Candesartan

Angiotensin-II Antagonist · Angiotensin II antagonist

Indications

Hypertension. Treatment of patients with heart failure and impaired left ventricle systolic function as add-on therapy to ACE inhibitors or when ACE inhibitors are not tolerated.

Dosage

Adults: Hypertension: Initial and usual maintenance dose; 8 mg once daily. Increase to 16 mg once daily if necessary. If BP control is inadequate after 4 wk treatment with 16 mg once daily, increase to max 32 mg once daily. With intravascular volume depletion, initially 4 mg once daily, increased up to 32 mg daily if necessary, dose increased at intervals of 4 wks, usual dose 8 mg once daily. Treatment of patients with heart failure and impaired left ventricle systolic function: Initially 4 mg once daily. Double dose at minimum 2 wk intervals to max 32 mg once daily. Children: Under 6 yr, not recommended. Hypertension: 6-18 yr, body-weight less than 50 kg, initially 4 mg once daily (lower dose in intravascular volume depletion), adjusted according to response, max 8 mg once daily; Body-weight 50 kg and over, initially 4 mg once daily (lower dose in intravascular volume depletion),…

Adverse Effects

Dizziness, headache, back pain, hyperkalaemia, hypotension, renal impairment.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe hepatic impairment, cholestasis. Precautions: Intravascular volume depletion; use lower initial dose and correct volume/salt depletion before starting therapy. Anaesthesia, renal impairment; monitor serum potassium and creatinine levels. Severe or end-stage renal impairment, haemodialysis; carefully titrate dose and monitor BP thoroughly. Renal artery stenosis, aortic or mitral stenosis, kidney transplant, obstructive hypertrophic cardiomyopathy, severe congestive heart failure, mild to moderate hepatic impairment, primary hyperaldosteronism.

Interactions

K+-sparing diuretics, K+-supplement, lithium, NSAIDs, other antihypertensives.

Advice to Patient

Take with or without meals. Preferably taken 1 hour before meals or 2 hours after meals. Contact prescriber if there is chest pain, palpitations, unusual weight gain, swelling of ankles or hands, constant fatigue, unusual flu or cold symptoms, dry cough, difficulty in breathing, swelling of eyes/face/lips, skin rash, muscle pain, weakness, unusual bleeding, blood in stool/urine/gums or excessive sweating. Change position slowly when climbing stairs and from lying or sitting to standing position. Full effects of candesartan may not occur for 4-5 weeks.

Pharmacokinetics

Onset of action: 2-3 hrs. Antihypertensive effect: Within 2 wks. Peak effect: 6-8 hrs. Maximum antihypertensive effect: 4-6 wks. Duration: >24 hrs. Absorption: Candesartan: Rapid and complete following conversion from candesartan cilexetil by GI esterases. Metabolism: Converted to active candesartan during absorption from GI tract. Hepatic (minor). Bioavailability, absolute: Candesartan: 15%. Half-life elimination (dose dependent): 5-9 hrs. Time to peak: Children (1-17 yrs); Adults: 3-4 hrs. Excretion: Faeces (67%). Urine (33%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.