The main antihypertensive drugs are classified as beta-blockers, diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, and calcium channel blockers.
Candesartan belongs to the group of angiotensin II receptor antagonists and is a drug widely used alone or in combination with other drugs in the treatment of hypertension and heart failure. Candesartan acts by inhibiting the renin-angiotensin system or RAS, which is a fundamental hormonal system in the regulation of blood pressure.
It is administered orally as a prodrug (biologically inactive form), candesartan cilexetil, which is rapidly converted to its active form, candesartan.
It is contraindicated in patients hypersensitive to candesartan.
Do not co-administer candesartan and aliskiren in patients with diabetes.
Treatment with candesartan should be avoided during pregnancy. If you take candesartan and become pregnant, you should inform your physician as soon as possible. Its use during breast-feeding should be evaluated by your doctor.
Treatment with candesartan is not recommended in children under one year of age.
Persons with symptomatic hypotension (due to diuretic treatment, dietary salt restriction, dialysis, diarrhea or vomiting) may require temporary adjustments in the dose of candesartan and should monitor blood pressure.
Drugs that inhibit the renin-angiotensin system such as candesartan may impair renal function and produce hyperkalemia (elevated potassium). It is recommended to monitor renal function and serum potassium levels during treatment.
Agents that increase serum potassium levels such as certain diuretics and potassium supplements. Monitor serum potassium levels if potassium-sparing diuretics and candesartan are coadministered.
Coadministration with lithium increases serum lithium and toxicity. Monitor lithium levels if co-administered.
Administration of candesartan with nonsteroidal anti-inflammatory drugs (including cyclooxygenase-2 or COX-2 inhibitors) may affect renal function, especially in elderly patients. Therefore, if they are administered together, renal function should be monitored periodically.
In general, the triple combination of candesartan with an ACE inhibitor and a mineralocorticoid receptor antagonist is not recommended. If candesartan is administered with another angiotensin receptor antagonist, ACE inhibitors or the drug aliskiren, blood pressure, renal function and electrolytes should be monitored.
The most common adverse reactions when treatment is discontinued in adults are headache, dizziness, hypotension, impaired renal function, and elevated potassium levels.
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