Candesartan

Candesartan (中文：坎地沙坦)

Pronunciation

Candesartan cilexetil Tablet 4mg

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Common Strengths of Candesartan

Candesartan is available in the following strengths:

• 4 mg
• 8 mg
• 16 mg
• 32 mg

Drug Trade Names of Candesartan

The brand names for candesartan is Blopress.

Mechanism of Action

Candesartan is an angiotensin II receptor blocker.

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

• For Adult
  • High blood pressure: 8 mg to 32 mg once a day
  • Heart failure: 4 mg to 32 mg once a day
• For children (aged 6 years and over)
  • High blood pressure:
    • Weighing less than 50 kg: 4 mg to 8 mg once a day
    • Weighing 50 kg or more: 4 mg to 16 mg once a day

Side Effects

Frequency	Adverse reactions
Very Rare (<1/10,000)	Dizziness
	Headache
	Cough
	Pruritus
	Rash
	Nausea
	Hyponatremia

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.

Drug Management

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.