Products
Candesartan is commercially available in tablet form (Atacand, Blopress, generics). It is also combined fixed with hydrochlorothiazide (Atacand plus, Blopress plus, generics). Candesartan has been approved in many countries since 1997. In 2020, a fixed combination with amlodipine was also released.
Structure and Properties
Candesartan (C24H20N6O3, Mr = 440.45 g/mol) is administered in the form of the prodrug candesartancilexetil, a white powder that is practically insoluble in water. Candesartancilexetil is an ester that is hydrolyzed to candesartan in the organism during absorption.
Effects
Candesartan (ATC C09CA06) has antihypertensive effects by abolishing the physiologic effects of angiotensin II. Angiotensin II is a peptide hormone directly involved in the development of hypertension. It has a potent vasoconstrictor effect and increases aldosterone release, which in turn causes increased water and sodium retention. The effects of candesartan are due to selective blockade of AT1 receptor.
Indications
For the treatment of essential hypertension (high blood pressure) and heart failure with impaired left ventricular systolic function.
Dosage
According to the SmPC. Candesartan may be administered once daily because of its long half-life of 9 hours. It is taken independently of meals. The usual daily dose for adults ranges from 8 to 32 mg.
Contraindications
- Hypersensitivity
- Severe liver dysfunction
- Cholestasis
- Pregnancy and lactation
- Hereditary angioedema, previous angioedema on sartans or ACE inhibitors.
- Combination with aliskiren in patients with diabetes mellitus or impaired renal function.
For complete precautions, see the drug label.
Interactions
Caution should be exercised with concomitant use of anticoagulants such as phenprocoumon. Lithium concentrations may potentially be increased. NSAIDs may attenuate the antihypertensive effects of candesartan, and other antihypertensive agents may potentiate the effects of candesartan.
Adverse Effects
The most common possible adverse effects include respiratory infections, drowsiness, dizziness, headache, low blood pressure (in heart failure), and back pain. Hyperkalemia, cough, renal impairment, and hepatic impairment occur rarely to very rarely.