Candesartan Cilexetil

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Generic Name of Candesartan Cilexetil - Learn More

Candesartan Cilexetil Precaution - What You Need to Know

Candesartan Cilexetil is an angiotensin II receptor antagonist (ARB) primarily used to treat high blood pressure (hypertension) and heart failure. Before using this medication, it is important to assess the patient’s medical history, particularly for kidney issues, dehydration, or electrolyte imbalances. Candesartan should be used with caution in patients with pre-existing renal impairment, as it may cause further kidney dysfunction. Kidney function should be monitored regularly during treatment, especially in patients who have conditions such as kidney disease or diabetes.

Pregnant women should avoid using candesartan as it can harm the developing fetus, particularly in the second and third trimesters. If pregnancy is detected during treatment, the medication should be discontinued immediately, and an alternative treatment should be considered. Candesartan is also not recommended during breastfeeding as it may be excreted in breast milk and could harm the infant.

Patients with a history of hyperkalemia (high potassium levels) should be closely monitored, as candesartan can increase potassium levels, potentially leading to dangerous cardiac arrhythmias. This medication should also be avoided in patients with a history of angioedema, as it may cause or exacerbate this condition.

Candesartan Cilexetil Indication - Uses and Benefits

Candesartan Cilexetil is primarily prescribed to treat hypertension (high blood pressure) and heart failure. By blocking the effects of angiotensin II, a substance in the body that constricts blood vessels, candesartan helps lower blood pressure by relaxing blood vessels and making it easier for the heart to pump blood. This is beneficial for reducing the risk of stroke, heart attack, and kidney problems that can result from chronic high blood pressure.

In heart failure, candesartan helps reduce the symptoms by decreasing the load on the heart, improving its pumping ability, and reducing fluid retention. The medication can also be used to reduce the risk of cardiovascular events in patients with heart failure, improving overall heart function and preventing the worsening of heart failure symptoms.

Off-label, candesartan has been used for treating diabetic nephropathy (kidney disease due to diabetes) and other conditions that benefit from blood pressure management and renal protection. However, these uses should be considered carefully, and clinical judgment should guide therapy decisions.

Candesartan Cilexetil Contraindications - Important Warnings

Candesartan Cilexetil should not be used in patients who are allergic to any of the components of the medication, including candesartan itself. It is also contraindicated in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy, as this condition may worsen with further use of this drug.

The medication is contraindicated in pregnant women, particularly during the second and third trimesters, due to the risk of fetal injury or death. Candesartan should not be used during breastfeeding as it can pass into breast milk and potentially harm the infant.

Patients with severe liver impairment, such as hepatic cirrhosis, should avoid using candesartan, as the drug is metabolized by the liver and its clearance can be significantly reduced in these individuals. In such cases, alternative antihypertensive therapy may be necessary.

Additionally, the medication should not be used in individuals with bilateral renal artery stenosis or unilateral stenosis in a solitary kidney, as it can further impair kidney function, potentially leading to acute renal failure.

Candesartan Cilexetil Side Effects - What to Expect

The most common side effects of candesartan Cilexetil are dizziness, headache, and fatigue, especially when starting treatment or increasing the dosage. These effects are typically mild and improve over time as the body adjusts to the medication.

Serious side effects, though rare, can include hyperkalemia (high potassium levels), which may result in muscle weakness, irregular heartbeats, or fatigue. Kidney function should be monitored, as candesartan can potentially cause renal impairment, particularly in patients with pre-existing kidney conditions.

Angioedema, a rare but potentially life-threatening allergic reaction involving swelling of the face, lips, throat, and tongue, has been reported in some patients. If symptoms of angioedema occur, such as difficulty breathing or swallowing, immediate medical attention is required.

Other serious side effects include hypotension (low blood pressure), especially after the first dose, and liver enzyme abnormalities. If a patient experiences severe hypotension, dizziness, or fainting, they should seek medical attention. Additionally, jaundice or abdominal pain may indicate liver problems, and the medication should be discontinued if these symptoms occur.

Candesartan Cilexetil Pregnancy Category ID - Safety Information

Candesartan Cilexetil Mode of Action - How It Works

Candesartan Cilexetil works by selectively blocking the action of angiotensin II, a potent vasoconstrictor that is involved in regulating blood pressure. Angiotensin II acts on the angiotensin II type 1 (AT1) receptors, leading to vasoconstriction, increased aldosterone secretion, and fluid retention, all of which contribute to high blood pressure and heart failure symptoms. By blocking these receptors, candesartan prevents the constriction of blood vessels and the release of aldosterone, leading to vasodilation, reduced fluid retention, and lowered blood pressure.

Pharmacokinetically, candesartan Cilexetil is a prodrug, meaning it is converted to its active form, candesartan, in the body after administration. Candesartan binds specifically to the AT1 receptor, and this binding prevents the physiological actions of angiotensin II. This mechanism is particularly beneficial in conditions such as hypertension and heart failure, where controlling blood pressure and reducing cardiac workload are key treatment goals.

Candesartan has a long half-life, which allows for once-daily dosing. Its effects are sustained throughout the day, providing consistent blood pressure control.

Candesartan Cilexetil Drug Interactions - What to Avoid

Candesartan Cilexetil can interact with several medications, potentially altering its efficacy or increasing the risk of side effects. When used with other antihypertensive drugs, such as diuretics, ACE inhibitors, or other ARBs, the blood pressure-lowering effect may be enhanced, which could result in hypotension (low blood pressure). This is particularly true when starting treatment or increasing the dose, so careful monitoring of blood pressure is essential.

Concomitant use of potassium-sparing diuretics (e.g., spironolactone), potassium supplements, or salt substitutes containing potassium can increase the risk of hyperkalemia, as candesartan can elevate potassium levels. Monitoring serum potassium levels is crucial during co-administration of these agents.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can reduce the antihypertensive effect of candesartan by impairing renal function and fluid balance. Chronic NSAID use in combination with candesartan may also increase the risk of kidney injury, particularly in dehydrated patients.

Lithium levels can be elevated when used with candesartan, increasing the risk of lithium toxicity. The combination should be avoided unless the benefits outweigh the risks, and lithium levels should be monitored regularly.

Candesartan Cilexetil Adult Dose - Recommended Dosage

For hypertension, the typical starting dose of candesartan Cilexetil for adults is 16 mg once daily. Depending on the patient's blood pressure response, the dose may be increased to a maximum of 32 mg once daily. The dosage can be adjusted based on the patient’s response and tolerability, with many patients benefiting from a dose of 8–16 mg daily.

For heart failure, the recommended starting dose is usually 4 mg once daily, which may be gradually increased to a target dose of 32 mg once daily, depending on the patient’s condition and tolerability. Treatment initiation should begin at lower doses in patients with heart failure to avoid excessive drops in blood pressure.

Candesartan can be taken with or without food, and it should be taken at the same time each day to maintain consistent blood levels.

Candesartan Cilexetil Child Dose - Dosage for Children

Candesartan Cilexetil is not typically recommended for use in children under the age of 1 due to insufficient data on its safety and efficacy in pediatric populations. In children aged 1 year or older, the typical starting dose for hypertension is 0.2 mg/kg once daily, with a maximum dose of 8 mg daily. Dosage should be individualized based on the child’s response to treatment, and kidney function should be monitored closely.

For children with heart failure, candesartan should be prescribed with caution, and the appropriate dosage should be determined by a pediatric cardiologist based on the child’s weight and condition. Given the potential for adverse effects, pediatric use of this medication requires careful consideration and ongoing monitoring of blood pressure and kidney function.

Candesartan Cilexetil Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, particularly those with a creatinine clearance of less than 30 mL/min, candesartan should be used with caution. For these patients, starting doses may need to be reduced, and blood pressure and kidney function should be monitored closely. Dosing adjustments may be necessary if renal function deteriorates during treatment.

For patients undergoing hemodialysis, the use of candesartan may require dose modification, as the drug is not significantly removed by dialysis. However, careful monitoring is advised to ensure that blood pressure is adequately controlled, and kidney function is not further compromised.

Angiotensin-II receptor blocker -