Atacand 32mg Tablets

Candesartan cilexetil is a prodrug that is rapidly and completely hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is an angiotensin II receptor blocker (ARB) that selectively blocks the binding of angiotensin II to the AT1 receptor in many tissues, including vascular smooth muscle and the adrenal gland. This blockade inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation, decreased peripheral vascular resistance, and reduced blood pressure. It does not inhibit ACE, nor does it bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of kidney problems, including:
+ Inability to pass urine
+ Changes in urine output
+ Blood in the urine
+ Sudden significant weight gain
Signs of high potassium levels, such as:
+ Abnormal heartbeat
+ Confusion
+ Weakness, lightheadedness, or dizziness
+ Feeling like passing out
+ Numbness or tingling
+ Shortness of breath
Severe dizziness or fainting

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Dizziness
Back pain
Flu-like symptoms
Common cold symptoms
Sore throat
Stuffy nose

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions before starting this medication:

Any allergies you have, including allergies to this drug, its components, or other substances, as well as any symptoms you experienced due to these allergies.
If you have kidney disease, as this may affect how your body processes the medication.
If you are taking a medication that contains aliskiren and you also have diabetes or kidney problems, as this combination may increase the risk of certain complications.
If you are breast-feeding, as you should not breast-feed while taking this medication.

Special Considerations for Children:

If your child is under 1 year of age, do not give them this medication, as it is not recommended for infants younger than 1 year.

Additional Precautions:

This list is not exhaustive, and it is crucial to inform your doctor and pharmacist about all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you have.
You must verify that it is safe to take this medication with all your other medications and health conditions.
Do not start, stop, or change the dose of any medication without consulting your doctor first.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.

Follow your doctor's instructions for monitoring your blood pressure. Additionally, have your blood work and other laboratory tests checked as directed by your doctor. It may take 4 to 6 weeks to experience the full effects of this medication.

If you are using a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium supplement, consult with your doctor. Similarly, if you are on a low-sodium or sodium-free diet, discuss this with your doctor.

When taking this medication for high blood pressure, consult your doctor before using over-the-counter (OTC) products that may increase blood pressure, such as cough or cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.

Before consuming alcohol, talk to your doctor. In hot weather or during physical activity, be cautious and drink plenty of fluids to prevent dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these conditions may lead to low blood pressure.

It is also important to note that this medication may be less effective in lowering blood pressure in Black patients. In some cases, your doctor may need to prescribe an additional medication. If you have any questions or concerns, discuss them with your doctor.

• Aliskiren (in patients with diabetes or moderate to severe renal impairment [GFR <60 mL/min/1.73 m²])

• Potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride)
• Potassium supplements
• Salt substitutes containing potassium
• NSAIDs (including selective COX-2 inhibitors) - may reduce antihypertensive effect and increase risk of renal impairment and hyperkalemia
• Lithium (increased serum lithium concentrations and toxicity)

• Other antihypertensive agents (additive hypotensive effect)
• Diuretics (increased risk of hypotension, especially first-dose hypotension)
• Trimethoprim (increased risk of hyperkalemia)

• Dizziness or lightheadedness (signs of hypotension)
• Swelling of face, lips, tongue, or throat (signs of angioedema)
• Muscle weakness, fatigue, irregular heartbeats (signs of hyperkalemia)
• Decreased urine output, swelling in ankles/feet (signs of worsening renal function)

Candesartan is contraindicated in pregnancy, especially during the second and third trimesters, due to the risk of fetal injury and death. Exposure during the first trimester should also be avoided if possible.

Not recommended during breastfeeding. Candesartan is excreted into the milk of lactating rats, and there is a potential for serious adverse effects in the nursing infant.

Approved for hypertension in children 1 to <17 years of age. Dosing is weight-based for younger children. Safety and efficacy for heart failure in pediatric patients have not been established. Close monitoring of renal function and potassium is crucial.

No overall differences in efficacy or safety have been observed between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Start with lower doses and titrate cautiously, monitoring renal function and potassium closely due to higher likelihood of impaired renal function.

• Candesartan is a prodrug; the active compound is candesartan.
• Unlike ACE inhibitors, ARBs like candesartan do not cause cough as a common side effect, making them a good alternative for patients who develop ACE inhibitor-induced cough.
• Risk of hyperkalemia is increased when co-administered with potassium-sparing diuretics, potassium supplements, or NSAIDs. Monitor serum potassium closely.
• First-dose hypotension can occur, especially in volume-depleted patients (e.g., those on high-dose diuretics). Consider reducing diuretic dose or initiating candesartan at a lower dose.
• Angioedema is a rare but serious side effect; patients should be advised to seek immediate medical attention if swelling of the face, lips, tongue, or throat occurs.
• Patients with severe heart failure whose renal function is dependent on the activity of the renin-angiotensin-aldosterone system may be at risk of oliguria and/or progressive azotemia, and rarely, acute renal failure and/or death.

• ACE inhibitors (e.g., Lisinopril, Enalapril)
• Beta-blockers (e.g., Metoprolol, Carvedilol)
• Calcium Channel Blockers (e.g., Amlodipine, Nifedipine)
• Thiazide diuretics (e.g., Hydrochlorothiazide)
• Loop diuretics (e.g., Furosemide - for heart failure)
• Direct Renin Inhibitors (e.g., Aliskiren - limited use)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.