Monitor blood pressure if the combination is necessary. About 26% of an oral dose is excreted unchanged in urine. Chlorpheniramine; Phenylephrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Lithium: (Moderate) Monitor serum lithium concentrations during concomitant angiotensin II receptor blocker use; reduce the lithium dose based on serum lithium concentration and clinical response. If you get pregnant while taking Candesartan cilexetil tablets, tell your doctor right away. Niacin, Niacinamide: (Moderate) Cutaneous vasodilation induced by niacin may become problematic if high-dose niacin is used concomitantly with other 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. The trough to peak ratio for the reduction in BP is generally 80100%, confirming the smooth 24-hr BP lowering profile. Carbinoxamine; Dextromethorphan; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. If these drugs are administered concurrently, blood pressure should be monitored closely. The elimination half-life is about 912 hours. It may be advisable to monitor blood pressure. Apraclonidine: (Minor) Alpha blockers as a class may reduce heart rate and blood pressure. Candesartan oral suspension can be prepared in concentrations within the range of 0.1 to 2 mg/mL. Candesartan is an oral angiotensin II receptor blocker. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. WebIMPORTANT WARNING: Tell your doctor if you are pregnant or plan to become pregnant. Co-administration may lead to increased exposure to CYP2C9 substrates; however, the clinical impact of this has not yet been determined. Acetaminophen; Chlorpheniramine; Phenylephrine : (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. In addition, use caution in patients receiving drugs where hypokalemia is a particular risk. 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. Nefazodone: (Minor) Although relatively infrequent, nefazodone may cause orthostatic hypotension in some patients; this effect may be additive with antihypertensive agents. Phenelzine: (Moderate) Additive hypotensive effects may be seen when phenelzine is combined with angiotensin II receptor antagonists. Nesiritide, BNP: (Major) The potential for hypotension may be increased when coadministering nesiritide with antihypertensive agents. 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. It is not intended to be a substitute for the exercise of professional judgment. Dose as for GFR=1020 mL/min. Also monitor for any changes in blood pressure, fluid retention, or renal function. Careful monitoring of blood pressure is suggested during concurrent therapy of phenelzine with angiotensin II receptor antagonists. Adjust the dosage according to blood pressure response. Alpha-glucosidase Inhibitors: (Moderate) Angiotensin II receptor antagonists (ARBs) may enhance the hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. If the antihypertensive cannot be stopped, patients should not receive amifostine. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. Ora-Plus, Ora-Sweet SF, and Ora-Blend SF are registered trademarks of Paddock Laboratories, Inc. After administration, fosaprepitant is rapidly converted to aprepitant and shares the same drug interactions. The potential reduction in blood pressure can precipitate orthostatic hypotension and associated dizziness, tachycardia, and syncope. A lower starting dose (e.g., <= 8 mg/day) may be initiated in patients with severe renal impairment, including those requiring dialysis. Candesartan has not been adequately studied in patients with severe hepatic insufficiency. 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. 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). Codeine; Guaifenesin; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. 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. Tranylcypromine: (Contraindicated) The use of hypotensive agents and tranylcypromine is contraindicated by the manufacturer of tranylcypromine because the effects of hypotensive agents may be markedly potentiated. Nitroprusside: (Moderate) Additive hypotensive effects may occur when nitroprusside is used concomitantly with other antihypertensive agents. Dosage adjustments may be necessary. Monitor heart rate and blood pressure. Orthostatic vital signs should be monitored in patients receiving paliperidone and angiotensin II receptor antagonists who are susceptible to hypotension. Monitor heart rate and blood pressure. Peak concentrations are attained about 34 hours after an oral dose. Candesartan selectively blocks the binding of angiotensin II to AT1 in many tissues including vascular smooth muscle and the adrenal glands. Inactive ingredients in Candesartan cilexetil tablets and Candesartan cilexetil oral suspension are: How does Candesartan cilexetil tablet work? Blood pressure response is dose-related over the range of 216 mg. After 1 week of candesartan administration, the pressor effect of angiotensin II was inhibited by 50% at 24 hours post-dose. Atacand:- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F. Candesartan should be used with caution in patients with hypovolemia, including patients receiving high doses of diuretics. Additive hypotensive effects are possible. Isocarboxazid: (Moderate) Additive hypotensive effects may be seen when isocarboxazid is combined with angiotensin II receptor antagonists. This effect is of particular concern in the setting of acute myocardial infarction, unstable angina, or other acute hemodynamic compromise. Before you take Candesartan cilexetil tablets, tell your doctor if you: are pregnant or planning to become pregnant, are breast-feeding or plan to breast-feed, Tell your doctor about all the medicines you take, How should I take Candesartan cilexetil tablets. Diazoxide: (Moderate) Additive hypotensive effects can occur with the concomitant administration of diazoxide with other antihypertensive agents. WebWho can take candesartan. Patients should be instructed to rise slowly from a sitting position, and to report syncope or changes in blood pressure or heart rate to their health care provider. Start with 4-8 mg/day orally once a day. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Most of the antihypertensive effect is seen within 2 weeks of initial dosing; however, the full effect may not be observed for up to 4 weeks. Web(1.3) -----------------------DOSAGE AND ADMINISTRATION ----------------------- Hypertension Usual adult dose: 50 mg once daily. The concurrent administration of antihypertensive agents and duloxetine may increase the risk of hypotension. Use caution with in-clinic dosing for erectile dysfunction (ED) and monitor for the effects on blood pressure. Monitoring blood pressure is recommended during dose titration and periodically during followup in treating patients with heart failure. Monitor heart rate and blood pressure. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. There is some evidence that ARB medications also reduce protenuria in patients with renal disease and diabetic retinopathy. Careful monitoring of blood pressure and hypotensive symptoms is recommended especially in patients with ischemic heart disease and in patients on antihypertensive agents. Candesartan cilexetil tablets can cause harm or death to an unborn baby. Amphetamine; Dextroamphetamine Salts: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, such as angiotensin II receptor antagonists. CoQ10 use in combination with antihypertensive agents may lead to additional reductions in blood pressure in some individuals. Candesartan should be used with great care in patients who exhibit signs of hypotension. They work by preventing calcium from entering the cells of the heart and arteries. Brand name (s): What should I avoid while taking Candesartan cilexetil tablets? Olanzapine: (Moderate) Olanzapine may induce orthostatic hypotension and thus enhance the effects of antihypertensive agents. The usual dosage range is 0.05 to 0.4 mg/kg/day PO, given in 1 to 2 doses/day. WebMajor Moderate Minor Unknown Acetylsalicylic Acid (aspirin) Aspir 81 (aspirin) Aspirin Low Strength (aspirin) Celebrex (celecoxib) CoQ10 (ubiquinone) Crestor Decreased dosage of the antihypertensive agent may be required when given with trazodone. We comply with the HONcode standard for trustworthy health information. Concomitant use of fenofibric acid with CYP2C9 substrates, such as candesartan, has not been formally studied. WebCandesartan is greater than 10,000 times more selective for AT1 than AT2. Monitor heart rate and blood pressure. WebHome Medicines A to Z Candesartan Who can and cannot take candesartan Who can take candesartan Most adults aged 18 and over can take candesartan. 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. Adjust the dosage according to blood pressure response. In vitro studies showed ivacaftor to be a weak inhibitor of CYP2C9. Candesartan should be used with caution patients with hyperkalemia. Nitrates: (Moderate) Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Use of any information is solely at the user's own risk. No initial dosage adjustment is necessary in patients with mild hepatic disease. 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). If concomitant use is necessary, closely monitor serum potassium concentrations. Oritavancin: (Moderate) Candesartan is metabolized by CYP2C9; oritavancin is a weak CYP2C9 inhibitor. Nitroglycerin: (Moderate) Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects. Use the oral suspension within 30 days after first opening the bottle. Maximal blood pressure reduction generally occurs within 4 to 6 weeks. Careful monitoring of blood pressure is suggested during concurrent therapy of isocarboxazid with angiotensin II receptor antagonists. Acetaminophen; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. More from Angiotensin 2 receptor blockers, Initial dose 2 mg and increase according to response, Unlikely to be dialysed. Dexbrompheniramine; Pseudoephedrine: (Moderate) The cardiovascular effects of pseudoephedrine may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. o pms-CANDESARTAN may be used alone or concomitantly with thiazide diuretics. Acetaminophen; Dextromethorphan; Phenylephrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by angiotensin II receptor antagonists. In spite of the effect of candesartan on aldosterone secretion, very little effect on serum potassium is observed. Do not use after the expiration date stated on the bottle. In response to cyclosporine-induced renal afferent vasoconstriction and glomerular hypoperfusion, angiotensin II is required to maintain an adequate glomerular filtration rate. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Respiratory, thoracic and mediastinal disorders. Monitor heart rate and blood pressure. While no specific drug interactions have been identified with systemic agents and apraclonidine during clinical trials, it is theoretically possible that additive blood pressure reductions could occur when apraclonidine is combined with the use of antihypertensive agents. Dosages should be adjusted carefully, according to blood pressure. Clinical practice guidelines classify candesartan as possibly effective for migraine prophylaxis. Epinephrine: (Moderate) Antihypertensives, including angiotensin II receptor antagonists, antagonize the vasopressor effects of parenteral epinephrine. >= 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. Do not co-administer aliskiren with ATACAND in patients with diabetes (4). Leukopenia, neutropenia and agranulocytosis. The usual dosage range is 4 to 32 mg/day PO, given in 1 to 2 doses/day. Macleods Pharma USA, Inc., You should confirm the information on the PDR.net site through independent sources and seek other professional guidance in all treatment and diagnosis decisions. In the Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) trial, no additional benefit over monotherapy was seen in patients receiving the combination of losartan and lisinopril compared to monotherapy; however, there was an increased incidence of hyperkalemia and acute renal injury. If indicated, dosage of the antihypertensive agents should be reduced. Injury or death to your unborn baby. Closely monitor blood pressure, renal function, and electrolytes in patients on ACE inhibitors and ARBs. Monitor heart rate and blood pressure. Contraindicated. Risk of prolonged QTc interval. candesartan, enalapril. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. If isoproterenol is used concomitantly with antihypertensives, the blood pressure should be monitored as the administration of isoproterenol can compromise the effectiveness of antihypertensive agents. This interaction can be therapeutically advantageous, but dosages must be adjusted accordingly. Theoretically, angiotensin II receptor antagonists should be less likely than angiotensin converting enzyme inhibitors (ACEIs) to precipitate angioedema because angiotensin II receptor antagonists do not cause accumulation of kinins. Keep Candesartan cilexetil tablets and all medicine out of the reach of children. According to OBRA, antihypertensive regimens should be individualized to achieve the desired outcome while minimizing adverse effects. This effect is of particular concern in the setting of acute myocardial infarction, unstable angina, or other acute hemodynamic compromise. General information about Candesartan cilexetil tablets. WebIndication Associated Conditions Contraindications & Blackbox Warnings Pharmacodynamics Mechanism of action Absorption Volume of distribution Protein binding Metabolism Route of elimination Half-life Clearance Adverse Effects Toxicity Pathways Pharmacogenomic Effects/ADRs o ATACAND may be used alone or concomitantly with thiazide diuretics. The usual dosage range is 2 to 16 mg/day PO, given in 1 to 2 doses/day. Monitor for decreases in blood pressure during times of coadministration. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Monitor serum potassium during the 1st month of drospirenone treatment if ARBs are used concurrently and thereafter as clinically indicated. Concomitant use may increase the risk of hyperkalemia. Children aged 6 years and over can also take it, but only to treat high blood pressure. Although an antihypertensive effect may occur after 2 weeks of therapy, maximal blood pressure reduction is generally obtained within 4 weeks. Trimethoprim: (Moderate) Monitor for hyperkalemia if concomitant use of an angiotensin II receptor antagonist and trimethoprim is necessary. Manufactured for: Isoproterenol: (Moderate) The pharmacologic effects of isoproterenol may cause an increase in blood pressure. Alemtuzumab: (Moderate) Alemtuzumab may cause hypotension. Dose range: 0.05-0.4 mg/kg/day orally. [64367] In rare cases when another antihypertensive agent cannot be used to treat a pregnant patient, serial ultrasound examinations should be performed to assess the intraamniotic environment. 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. Monitor heart rate and blood pressure. 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. WebExcerpt Candesartan is an oral angiotensin II receptor blocker. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. In the Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) trial, no additional benefit over monotherapy was seen in patients receiving the combination of losartan and lisinopril compared to monotherapy; however, there was an increased incidence of hyperkalemia and acute renal injury. Initial doses of cabergoline higher than 1 mg may produce orthostatic hypotension. Correct volume and/or sodium depletion prior to administration where possible. Tolvaptan: (Moderate) Monitor serum potassium concentrations closely if tolvaptan and angiotensin II receptor blockers are used together. The concurrent use of angiotensin II receptor antagonists (ARBs) may increase the risk of hyperkalemia, especially in the presence of renal impairment. Silodosin: (Moderate) During clinical trials with silodosin, the incidence of dizziness and orthostatic hypotension was higher in patients receiving concomitant antihypertensive treatment. Patients taking antihypertensive agents may need to have their therapy modified. Dosage adjustments may be necessary. Patients receiving an ARB in combination with pramlintide should be monitored for changes in glycemic control. Metformin; Repaglinide: (Moderate) Angiotensin II receptor antagonists (ARB) may enhance the hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Consider a cariprazine dose reduction if hypotension occurs. Dependent upon clinical response, dosage adjustments of either drug may be necessary. Following an oral dose of radiolabeled candesartan, approximately 33% of radioactivity is recovered in urine and about 67% in feces. Dextromethorphan; Quinidine: (Moderate) Quinidine can decrease blood pressure and should be used cautiously in patients receiving antihypertensive agents due to the potential for additive hypotension. 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.