about Candesartan class, uses, side effects contraindications
Candesartan
Short Description
Candesartan is an angiotensin II receptor blocker medication.
Angiotensin II is a substance in the body that encourages the contraction of blood vessels, so blocking its effectiveness causes blood vessels to widen, blood flowing smoothly, and blood pressure lowering.
Candesartan is used to treat high blood pressure in adults and children who are at least 1 year old, and to treat congestive heart failure.
This type of medicine is used to treat patients who cannot tolerate the effects of medicines from the family of ACE inhibitors, such as: Captopril, because of the side effects they cause, such as coughing or?angioedema?
Category
Chemical class: Angiotensin II receptor antagonist
Therapeutic class: Antihypertensive
Pregnancy category: C
(first trimester), D (later trimesters)
Indications
To manage, or as adjunct in managing, hypertension
Adults. Initial: 16 mg daily. Maintenance: 8 to 32 mg daily or 4 to 16 mg every 12 hr. Maximum: 32 mg daily.
DOSAGE ADJUSTMENT Initial dosage decreased to 2 mg for patients with moderate to severe hepatic impairment and to 4 mg for those with renal impairment, need for hemodialysis, or possibly a risk of hypotension. To treat heart failure in patients with an ejection fraction of 40% or less and NYHA class II–IV to reduce the risk of death from cardiovascular causes and reduce hospitalizations for heart failure
Adults.Initial: 4 mg daily for 2 wk; then doubled every 2 wk as tolerated until reaching target dose of 32 mg daily. Route Onset Peak Duration P.O. In 2 wk 4–5 wk Unknown
Mechanism of Action
Selectively blocks binding of angiotensin (AT) II to AT1receptor sites in many tissues, including vascular smooth muscle and adrenal glands. This inhibits vasoconstrictive and aldosterone-secreting effects of AT II, which reduces blood pressure.
Contraindications
Hypersensitivity to candesartan or its components
Interactions
diuretics, other antihypertensives: Possibly increased risk of hypotension heparin, potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes: Possibly increased risk of hyperkalemia lithium: Increased blood lithium level
Side Efect
CNS: Dizziness, headache
CV: Hypotension
EENT: Pharyngitis, rhinitis
GI: Elevated liver function test results, hepatitis
GU: Elevated BUN and serum creatinine levels
HEME: Agranulocytosis, leukopenia, neutropenia
MS: Back pain, rhabdomyolysis
RESP: Upper respiratory tract infection
Other: Hyperkalemia, hyponatremia
Cautions
If patient has known or suspected hypovolemia, expect to provide treatment, such as I.V. normal saline solution, as prescribed, to correct it before starting candesartan. Monitor patient closely during major surgery and anesthesia because candesartan increases risk of hypotension by blocking renin-angiotensin system. Watch for elevated BUN and serum creatinine levels, especially if patient has heart failure or impaired renal function; drug may cause acute renal failure. Report sigcandesartan cilexetil 171 C nificant or persistent increases immediately. If blood pressure isn’t controlled with candesartan alone, expect to give a diuretic, such as hydrochlorothiazide, as prescribed.
WARNING If patient receives a diuretic or antihypertensive with candesartan, has heart failure, or is elderly, assess blood pressure often because of added risk of hypotension. If patient develops hypotension, expect to stop drug temporarily. Immediately place patient in supine position and prepare to give I.V. normal saline solution, as prescribed. Expect to resume therapy after blood pressure stabilizes. If patient receives a diuretic, provide hydration, as ordered, to help prevent hypovolemia. Watch for evidence, such as hypotension with dizziness and fainting. If patient has heart failure and develops hypotension, dosage of diuretic, candesartan, or both may be reduced when blood pressure stablizes and therapy resumes. Check CBC for decreases in hemoglobin and hematocrit. If they’re significant or persistent, notify prescriber immediately. PATIENT SAFTY
Advise patient that full effects of candesartan may not occur for 4 to 5 weeks. Explain importance of lifestyle choices in controlling hypertension. Advise female patient to immediately report known or suspected pregnancy. Explain that if she becomes pregnant, prescriber may replace candesartan with another antihypertensive that’s safe to use during pregnancy.
Trade Name & Company Name
effect of Candesartan in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. The published experience for candesartan during Pregnancy
is limited to a few case reports. It is assumed the effects of candesartan are similar to other ACEI class agents. As such, it should be avoided throughout Pregnancy
unless there is no other option. The lowest dose effective should be used when candesartan is required for BP control during pregnancy. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Candesartan presumably crosses the human placenta since fetal renal effects are reported and other ACEIs cross. AT-1 receptors are expressed on many organs of the human fetus. ACEIs are considered both teratogenic and fetotoxic. They are contraindicated throughout Pregnancy
as all members of this class may cause cranial hypoplasia, reversible or irreversible renal failure, oligohydramnios, anuria, death, prematurity, IUGR, and patent ductus arteriosus. Breastfeeding
There is no published experience in nursing women. It is unknown whether candesartan enters human breast milk.
the follwing drugs will increse Candesartan by inhepiting cyp450
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the follwing drugs will decrease Candesartan by inhancing cyp450
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trad drugs based on Candesartan
| Gen name | Trade name | Catagory name |
| candesartan | Atacand | Angiotensin receptor blockers |
| Candesartan | ATACAND 16 MG TAB | |
| Candesartan | ATACAND 4 MG TAB | |
| Candesartan | ATACAND 8 MG TAB | |
| Candesartan | ATACAND PLUS TABLET | |
| Candesartan | BLOPRESS 16 MG TABLETS | |
| Candesartan | BLOPRESS 16 PLUS TABLETS | |
| Candesartan | BLOPRESS 8 PLUS TABLETS | |
| Candesartan | BLOPRESS 8MG TAB. | |
other drugs from same cataogory