Candesartan

Indications
 Oral
Hypertension
Adult: Initially, 8 mg once daily adjusted according to response. Maintenance: 8 mg once daily. Max: 32 mg daily.
Renal impairment: For patients with renal impairment or on haemodialysis: Initially, 4 mg once daily.
Hepatic impairment: Initially, 2 mg once daily. Avoid in severe impairment.
Oral
Heart failure
Adult: Initially, 4 mg once daily, may double dose at intervals of not <2 wk. Max: 32 mg daily.
Renal impairment: Reduce dose or discontinue treatment if renal function deteriorates.
Hepatic impairment: Initially, 2 mg once daily. Avoid in severe impairment.

Special Populations: Patients with renal and hepatic impairment: Initially, 2 mg once daily.
Contraindications
 Hypersensitivity. Pregnancy (2nd and 3rd trimester) and lactation.
Warnings / Precautions
 Volume or sodium depletion, preexisting renal insufficiency; aortic or mitral valve stenosis, hypertrophic obstructive cardiomyopathy, renal artery stenosis, primary hyperaldosteronism. Patients with a history of angioedema, urticaria. Monitor serum potassium levels especially in elderly and renally impaired patients. Hypotension may occur during major surgery and anaesthesia due to suppression of the renin-angiotensin system.
Adverse Reactions
 Dizziness, headache, vertigo, depression, somnolence, fever, back pain, upper respiratory tract infections, 1st dose orthostatic hypotension, rash, diarrhoea, decreased haemoglobin, renal impairment, hepatitis.
Drug Interactions
 Prior treatment with diuretics increases risk of excessive hypotension; use a lower initial dose. Potassium, potassium-sparing diuretics, trimethoprim or potassium supplements may increase risk of hyperkalaemia. NSAIDs may reduce antihypertensive response and increase risk of hyperkalaemia or acute renal failure. Excretion of lithium may be reduced; monitor lithium concentration.
See Below for More candesartan Drug Interactions
Mechanism of Actions
 Candesartan inhibits the binding of angiotensin II to AT1 receptors in many tissues such as vascular smooth muscles and adrenal gland which leads to vasoconstriction blockade and aldosterone release.
Absorption: Absorbed from the GI tract (oral); peak plasma concentrations after 3-4 hr.
Distribution: Protein-binding: 99%.
Metabolism: Hydrolysed to the active form, candesartan.
Excretion: Via urine and bile (as unchanged drug and small amounts of inactive metabolites); 9 hr (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 15-30°C.
ATC Classification
 C09CA06 - candesartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease.
Storage
 Oral: Store at 15-30°C.
Available As
  • Candesartan 10 mg
  • Candesartan 16 mg
  • Candesartan Cilexetil 16 mg
  • Candesartan 4 mg
  • Candesartan Cilexetil 4 mg
  • Candesartan 8 mg
  • Candesartan Cilexetil 8 mg

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