Candesartan

Candesartan (中文:坎地沙坦) is an angiotensin receptor blocker.

Pronunciation

Candesartan cilexetil Tablet 4mg

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Generic Name:	Candesartan
Class:	Cardiovascular Drug
Subclass:	angiotensin receptor blocker
Legal Classification:	P1S1S3

Drug Names

Generic Name 藥物化學名稱	HA Code 藥物代碼	Legal Classification法律藥物分類	Brand Name 藥名
Candesartan cilexetil Tablet 4mg	CAND01	P1S1S3	BLOPRESS 8MG PLUS TAB 8/12.5MG (candesartan cilexetil 8mg + hydrochlorothiazide 12.5mg) BLOPRESS 8MG PLUS TAB 16/12.5MG (candesartan cilexetil 16mg + hydrochlorothiazide 12.5mg)
Candesartan cilexetil Tablet 8mg		P1S1S3
Candesartan cilexetil Tablet 16mg		P1S1S3
Candesartan cilexetil Tablet 32mg		P1S1S3

Mechanism of Action

Candesartan relaxes and widens your blood vessels. This lowers your blood pressure and makes it easier for your heart to pump blood around your body. It is used to treat high blood pressure and heart failure. It helps to prevent future strokes, heart attacks and kidney problems. It also improves your survival if you are taking it for heart failure.

Route of Administration

Candesartan is given orally as the ester prodrug candesartan cilexetil which is rapidly converted to the active substance candesartan during absorption from the gastrointestinal tract. Onset of antihypertensive action occurs about 2 hours after a dose and the maximum effect is achieved within about 4 weeks of starting therapy.

Dosage

The dose of candesartan depends on why you need the medicine.

For adult, the usual dose is:

• High blood pressure – 8mg to 32mg once a day
• Heart failure – 4mg to 32mg once a day

For children (aged 6 years and over), the usual dose to treat high blood pressure is:

• For children weighing less than 50kg, 4mg to 8mg once a day
• For children weighing 50kg or more, 4mg to 16mg once a day

Side Effects

The following definitions of frequencies are used:

Very common ≥ 1/10

Common ≥ 1/100 to < 1/10

Uncommon ≥ 1/1,000 to < 1/100

Rare ≥ 1/10,000 to < 1/1,000

Very rare < 1/10,000

System Organ Class	Frequency	Adverse reactions
Nervous system disorders	Very rare	Dizziness, headache
Respiratory disorders	Very rare	cough
Skin disorders	Very rare	Pruritus, rash
Gastro-intestinal disorders	Very rare	Nausea
Vascular disorder	Common	Hypotension
Metabolism disorders	common	Hyperkalaemia
	Very rare	hyponatraemia

Pharmacokinetics

Following oral administration, candesartan cilexetil is converted to the active substance candesartan. Peak serum concentrations occur about 3 to 4 hours following tablet intake.

The bioavailability of candesartan is not affected by food.

It is excreted in urine and bile mainly as unchanged drug with a small amount as inactive metabolites. The terminal elimination half-life is about 9 hours.

PREGNANCY should be avoided in pregnancy unless essential.

BREAST FEEDING They are not recommended.

HEPATIC IMPAIRMENT Initially 4mg once daily in mild or moderate impairment. Avoid in severe hepatic impairment.

RENAL IMPAIRMENT Initially 4mg daily. Use with caution if eGFR < 15ml/minute/1.73m2

MONITORING REQUIREMENTS

Monitor plasma-potassium concentration, particularly in the elderly and in patients with renal impairment.

Drug Interaction:

Diuretics: enhanced hypotensive effect when given with diuretics

Potassium sparing diuretics (triamterene, amiloride and spironolactone) or potassium supplement: increase risk of hyperkalaemia

Caution:

• Aortic or mitral valve stenosis
• Hypertrophic cardiomyopathy
• Patients with a history of angioedema
• Patients with primary aldosteronism

Contraindication: cholestasis

FAQ

How should I take the tablet?

Usually take candesartan tablet once a day, can take it at any time, with or without food. Swallow the tablet whole with a drink of water.

What should I avoid while taking?

Avoid potassium-containing salt substitutes or potassium supplements, unless your doctor has told you to.

What happen if I miss a dose?

If you forget to take a dose and you usually take candesartan:

• Once a day – take it as soon as you remember unless it is less than 12 hours until your next dose. In this case leave out the missed dose and take your next dose at the usual time

Never take 2 doses to make up for a forgotten one.