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Administration
May be taken with or without food.
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Contraindications
Severe hepatic impairment and/or cholestasis. Children (<1 year). Pregnancy. Concomitant use with aliskiren in patients with diabetes mellitus or moderate to severe renal impairment (GFR <60 mL/min/1.73m2).
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Special Precautions
Patient with unstented unilateral/bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, history of angioedema, relevant aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy, primary hyperaldosteronism. Black patients. Patients undergoing surgery. Renal and mild to moderate hepatic impairment. Children. Lactation. Monitoring Parameters Monitor blood pressure, electrolytes, renal function (e.g. serum creatinine, BUN), urinalysis, signs and symptoms of hypotension, tachycardia, CNS changes, hyperglycaemia, signs of angioedema; serum K during dose increase and periodically thereafter (in heart failure).
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Adverse Reactions
Significant: Angioedema, hypotension, hyperkalaemia, renal impairment.
Blood and lymphatic system disorders: Agranulocytosis, leucopenia, neutropenia.
Gastrointestinal disorders: Nausea.
Hepatobiliary disorders: Abnormal hepatic function or hepatitis.
Immune system disorders: Urticaria.
Infections and infestations: Respiratory infection.
Investigations: Increased liver enzymes.
Metabolism and nutrition disorders: Hyponatraemia.
Musculoskeletal and connective tissue disorders: Arthralgia, back pain, myalgia.
Nervous system disorders: Dizziness, headache, vertigo.
Respiratory, thoracic and mediastinal disorders: Cough.
Skin and subcutaneous tissue disorders: Rash, pruritus.
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Drug Interactions
Increased risk of hypotension with high dose diuretics and anaesthesia. Increased serum K levels with K-sparing diuretics (e.g. spironolactone), K supplements, K-containing salt substitutes or other drugs that increase K levels (e.g. heparin). May increase serum lithium concentration. Reduced antihypertensive effect, and increased risk of worsening renal function and increased serum K with NSAIDs (e.g. selective COX-2 inhibitors, aspirin).
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CIMS Class
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ATC Classification
C09CA06 - candesartan ; Belongs to the class of angiotensin II antagonists. Used in the treatment of cardiovascular disease.
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