Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. > 50 kg: 32 mg/day PO.< 50 kg: 16 mg/day PO. WebWho can take candesartan. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Increases in serum creatinine may also occur in heart failure patients treated with candesartan. Monitor heart rate and blood pressure. Greater sensitivity to the hypotensive effects and renal-related adverse reactions of candesartan is possible in geriatric patients due to an age-related decline in renal function. Trazodone: (Minor) Due to additive hypotensive effects, patients receiving antihypertensive agents concurrently with trazodone may have excessive hypotension. Dose as for GFR<10 mL/min, Unlikely to be dialysed. Although an antihypertensive effect may occur after 2 weeks of therapy, maximal blood pressure reduction is generally obtained within 4 weeks. This interaction can be therapeutically advantageous, but dosages must be adjusted accordingly. Ora-Plus, Ora-Sweet SF, and Ora-Blend SF are registered trademarks of Paddock Laboratories, Inc. Typically, a concentration of 1 mg/mL will be suitable for the prescribed dose. We comply with the HONcode standard for trustworthy health information. Initially, 16 mg PO once daily, unless the patient is volume-depleted. >= 6 years and weighing > 50 kg: 32 mg/day PO.>= 6 years and weighing < 50 kg: 16 mg/day PO.< 6 years: 0.4 mg/kg/day PO. In addition, angiotensin II receptor antagonists have been associated with a reduced incidence in the development of new-onset diabetes in patients with hypertension or other cardiac disease. Peak concentrations are attained about 34 hours after an oral dose. Any strength of candesartan tablets can be used in the preparation of the suspension. Amiloride; Hydrochlorothiazide, HCTZ: (Major) Potassium-sparing diuretics, such as amiloride, should be used with caution in patients taking drugs that may increase serum potassium levels such as angiotensin II receptor antagonists. The first dose response (acute postural hypotension) of prazosin may be exaggerated in patients who are receiving beta-adrenergic blockers, diuretics, or other antihypertensive agents. Candesartan is used to treat high blood pressure and heart failure. This drug may be used as part of a combination therapy. That means you need to take it with other drugs. Candesartan belongs to a class of drugs called angiotensin 2 receptor blocker. A class of drugs refers to medications that work similarly. (Moderate) Monitor blood glucose during concomitant metformin and angiotensin receptor blocker use. o ATACAND may be used alone or concomitantly with thiazide diuretics. What are the possible side effects of Candesartan cilexetil tablets? Manufactured by: When volume-depletion is suspected (e.g., in patients taking diuretics, particularly those with impaired renal function), initiate therapy with a lower dose (e.g., 8 mg PO once daily). Candesartan Definition & Meaning | Merriam-Webster Medical Estradiol: (Minor) Estrogens can induce fluid retention and may increase blood pressure in some patients; patients who are receiving antihypertensive agents concurrently with hormonal contraceptives should be monitored for antihypertensive effectiveness. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Canagliflozin; Metformin: (Moderate) Monitor blood glucose during concomitant metformin and angiotensin receptor blocker use. Garlic is able to thin the blood, which is extremely important in the treatment of circulatory diseases, caused by Nitroglycerin: (Moderate) Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Caution is advised when tizanidine is to be used in patients receiving concurrent antihypertensive therapy. Dose range: Adjust within 2 weeks to dose range 4-32 mg/day PO; not to exceed 32 mg/day. In addition to the above, Candesartan cilexetil oral suspension also includes the following inactive ingredients: Ora Plus, Ora Sweet or Ora-Blend. Cabergoline has been associated with hypotension. Hyponatremia or hypovolemia predisposes patients to acute hypotensive episodes following initiation of ACE inhibitor therapy. Dexbrompheniramine; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor antagonists affect the RAS system and have caused increases in serum creatinine in susceptible individuals including patients with heart failure or renal artery stenosis. Monitor heart rate and blood pressure. Some patients develop significant hypotension shortly after administration of the first dose. The elimination half-life is about 912 hours. It is prudent to use substantial caution when prescribing angiotensin II receptor antagonists in patients with a history of ACE-inhibitor induced angioedema. Monitor heart rate and blood pressure. Monitor for decreases in blood pressure during times of coadministration. Web(1.3) -----------------------DOSAGE AND ADMINISTRATION ----------------------- Hypertension Usual adult dose: 50 mg once daily. Candesartan should be used with caution in patients whose renal function is critically dependent on the activity of the renin-angiotensin-aldosterone system (RAS) (e.g., patients with heart failure). Isosorbide Dinitrate, ISDN: (Moderate) Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Candesartan cilexetil tablets are a type of medicine called angiotensin receptor blocker, which blocks the effect of the hormone angiotensin II, causing the blood vessels to relax. Candesartan is an angiotensin II receptor blocker (sometimes called an ARB). Note: Candesartan is marketed Contemporary Use of Digoxin in the Management of Coadministration may also result in increases in serum creatinine in heart failure patients. Monitor heart rate and blood pressure. Although no dosage adjustment is recommended for geriatric patients, the plasma concentrations of candesartan are higher in the elderly, with a 50% increase in Cmax and 80% increase in AUC, compared to younger subjects. Coadministration may also result in increases in serum creatinine in heart failure patients. Monitor heart rate and blood pressure. Candesartan cilexetil tablets can cause harm or death to an unborn baby. HIGHLIGHTS OF PRESCRIBING INFORMATION These Carbinoxamine; Dextromethorphan; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Nitroprusside: (Moderate) Additive hypotensive effects may occur when nitroprusside is used concomitantly with other antihypertensive agents. In patients with severe renal impairment (CrCl less than 30 mL/min), the AUC and Cmax of candesartan are about double the values observed in patients with normal renal function. Patients with heart failure given candesartan commonly have some reduction in blood pressure including symptomatic hypotension. According to OBRA, antihypertensive regimens should be individualized to achieve the desired outcome while minimizing adverse effects. Isosorbide Mononitrate: (Moderate) Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Spironolactone; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum potassium concentrations closely if angiotensin II receptor antagonists and spironolactone are used together. Nateglinide: (Moderate) Angiotensin II receptor antagonists (ARB) may enhance the hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Lumacaftor; Ivacaftor: (Minor) Increased monitoring is recommended if ivacaftor is administered concurrently with CYP2C9 substrates, such as candesartan. Concurrent use can cause hyperkalemia, especially in elderly patients or patients with impaired renal function. Initially, 8 to 16 mg PO once daily or divided into 2 equal doses. Ephedrine; Guaifenesin: (Moderate) The cardiovascular effects of sympathomimetics, such as ephedrine, may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. If you become pregnant while you are taking candesartan, stop taking candesartan and call your doctor immediately. Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) Drospirenone has antimineralocorticoid effects and may increase serum potassium. Patients using cardiovascular drugs concomitantly with apraclonidine should have their pulse and blood pressure monitored periodically. Dextromethorphan; Guaifenesin; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Metformin; Repaglinide: (Moderate) Angiotensin II receptor antagonists (ARB) may enhance the hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Dose Range: Adjust within 2 weeks to dose range 2-16 mg/day orally once a day; Max: 32 mg/day. When pregnancy is detected, every effort should be made to discontinue candesartan therapy. In patients with mild hepatic impairment (Child-Pugh class A), the AUC and Cmax for candesartan are increased by 30% and 56%, respectively, compared to normal subjects. Hypotension, very rarely, may be severe and warrant the use of intravenous fluids and vasopressors. About 26% of an oral dose is excreted unchanged in urine. Drospirenone: (Moderate) Drospirenone has antimineralocorticoid effects and may increase serum potassium. Patients receiving an ARB in combination with antidiabetic agents should be monitored for changes in glycemic control. Fish Oil, Omega-3 Fatty Acids (Dietary Supplements): (Moderate) High doses of fish oil supplements may produce a blood pressure lowering effect. Potassium: (Moderate) Monitor serum potassium concentrations closely if potassium supplements and angiotensin II receptor antagonists are used together. Send the page "" A lower starting dose (e.g., <= 8 mg/day) may be initiated in patients with severe renal impairment, including those requiring dialysis. Naproxen; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. In general, avoid combined use of two renin-angiotensin-aldosterone system (RAAS) inhibitors, particularly in patients with CrCl less than 60 mL/minute. Acetaminophen; Guaifenesin; Phenylephrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Cariprazine: (Moderate) Orthostatic vital signs should be monitored in patients who are at risk for hypotension, such as those receiving cariprazine in combination with antihypertensive agents. Although an antihypertensive effect may occur after 2 weeks of therapy, maximal blood pressure reduction is generally obtained within 4 weeks. Titrate milrinone dosage according to hemodynamic response. Patients who develop hyperkalemia may continue eplerenone with proper dose adjustment; eplerenone dose reduction decreases potassium concentrations. Well-controlled hypertensive patients receiving phenylephrine at recommended doses do not appear at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. Closely observe newborns with histories of in utero exposure to candesartan for hypotension, oliguria, and hyperkalemia. In vitro studies showed ivacaftor to be a weak inhibitor of CYP2C9. Atypical antipsychotics may cause orthostatic hypotension and syncope, most commonly during treatment initiation and dosage increases. In addition, angiotensin II receptor antagonists have been associated with a reduced incidence in the development of new-onset diabetes in patients with hypertension or other cardiac disease. In some patients, this may be desirable, but orthostatic hypotension may occur. Triamterene; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum potassium concentrations in patients receiving angiotensin II receptor antagonists concomitantly with triamterene. Hypersensitivity, Severe hepatic impairment, Do not coadminister with aliskiren in patients with diabetes. INDIA Angiotensin II receptor blockers treat high blood pressure. Trimethoprim: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin II receptor antagonist and trimethoprim is necessary. WebIMPORTANT WARNING: Tell your doctor if you are pregnant or plan to become pregnant. ARBs block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the angiotensin receptor in many tissues. hyperkalemia / Delayed / 0-6.3agranulocytosis / Delayed / 0-1.0anaphylactoid reactions / Rapid / 0-1.0rhabdomyolysis / Delayed / 0-1.0angioedema / Rapid / 0-0.5myocardial infarction / Delayed / 0-0.5renal failure (unspecified) / Delayed / Incidence not knownazotemia / Delayed / Incidence not knownteratogenesis / Delayed / Incidence not known, elevated hepatic enzymes / Delayed / 1.0-10.0hyperbilirubinemia / Delayed / 1.0-10.0hyponatremia / Delayed / 0-1.0leukopenia / Delayed / 0-1.0thrombocytopenia / Delayed / 0-1.0neutropenia / Delayed / 0-1.0anemia / Delayed / 0-1.0hepatitis / Delayed / 0-1.0angina / Early / 0-0.5peripheral edema / Delayed / 1.0chest pain (unspecified) / Early / 1.0depression / Delayed / 0.5hypertriglyceridemia / Delayed / 0.5hyperglycemia / Delayed / 0.5dyspnea / Early / 0.5hyperuricemia / Delayed / 0.5palpitations / Early / 0.5sinus tachycardia / Rapid / 0.5hypotension / Rapid / Incidence not knownorthostatic hypotension / Delayed / Incidence not known, infection / Delayed / 6.0-6.0dizziness / Early / 4.0-4.0back pain / Delayed / 3.0-3.0pharyngitis / Delayed / 2.0-2.0rhinitis / Early / 2.0-2.0urticaria / Rapid / 0-1.0pruritus / Rapid / 0-1.0abdominal pain / Early / 1.0diarrhea / Early / 1.0vomiting / Early / 1.0headache / Early / 1.0nausea / Early / 1.0arthralgia / Delayed / 1.0fatigue / Early / 1.0rash / Early / 0.5cough / Delayed / 1.0myalgia / Early / 0.5fever / Early / 0.5paresthesias / Delayed / 0.5asthenia / Delayed / 0.5vertigo / Early / 0.5anxiety / Delayed / 0.5dyspepsia / Early / 0.5syncope / Early / Incidence not known. Monitor blood pressure if the combination is necessary. The trough to peak ratio for the reduction in BP is generally 80100%, confirming the smooth 24-hr BP lowering profile of candesartan. We do not record any personal information entered above. Articaine; Epinephrine: (Moderate) Antihypertensives, including angiotensin II receptor antagonists, antagonize the vasopressor effects of parenteral epinephrine. Monitor heart rate and blood pressure. Indications and Contraindications. Well-controlled hypertensive patients receiving phenylephrine at recommended doses do not appear at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. Calcium Phosphate, Supersaturated: (Moderate) Concomitant use of medicines with potential to alter renal perfusion or function such as angiotensin II receptor antagonists, may increase the risk of acute phosphate nephropathy in patients taking sodium phosphate monobasic monohydrate; sodium phosphate dibasic anhydrous. If you would like more information, talk with your doctor. Iloperidone: (Moderate) Secondary to alpha-blockade, iloperidone can produce vasodilation that may result in additive effects during concurrent use with antihypertensive agents. Paliperidone: (Moderate) Paliperidone may cause orthostatic hypotension, thereby enhancing the hypotensive effects of antihypertensive agents. Low doses (e.g., 16 mg/day) of candesartan do not appear to affect plasma aldosterone concentration; however, higher doses (e.g., 32 mg/day) have been shown to decrease aldosterone levels. Pentoxifylline: (Moderate) Pentoxifylline has been used concurrently with antihypertensive drugs (beta blockers, diuretics) without observed problems. Angiotensin-converting enzyme inhibitors (ACEIs) are the most commonly indicated medications in the treatment of cardiovascular and renal diseases, including heart failure, acute coronary syndrome, nephrotic syndrome, Keep Candesartan cilexetil tablets and all medicine out of the reach of children. Concomitant use may increase the risk of hyperkalemia. Patients receiving an ARB in combination with antidiabetic agents should be monitored for changes in glycemic control.