechanism.
Amber Does Hibiscus Extract interact with ?
Hibiscus tends to lower blood pressure on its own, and indapamide is a water tablet used to lower it. Taken together the blood-pressure effects may stack, so watch for dizziness on standing, especially in the first couple of weeks. If symptoms appear, tell your GP.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Melatonin interact with ?
Taken at night, melatonin can modestly lower blood pressure during sleep. Combined with a blood-pressure medicine like indapamide this may add up to a slightly larger drop than the medicine alone. This is usually mild and often welcome, but if you notice dizziness or lightheadedness, check your blood pressure and mention it to your prescriber.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Pine Bark Extract interact with ?
Pine bark extract (pycnogenol) has a mild blood-pressure-lowering effect, and indapamide lowers blood pressure as well. The combined effect tends to be slightly larger. Watch for dizziness on standing in the first couple of weeks and tell your GP if symptoms appear.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Taurine interact with ?
Taurine tends to lower blood pressure on its own, and indapamide is a water tablet used to lower it. Taken together the blood-pressure effects may stack, so watch for dizziness on standing, especially in the first couple of weeks. The added effect tends to be modest. If symptoms appear, tell your GP.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Hypercalcaemia risk
Amber Does Calcium interact with ?
Indapamide is a thiazide-like diuretic that makes the kidneys keep more calcium, and a calcium supplement adds more calcium directly. Together they may raise blood calcium too high, particularly at higher calcium doses or alongside vitamin D. Let your prescriber know you take both; modest calcium doses are usually fine when your blood calcium is checked from time to time.
Evidence: Supported by human study data.
Amber Does Vitamin D3 interact with ?
Indapamide is a thiazide-like diuretic that makes the kidneys keep more calcium, and vitamin D increases how much calcium you absorb. Together, particularly at higher vitamin D doses or with calcium supplements, blood calcium may rise too high. Let your prescriber know you take both; normal replacement doses of vitamin D are usually fine when your blood calcium is checked from time to time.
Evidence: Supported by human study data.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Reduced renal lithium clearance
Amber Does Lithium Orotate interact with ?
Thiazide-like water tablets such as indapamide make the kidneys hold on to lithium and have the strongest lithium-raising effect of these medicines. With prescription lithium this is a recognised cause of toxicity. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. If you take a thiazide-like diuretic, check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Renal zinc wasting (drug-induced)
Amber Does Zinc interact with ?
Taking a zinc supplement alongside indapamide is supportive rather than harmful: indapamide is a thiazide-like water tablet, and the classic thiazides are known to make the kidneys pass more zinc into the urine, which can lower body zinc over months. Indapamide works a bit more gently on the kidney's salt handling and has not been measured directly for zinc, so the effect is likely present but probably smaller. If you have been on indapamide long term, your GP can check your zinc if you have symptoms like a poor sense of taste or slow-healing skin.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does Zinc Bisglycinate interact with ?
Taking a zinc supplement alongside indapamide is supportive rather than harmful: indapamide is a thiazide-like water tablet, and the classic thiazides are known to make the kidneys pass more zinc into the urine, which can lower body zinc over months. Indapamide works a bit more gently on the kidney's salt handling and has not been measured directly for zinc, so the effect is likely present but probably smaller. If you have been on indapamide long term, your GP can check your zinc if you have symptoms like a poor sense of taste or slow-healing skin.
Evidence: Limited human data, based on case reports and a known mechanism.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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