Candesartan 32mg Tablets

Candesartan is a selective AT1 subtype angiotensin II receptor antagonist. It 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 resistance, and reduced sodium and water retention, thereby lowering blood pressure and reducing cardiac preload/afterload in heart failure.

Urgent 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, 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 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, 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 before starting this medication:

Any allergies you have, including allergies to this drug, its components, or other substances, and describe the symptoms you experienced.
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 have either diabetes or kidney problems, as this combination may increase the risk of adverse effects.
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 administer 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 discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist to ensure safe use.
* Do not initiate, discontinue, or modify the dosage of any medication without consulting your doctor to avoid potential interactions or adverse effects.

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

When starting this drug, 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.

Regularly monitor your blood pressure as directed by your healthcare provider. Additionally, follow your doctor's instructions for having your blood and other laboratory tests checked.

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 product, consult with your doctor.

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 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
• Lithium (increased serum lithium concentrations and toxicity)

• Other antihypertensives (additive hypotensive effect)
• Diuretics (increased risk of hypotension, especially with initial doses)
• Trimethoprim (increased risk of hyperkalemia)

• Not available

• Dizziness or lightheadedness (especially upon standing, indicating hypotension)
• Fatigue or weakness
• Swelling of face, lips, tongue, or throat (signs of angioedema)
• Muscle weakness, irregular heartbeat, or numbness/tingling (signs of hyperkalemia)
• Signs of worsening renal function (e.g., decreased urine output, swelling)

Candesartan is contraindicated in the 2nd and 3rd trimesters of pregnancy due to significant risk of fetal injury and death. It should be discontinued as soon as pregnancy is detected. Exposure during the 1st trimester is associated with a lower, but still present, risk of major congenital malformations.

Limited data suggest that candesartan is excreted into human milk. Due to the potential for serious adverse effects in the breastfed infant (e.g., hypotension, hyperkalemia, renal impairment), breastfeeding is generally not recommended while taking candesartan. A safer alternative should be considered.

Approved for hypertension in children 1 to <17 years of age. Dosing is weight-based for younger children. Close monitoring of blood pressure, renal function, and potassium is essential. Not recommended for heart failure in pediatric patients.

No overall differences in efficacy or safety have been observed between elderly and younger patients. However, elderly patients may be more sensitive to the effects of candesartan, particularly regarding renal function and blood pressure. Initiate at the lower end of the dosing range and titrate carefully. Monitor renal function and potassium closely.

• Candesartan cilexetil is a prodrug; it is rapidly converted to the active drug candesartan in the GI tract.
• Unlike ACE inhibitors, ARBs like candesartan do not typically cause a cough, making them a suitable alternative for patients who develop ACE inhibitor-induced cough.
• Always check for concomitant use of potassium-sparing diuretics, potassium supplements, or NSAIDs, as these can increase the risk of hyperkalemia and/or renal dysfunction.
• Educate patients about the importance of avoiding pregnancy while on candesartan due to the severe fetal risks.
• For heart failure, candesartan is typically initiated at a low dose and gradually titrated upwards to the target dose (32 mg daily) as tolerated, often in combination with a beta-blocker.
• Patients with severe heart failure or significant renal impairment may be more susceptible to hypotension and acute kidney injury, requiring closer monitoring.

• Other Angiotensin II Receptor Blockers (ARBs): Valsartan, Losartan, Irbesartan, Olmesartan, Telmisartan, Azilsartan
• Angiotensin-Converting Enzyme (ACE) Inhibitors: Lisinopril, Enalapril, Ramipril
• Beta-blockers: Metoprolol, Carvedilol
• Calcium Channel Blockers: Amlodipine, Nifedipine
• Diuretics: Hydrochlorothiazide, Furosemide
• Direct Renin Inhibitors: Aliskiren (limited use)

If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with 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 what was taken, the amount, and the time it occurred.