Finil Special Precautions

Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected.
May cause hyperkalemia; avoid potassium supplementation unless specifically required by healthcare provider. Avoid use or use a smaller dose in patients who are volume depleted; correct depletion first. May be associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow (eg, renal artery stenosis, heart failure) whose glomerular filtration rate (GFR) is dependent on efferent arteriolar vasoconstriction by angiotensin II; deterioration may result in oliguria, acute renal failure, and progressive azotermia. Small increases in serum creatinine may occur following initiation; consider discontinuation only in patients will progressive and/or significant deterioration in renal function. Use with caution in unstented unilateral/bilateralrenal artery stenosis, preexisting renal insufficiency, or significant aortic/mitral stenosis. Systemic exposure increases in hepatic impairment. U.S. manufacturer labeling recommends a dosage adjustment in patients with moderate hepatic impairment; pharmacokinetics have not been studied in severe hepatic impairment. Use caution when initiating in heart failure; may need to adjust dose, and/or concurrent diuretic therapy, because of candesartan­ induced hypotension. In surgical patients on chronic angiotensin receptor blocker (ARB) therapy, intraoperative hypotension may occur with induction and maintenance of general anesthesia. Potentially significant drug-drug inte­ractions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Pediatric patients with a GFR <30 mL/minute/1.73 m² should not receive candesartan; has not been evaluated. Avoid use in infants <1 year of age due to potential effects on the development of immature kidneys.