Candesartan and Hydrochlorothiazide

Angiotensin-II Antagonist · Angiotensin II antagonist/Thiazide diuretic

Indications

Hypertension.

Dosage

Adults: Usual dosage: 1 tab given once daily. Max 32/25 mg once daily. Children: Not recommended.

Adverse Effects

Dizziness, headache, back pain, electrolyte imbalance.

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, electrolyte imbalance, 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, skeletal muscle relaxants.

Advice to Patient

Take with or without meals. Do not take dose within 4 hours of bedtime. Contact prescriber if there is dry mouth, increased thirst, irregular heartbeat, muscle weakness/cramps, change in frequency of urination, confusion, toe/joint pain, impaired vision, eye pain, severe dizziness, allergic reaction (rash, hives, itching, swelling of face/lips/tongue, difficulty in breathing). Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Do not take diet and supplements containing potassium without consulting prescriber. Change position slowly from sitting or lying to standing. Reduce alcohol intake. Check blood sugar level regularly and inform prescriber about changes. Avoid direct sunlight, tanning booths and sunlamps. Wear sunscreen, eyewear and protective clothing to prevent photosensitivity.

Pharmacokinetics

CANDESARTAN: 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%). HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak:…

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

Always consult a pharmacist or doctor.