Cardes
Generic Name
Candesartan
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Candesartan is an angiotensin II receptor blocker (ARB) used to treat high blood pressure (hypertension) and heart failure. It works by relaxing blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood.
Uses & Indications
Dosage
Adults
For hypertension: Initial dose 8 mg once daily, dose can be increased to 16 mg, then 32 mg once daily. For heart failure: Initial dose 4 mg once daily, target dose 32 mg once daily.
Elderly
No initial dosage adjustment is necessary for elderly patients.
Renal_impairment
For severe renal impairment (CrCl < 30 mL/min): Initial dose 4 mg once daily. Monitor renal function and potassium levels.
How to Take
Candesartan tablets should be swallowed whole with water, once daily, with or without food. It is recommended to take the medicine at the same time each day.
Mechanism of Action
Candesartan selectively blocks the binding of angiotensin II to the AT1 receptor in many tissues, including vascular smooth muscle and the adrenal gland. This inhibits the vasoconstrictor and aldosterone-secreting effects of angiotensin II, leading to vasodilation, decreased blood pressure, and reduced fluid retention.
Pharmacokinetics
Onset
Peak plasma concentrations are achieved 3-4 hours after administration. Blood pressure reduction begins within 2 hours, with maximal effect seen within 4-6 weeks of consistent therapy.
Excretion
Approximately 33% of an oral dose is excreted in the urine and 67% in the feces via bile as unchanged drug and inactive metabolite.
Half life
The elimination half-life of candesartan is approximately 9-15 hours.
Absorption
Candesartan cilexetil is a prodrug that is rapidly converted to the active drug, candesartan, during absorption from the gastrointestinal tract. Absolute bioavailability is approximately 15% (tablet) to 40% (solution).
Metabolism
Candesartan is minimally metabolized in the liver by O-deethylation to an inactive metabolite.
Side Effects
Contraindications
- Hypersensitivity to candesartan or any component of the formulation.
- Pregnancy (especially during the 2nd and 3rd trimesters) due to risk of fetal injury or death.
- Concomitant use with aliskiren in patients with diabetes mellitus or renal impairment (GFR < 60 mL/min/1.73 m²).
- Severe hepatic impairment and/or cholestasis.
Drug Interactions
Lithium
Concurrent use may increase serum lithium concentrations and lead to lithium toxicity.
Diuretics and other antihypertensives
May enhance the hypotensive effects.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
May reduce the antihypertensive effect and increase the risk of renal impairment.
Potassium-sparing diuretics, potassium supplements, or other agents that increase potassium levels
May lead to hyperkalemia (high potassium levels).
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
The most likely manifestation of overdose is hypotension, dizziness, and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. Treatment should be symptomatic and supportive, including close monitoring and management of blood pressure and fluid status.
Pregnancy & Lactation
Candesartan is contraindicated in the 2nd and 3rd trimesters of pregnancy due to significant risk of fetal toxicity (e.g., renal dysfunction, oligohydramnios, fetal death). It is not recommended during breastfeeding as it is unknown whether candesartan is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Widely available in pharmacies
Approval Status
DGDA Approved
Patent Status
Off-patent in many regions
WHO Essential Medicine
YesClinical Trials
Candesartan has been extensively studied in large-scale clinical trials (e.g., CHARM program, RALES) demonstrating its efficacy and safety in hypertension and heart failure.
Doctor Notes
- Monitor serum potassium and renal function (creatinine, GFR) regularly, especially in patients with heart failure, renal impairment, or concomitant use of potassium-sparing agents.
- Advise female patients of childbearing potential about the risks of fetal exposure and the need for effective contraception.
- Consider a lower starting dose in volume-depleted patients or those with severe renal impairment to avoid symptomatic hypotension.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking candesartan without consulting your doctor, even if you feel well, as blood pressure may rise again.
- Report any unusual symptoms or side effects to your healthcare provider immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Candesartan may cause dizziness or lightheadedness, especially at the start of treatment or when changing dose. Exercise caution when driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a low-sodium diet and limit alcohol intake.
- Engage in regular physical activity as advised by your doctor.
- Avoid smoking and manage stress to support cardiovascular health.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.