Candez Drug Interactions

Potassium-sparing diuretics/potassium supplements/salt substitutes: May increase serum potassium; thus, concomitant use is not recommended.
Lithium: Reversible increases in lithium concentrations and toxicity; thus, coadministration is not recommended. If coadministration proves necessary, monitor serum lithium level carefully.
Nonsteroidal anti-inflammatory drugs [NSAIDs, i.e., selective cyclooxygenase-2 (COX-2) inhibitors, aspirin >3 g/day]: Reduced antihypertensive effect of candesartan. Concurrent administration of angiotensin II receptor antagonists and NSAIDs may result in an increased risk of worsening of renal function (including possible acute renal failure) and an increase in serum potassium, particularly in patients with poor pre-existing renal function. The combination should be administered with caution, especially in the elderly. Regularly monitor renal function after initiation of concomitant therapy and adequately hydrate patients.
Dual blockade of the Renin-Angiotensin-Aldosterone System (RAAS): Dual blockade of the RAAS with angiotensin II receptor antagonists, ACE inhibitors or aliskiren is associated with increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) compared with monotherapy. Closely monitor blood pressure, renal function and electrolytes in patients on candesartan and other agents that affect the RAAS.
Do not coadminister candesartan with aliskiren in patients with diabetes mellitus or renal impairment (GFR <60 mL/min/1.73 m²). Avoid concomitant use of angiotensin II receptor antagonists and ACE inhibitors in patients with diabetic nephropathy.
Antihypertensive agents (e.g., diuretic): Candesartan administration to patients under diuretic therapy may enhance antihypertensive effect. Start candesartan at a lower dose. Candesartan's antihypertensive effect may also be enhanced by other class of antihypertensive agents.
Others: In studies, coadministration of candesartan with other drugs such as glibenclamide, nifedipine, digoxin, warfarin, hydrochlorothiazide, and oral contraceptives showed no significant drug interactions. Since candesartan is not significantly metabolized by the cytochrome P450 system and at therapeutic concentrations has no effects on P450 enzymes, interactions with drugs that inhibit or are metabolized by those enzymes would not be expected.