Blopress Drug Interactions

No drug interactions of clinical significance have been identified.
Compounds which have been investigated in clinical pharmacokinetic studies include hydrochlorothiazide, warfarin, digoxin, oral contraceptives (i.e. ethinylestradiol/levonorgestrel), glibenclamide, nifedipine and enalapril.
Candesartan is eliminated only to a minor extent by hepatic metabolism (CYP2C9). Available interaction studies indicate no effect on CYP2C9 and CYP3A4 but the effect on other cytochrome P450 isoenzymes is presently unknown.
The antihypertensive effect of Blopress may be enhanced by other antihypertensives.
Based on experiences with the use of other drugs that affect the renin-angiotensin-aldosterone system, concomitant use of potassium-sparing diuretics, potassium supplements, salts substitutes containing potassium, or other drugs that may increase potassium levels (e.g. heparin) may lead to increase in serum potassium.
Lithium: Reversible increase in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with ACE inhibitors. A similar effect may occur with angiotensin II receptor antagonists and careful monitoring of serum lithium levels is recommended during concomitant use.
NSAIDs: As with other antihypertensive agents, the antihypertensive effect of candesartan may be attenuated by non-steroidal anti-inflammatory drugs such as indomethacin, selective COX-2 inhibitors, acetylsalicylic acid and non-selective NSAIDs.
As with ACE inhibitors, concomitant use of angiotensin II receptor antagonists and NSAIDs may lead to an increased risk of worsening of renal function, including possible acute renal failure, and an increase in serum potassium, especially in patients with poor pre-existing renal function. The combination should be administered with caution, especially in older and volume-depleted patients.
Patients should be adequately hydrated and consideration should be given to monitoring renal function after initiation of concomitant therapy and periodically thereafter.
Dual Blockade of the Renin-Angiotensin-Aldosterone System (RAAS): Dual blockade of the RAAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.
The bioavailability of candesartan is not affected by food.