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Candesartan cilexetil

HTN, heart failure & impaired left ventricle systolic function (ejection fraction ≤40%) as add-on therapy to ACE inhibitors or when ACE inhibitors are not tolerated.

HTN Adult Initially 8 mg once daily, may be increased to 16 mg once daily. May be further increased to max: 32 mg once daily if BP is insufficiently controlled after 4 wk of treatment. Patient w/ intravascular vol depletion, mild to moderate hepatic & severe renal impairment Initially 4 mg once daily. Heart failure Initially 4 mg once daily. Up-titration to target dose: 32 mg once daily or highest tolerated dose by doubling dose at 2-wk intervals at least.

May be taken with or without food.

Hypersensitivity. Concomitant use w/ aliskiren-containing products in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²). Severe hepatic impairment &/or cholestasis. 2nd & 3rd trimesters of pregnancy. Childn <1 yr.

Hypersensitivity to bisulphites. Not recommended in dual blockade of renin-angiotensin-aldosterone system & primary aldosteronism. Bilateral renal artery stenosis or artery stenosis to solitary kidney; hypotension; aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy; severe CHF or underlying renal disease including renal artery stenosis. Excessive BP decrease in patients w/ ischemic cardiopathy or cerebrovascular disease. Anaesth & surgery. Periodically monitor serum K & creatinine levels; electrolytes. Monitor BP in patients on hemodialysis. Black patients. Not to be used concomitantly w/ ACE inhibitors in patients w/ diabetic nephropathy; heart failure. Not recommended in combination w/ ACE inhibitors, K-sparing diuretics eg, spironolactone; mineralocorticoid-receptor antagonist; medicinal products w/ BP-lowering effects. Concomitant use w/ K-sparing diuretics, K supplements, K-containing salt substitutes or other medicinal products increasing K level eg, heparin. Not to be taken by patients w/ galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. May affect ability to drive & use machines. Very severe or end-stage renal impairment (CrCl <15 mL/min); recent kidney transplantation. Not recommended during 1st trimester of pregnancy & lactation. Childn w/ GFR <30 mL/min/1.73 m²; childn & adolescents <18 yr. Elderly ≥75 yr.

Resp infection; dizziness/vertigo, headache. Hyperkalemia; hypotension; renal impairment.

Increased K levels w/ K-sparing diuretics, K supplements or K-containing salt substitutes, heparin. Reversible increased serum lithium conc & toxicity. Attenuated antihypertensive effects w/ NSAIDs eg, selective COX-2 inhibitors, ASA >3 g daily, non-selective NSAIDs. Increased risk of worsened renal function w/ ACE inhibitors, NSAIDs.

Angiotensin II Antagonists

C09CA06 - candesartan ; Belongs to the class of angiotensin II receptor blockers (ARBs). Used in the treatment of cardiovascular disease.

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