GENERIC NAME: candesartan cilexetil

BRAND NAME: Atacand

DRUG CLASS AND MECHANISM: Candesartan cilexetil (candesartan) is in a class of drugs called angiotensin receptor blockers which includes losartan (Cozaar), valsartan (Diovan), and irbesartan (Avapro). Like these other drugs, candesartan blocks the ability of the chemical angiotensin II to raise the blood pressure by constricting or squeezing arteries and veins. This leads to a reduction in blood pressure. In addition, by reducing the pressure against which the heart must pump blood, candesartan reduces the work of the heart. The effects of angiotensin II also can be blocked by another class of drugs called angiotensin converting enzyme (ACE) inhibitors which prevent the formation of angiotensin II. ACE inhibitors include captopril (Capoten), enalapril (Vasotec), benazepril (Lotensin), and lisinopril (Zestril).) Candesartan was approved by the FDA in 1998.

GENERIC AVAILABLE: no

PRESCRIPTION: yes

PREPARATIONS: Tablets, 4mg, 8mg, 16mg, 32mg.

STORAGE: Tablets should be stored at room temperature, between 15 and 30°C (59-86°F).

PRESCRIBED FOR: Candesartan is used to treat high blood pressure. It may be used alone or in combination with other drugs. It has less of an effect in black patients, as do ACE inhibitors. Angiotensin receptor blockers are being studied in patients with congestive heart failure to reduce the work of the heart and for protection of the kidneys in patients with diabetes. For these purposes, the blockers appear to be approximately as effective as ACE inhibitors.

DOSING: Candesartan usually is taken once daily.

DRUG INTERACTIONS: No important drug interactions have been described with candesartan. Since ACE inhibitors and angiotensin receptor blockers both can increase the concentrations of potassium in the blood, other medications that can increase the concentration of potassium in the blood, such as hydrodiuril (Dyazide), spironolactone (Aldactone), and potassium supplements, should be used cautiously with candesartan.

PREGNANCY: When used in the second or third trimester of pregnancy, ACE inhibitors can cause injury and even death to the fetus. Therefore, candesartan--which has an action that is similar to the ACE inhibitors--should not be used during pregnancy. If pregnancy occurs, candesartan should be stopped as soon as possible.

NURSING MOTHERS: Losartan (Cozaar) is secreted in rat milk, and is toxic to newborn rats. Since candesartan is chemically similar to losartan, it should be avoided in nursing mothers. It's safety and efficacy in children have not been established.

SIDE EFFECTS: The most common side effect with candesartan is dizziness which occurs in 1 out of every 25 persons).

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