Candez

HTN as monotherapy or in combination w/ other antihypertensives. Heart failure in patients w/ impaired left ventricular systolic function (left ventricular ejection fraction & ≤40%) to reduce CV death & to reduce heart failure hospitalizations.

Individualized dosage. Heart failure Initially 4 mg once daily, increased at approx 2-wk intervals to achieve target dose of 32 mg once daily. HTN Monotherapy in patient who is not vol depleted Initially 16 mg once daily. May be administered once daily or bid w/ total daily doses from 8-32 mg. Patient w/ intravascular vol depletion Initially 4 mg once daily. Renal impairment Mild: 4 mg once daily. Moderate: 2 mg once daily. Hepatic impairment Mild to moderate: 2 mg once daily. Elderly Consider lower dose.

May be taken with or without food.

Hypersensitivity. Severe hepatic impairment &/or cholestasis. Concomitant use w/ aliskiren in patients w/ DM or renal impairment (GFR <60 mL/min/1.73 m²). Pregnancy (2nd & 3rd trimesters) & lactation.

Fetal toxicity. Hypotension (carefully monitor BP during initial dose titration or subsequent upward dose adjustment). Correct hypovolemia. Patients suffering from hemodynamically relevant aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy. Hypotension during anesth & surgery. May increase BUN & serum creatinine in patients w/ unilateral or bilateral renal artery stenosis. Carefully titrate & monitor BP in patients on hemodialysis. Not recommended in patients w/ primary hyperaldosteronism. Excessive hypotension may result in MI or stroke in patients w/ ischemic cardiopathy or ischemic cerebrovascular disease. Concomitant use w/ K-sparing diuretics, K supplements, salt substitutes containing K or other drugs that may increase K levels (eg, heparin). Combination w/ an ACE inhibitor & K-sparing diuretic (eg, spironolactone) in patients w/ heart failure is not recommended. May affect ability to drive or use machines. Severe renal impairment (periodically monitor serum K & creatinine levels). Hepatic impairment. Triple combination of candesartan w/ ACE inhibitor & mineralocorticoid receptor antagonist in heart failure is not recommended. Childn <18 yr. Elderly.

Back pain, dizziness, upper resp tract infection, pharyngitis, & rhinitis. Agranulocytosis, anemia, eosinophilia, leukocytosis, leukopenia, neutropenia, thrombocytopenia; hyperkalemia, hypoglycemia, hyponatremia, thirst; insomnia; headache, lightheadedness, numbness of limbs/tongue, sleepiness, syncope, vertigo, abnormal taste; abnormal vision; atrial fibrillation, bradycardia, extrasystole, palpitation; hypotension, shock, hot flushes; cough, epistaxis, interstitial pneumonia, sinusitis; anorexia, constipation, diarrhea, epigastric pain, gastric ulcer, nausea, stomach discomfort, stomatitis, vomiting; abnormal hepatic function, hepatitis, jaundice; angioedema, eczema, photosensitivity, pruritus, rash, urticaria; arthralgia, myalgia, rhabdomyolysis; renal impairment/failure, proteinuria, pollakiuria; edema, fatigue, fever, malaise, lumbar pain, weakness; increases in serum K, serum creatinine, BUN, AST, ALT, alkaline phosphatase, γ-glutamyl transpeptidase, lactic dehydrogenase, creatinine phosphokinase, c-reactive protein, total cholesterol, serum uric acid; decreases in serum total protein, Hb.

May increase serum K w/ K-sparing diuretics/K supplements/salt substitutes. Reversible increases in lithium conc & toxicity. Reduced antihypertensive effect w/ NSAIDs (ie, COX-2 inhibitors, aspirin >3 g/day); increased risk of worsening of renal function (including possible acute renal failure) & increase in serum K, particularly in patients w/ poor preexisting renal function. Increased risk of hypotension, hyperkalemia & changes in renal function (including acute renal failure) w/ ACE inhibitors or aliskiren. May enhance antihypertensive effect w/ diuretics.

Angiotensin II Antagonists

C09CA06 - candesartan ; Belongs to the class of angiotensin II receptor blockers (ARBs). Used in the treatment of cardiovascular disease.

Rx