Atacand HCT 32-12.5mg Tablets

Candesartan is an angiotensin II receptor blocker (ARB). It selectively blocks the binding of angiotensin II to the AT1 receptor in many tissues, including vascular smooth muscle and the adrenal gland. This inhibits the vasoconstrictive and aldosterone-secreting effects of angiotensin II, leading to vasodilation and reduced sodium and water reabsorption. Hydrochlorothiazide is a thiazide diuretic. It inhibits the reabsorption of sodium and chloride ions in the distal convoluted tubule of the nephron, leading to increased excretion of sodium, chloride, and water, as well as potassium and magnesium. This results in reduced plasma volume and peripheral vascular resistance.

Serious Side Effects: Seek Medical Attention Immediately

Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:

Signs of an allergic reaction: 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, or swelling of the mouth, face, lips, tongue, or throat.
Signs of high blood sugar: confusion, feeling sleepy, unusual thirst or hunger, frequent urination, flushing, fast breathing, or fruity-smelling breath.
Signs of fluid and electrolyte problems: mood changes, confusion, muscle pain or weakness, fast or abnormal heartbeat, severe dizziness or fainting, increased thirst, seizures, feeling very tired or weak, decreased appetite, inability to urinate or changes in urine output, dry mouth, dry eyes, or severe nausea and vomiting.
Signs of kidney problems: inability to urinate, changes in urine output, blood in the urine, or significant weight gain.
Signs of lupus: rash on the cheeks or other body parts, easy sunburn, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.

Eye Problems

This medication can cause certain eye problems, which can lead to permanent vision loss if left untreated. If you experience any eye problems, symptoms such as changes in vision or eye pain usually occur within hours to weeks of starting this medication. Contact your doctor immediately if you experience these symptoms.

Skin Cancer Risk

Rarely, people taking hydrochlorothiazide have developed certain types of skin cancer. To minimize this risk, protect your skin from the sun and follow your doctor's instructions for skin checks. Contact your doctor immediately if you notice any changes in the color or size of a mole, or any new or changing skin lump or growth.

Other Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. However, if you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor or seek medical help:

Signs of a common cold
Back pain
Flu-like symptoms
* Dizziness

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact 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 to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
A known sulfa allergy.
Current treatment with dofetilide.
Difficulty urinating.
Kidney disease or kidney problems.
High calcium levels in your blood.
* Use of a medication containing aliskiren, especially if you have diabetes or kidney problems.

Additionally, if you are breast-feeding or plan to breast-feed, you should discuss this with your doctor.

This list is not exhaustive, and it is crucial to disclose all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues to your doctor and pharmacist. They will help determine if it is safe to take this medication with your other treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

Important Warnings and Precautions

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

Caution with Daily Activities
Until you know how this medication affects you, avoid driving and other tasks that require alertness. To minimize the risk of dizziness or fainting, rise slowly from a sitting or lying position. Be cautious when climbing stairs.

Managing Diabetes and Blood Pressure
If you have diabetes, this medication may increase your blood sugar levels. Consult your doctor about maintaining control over your blood sugar. Monitor your blood pressure as directed by your doctor. Additionally, have your blood work and other laboratory tests checked as recommended by your doctor.

Potential Effects on Cholesterol and Triglyceride Levels
This medication may cause elevated cholesterol and triglyceride levels. Discuss this with your doctor.

Impact on Laboratory Tests
This medication may affect certain laboratory test results. Inform all your healthcare providers and laboratory personnel that you are taking this medication.

Interactions with Other Medications and Substances
If you are taking a salt substitute containing potassium, a potassium-sparing diuretic, or a potassium product, consult your doctor. If you are on a low-salt or salt-free diet, discuss this with 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, or certain natural products, consult your doctor. Also, discuss the use of alcohol, marijuana, or other forms of cannabis, as well as prescription or OTC medications that may slow your reactions, with your doctor.

Precautions in Hot Weather and with Physical Activity
Be cautious in hot weather or during physical activity, and drink plenty of fluids to prevent dehydration. If you experience excessive sweating, fluid loss, vomiting, or diarrhea, inform your doctor, as these symptoms may lead to low blood pressure.

Interactions with Other Medications
If you take cholestyramine or colestipol, consult your pharmacist about how to take these medications with this drug. Be aware of the potential for gout attacks.

Lupus Considerations
If you have lupus, this medication may activate or worsen the condition. Inform your doctor immediately if you experience any new or worsening symptoms.

Timing of Full Effect
It may take approximately one month to experience the full effects of this medication.

• Aliskiren (in patients with diabetes or renal impairment)
• Potassium supplements or potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride) - due to risk of hyperkalemia

• Lithium (increased lithium levels and toxicity)
• NSAIDs (e.g., ibuprofen, naproxen, celecoxib) - reduced antihypertensive effect, increased risk of renal impairment
• Other antihypertensives (additive hypotensive effects)
• Digoxin (thiazides may increase digoxin toxicity due to hypokalemia)
• Corticosteroids (enhanced electrolyte depletion, particularly hypokalemia)
• Cholestyramine and colestipol resins (reduced absorption of hydrochlorothiazide)

• Alcohol, barbiturates, or narcotics (potentiation of orthostatic hypotension)
• Antidiabetic drugs (oral agents and insulin) - thiazides may decrease glucose tolerance, requiring dosage adjustment
• Pressor amines (e.g., norepinephrine) - possible decreased response to pressor amines
• Skeletal muscle relaxants, non-depolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant

• Not available

• Dizziness
• Lightheadedness
• Fatigue
• Muscle cramps or weakness (signs of electrolyte imbalance)
• Excessive thirst or dry mouth (signs of dehydration)
• Swelling of face, lips, tongue, or throat (signs of angioedema - rare but serious)
• Persistent cough (less common with ARBs than ACEIs, but possible)
• Signs of gout (joint pain, swelling)

Contraindicated during pregnancy, especially during the second and third trimesters. Discontinue as soon as pregnancy is detected.

Not recommended. Both candesartan and hydrochlorothiazide are excreted in breast milk. Potential for serious adverse effects in the nursing infant.

Safety and effectiveness have not been established in pediatric patients. Not recommended for use.

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 monitor renal function and electrolytes closely due to increased likelihood of impaired renal function and polypharmacy.

• This combination is typically used when monotherapy with either an ARB or a thiazide diuretic is insufficient to control blood pressure.
• Take consistently at the same time each day, with or without food.
• Monitor for signs of electrolyte imbalance (e.g., muscle cramps, weakness, irregular heartbeat), especially potassium levels.
• Patients should be advised to report any signs of angioedema (swelling of face, lips, tongue, or throat) immediately.
• Avoid potassium supplements or salt substitutes containing potassium unless specifically advised by a physician.
• Patients with a history of gout may experience exacerbations due to the hydrochlorothiazide component.
• Inform patients about the black box warning regarding pregnancy and the need to discontinue immediately if pregnancy is detected.

• Other classes of antihypertensives (e.g., ACE inhibitors, calcium channel blockers, beta-blockers, other diuretics)
• Monotherapy with Candesartan or Hydrochlorothiazide if blood pressure is adequately controlled.

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with additional patient information leaflets, so be sure to check with your pharmacist for more details. If you have any questions or concerns about your 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 information about the medication taken, the amount, and the time it happened.