candesartan cilexetil (Oral route)

kan-de-SAR-tan sye-LEX-e-til

Commonly used brand name(s):

In the U.S.

• Atacand

Available Dosage Forms:

• Tablet

Therapeutic Class: Cardiovascular Agent

Pharmacologic Class: Angiotensin II Receptor Antagonist

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Uses For candesartan cilexetil

Candesartan belongs to the class of medicines called angiotensin II inhibitors. It is used to treat high blood pressure (hypertension).

High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Candesartan works by blocking the action of a substance in the body that causes blood vessels to tighten. As a result, candesartan relaxes blood vessels. This lowers blood pressure.

Candesartan is also used to treat heart failure and cut down on the number of hospital visits for heart problems.

candesartan cilexetil is available only with your doctor's prescription.

Before Using candesartan cilexetil

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For candesartan cilexetil, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to candesartan cilexetil or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on candesartan cilexetil have been done only in adult patients, and there is no specific information comparing use of candesartan in children with use in other age groups.

Geriatric

candesartan cilexetil has been tested in patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, blood levels of candesartan are increased in the elderly. Older people may be more sensitive than younger adults to the effects of candesartan. Older adults with heart failure may need to be monitored more carefully for signs of low blood pressure.

Pregnancy

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Using candesartan cilexetil with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Lithium

Using candesartan cilexetil with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aceclofenac
• Acemetacin
• Alclofenac
• Apazone
• Benoxaprofen
• Bromfenac
• Bufexamac
• Carprofen
• Celecoxib
• Clometacin
• Clonixin
• Dexketoprofen
• Diclofenac
• Diflunisal
• Dipyrone
• Droxicam
• Etodolac
• Etofenamate
• Felbinac
• Fenbufen
• Fenoprofen
• Fentiazac
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Ibuprofen
• Indomethacin
• Indoprofen
• Isoxicam
• Ketoprofen
• Ketorolac
• Lornoxicam
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Nabumetone
• Naproxen
• Niflumic Acid
• Nimesulide
• Oxaprozin
• Oxyphenbutazone
• Phenylbutazone
• Pirazolac
• Piroxicam
• Pirprofen
• Propyphenazone
• Proquazone
• Rofecoxib
• Sulindac
• Suprofen
• Tenidap
• Tenoxicam
• Tiaprofenic Acid
• Tolmetin
• Valdecoxib
• Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of candesartan cilexetil. Make sure you tell your doctor if you have any other medical problems, especially:

• Dehydration (fluid and electrolyte loss due to excessive perspiration, vomiting, diarrhea, prolonged diuretic therapy, dialysis, or dietary salt restriction)—Blood pressure-lowering effects of candesartan may be increased.

• Heart failure—Lowering of blood pressure by candesartan may make this condition worse. Your doctor may need to lower your dose or take other precautions.

• Kidney disease—Effects of candesartan may make this condition worse.

• Liver disease, severe or moderate—For severe liver disease, effects of candesartan are unknown. For moderate liver disease, your doctor may need to lower your starting dose of candesartan.

Proper Use of candesartan cilexetil

Take candesartan cilexetil only as directed by your doctor. Do not take more of it and do not take it more often than your doctor ordered. candesartan cilexetil also works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at the same time each day.

Dosing

The dose of candesartan cilexetil will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of candesartan cilexetil. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For heart failure
    • Adults—4 milligrams (mg) once a day. Your doctor may increase your dose as needed.
    • Children—Use and dose must be determined by your doctor.
  • For high blood pressure:
    • Adults—16 milligrams (mg) once a day. Your doctor may increase your dose as needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of candesartan cilexetil, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using candesartan cilexetil

It is important that your doctor check your progress at regular visits to make sure that candesartan cilexetil is working properly and to check for unwanted effects.

Check with your doctor immediately if you think that you may be pregnant. Candesartan may cause birth defects or other problems in the baby if taken during pregnancy.

Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Dizziness or lightheadedness may occur, especially if you have been taking a diuretic (water pill). Make sure you know how you react to candesartan cilexetil before you drive, use machines, or do anything else that could be dangerous if you experience these effects.

Check with your doctor right away if you become sick while taking candesartan cilexetil, especially with severe or continuing nausea and vomiting or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure.

Dizziness, lightheadedness, or fainting also may occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather.

Black patients may have a smaller response to the blood pressure-lowering effects of candesartan.

candesartan cilexetil Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Arm, back or jaw pain
• bleeding gums
• chest pain or discomfort
• chest tightness or heaviness
• chills
• cough or hoarseness
• dizziness
• fainting
• fast or irregular heartbeat
• fever
• joint pain
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs
• lightheadedness
• lower back or side pain
• nausea
• nosebleeds
• pain or discomfort in arms, jaw, back or neck
• painful or difficult urination
• shortness of breath
• sweating
• swelling of feet or lower legs
• vomiting

• Abdominal pain
• black, tarry stools
• bloody urine
• coma
• confusion
• convulsions
• dark urine
• decreased urine output
• difficult or troubled breathing
• general feeling of tiredness or weakness
• headache
• hives or welts
• increased blood pressure
• increased thirst
• itching
• light-colored stools
• loss of appetite
• muscle pain or cramps
• nervousness
• numbness or tingling in hands, feet, or lips
• pale skin
• redness of skin
• skin rash
• sore throat
• sores, ulcers, or white spots on lips or in mouth
• stomach pain
• swelling of face, ankles, or hands
• unusual bleeding or bruising
• unusual tiredness or weakness
• upper right abdominal pain
• weakness or heaviness of legs
• weight gain
• yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Ear congestion or pain
• head congestion
• nasal congestion
• runny and/or stuffy nose
• sneezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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