Candesartan is a commonly used drug that is used to treat high blood pressure. It has a dilating effect on the blood vessels, so that the blood pressure is lowered as a result. Side effects can therefore be dizziness or even too low blood pressure to fainting. Candesartan is often combined with other antihypertensives such as beta-blockers or diuretics. Caution is advised if other medications are taken at the same time or if kidney disease is present.
What is candesartan?
Candesartan is a drug used mainly for the treatment of high blood pressure (arterial hypertension) and heart failure (congestive heart failure). Candesartan therefore belongs to the group of antihypertensives, also known as antihypertensives in technical terminology. Candesartan is an active ingredient that is taken in tablet form in its preform candesartancilexetil and is only converted into the active drug candesartan in the intestine. Candesartan is marketed by various manufacturers and is accordingly available under different trade names, for example Atacand or Blopress. The advantage over other agents is that candesartan has relatively few side effects in many sufferers with heart and blood pressure problems.
How does candesartan work?
Just like many antihypertensive medications, candesartan works to lower blood pressure via the renin-angiotensin-aldosterone system (RAAS). This system primarily influences the metabolism of our kidneys, salt metabolism and the widening of our blood vessels. Candesartan belongs to the subgroup of angiotensin II receptor antagonists. Angiotensin II is responsible for an increase in arterial blood pressure via various mechanisms: more sodium salt is retained in the blood and the vessels become narrow. Angiotensin II receptor antagonists such as candesartan suppress the effect of angiotensin II and thus help to keep blood pressure low. There are also other drugs in this class on the market, such as valsartan and losartan.
Side effects of candesartan
The side effects that may occur during therapy with candesartan are mainly related to candesartan’s vasodilating effect, which lowers blood pressure. Side effects may include:
- Dizziness
- Hypotension (low blood pressure)
- Headache
- Nausea and digestive problems
- Irritative cough
- Kidney failure
- Change in blood salts, especially increase in the level of potassium in the blood.
Candesartan interactions
Candesartan affects the metabolism of salts in the blood, especially potassium. Therefore, it should be taken only with caution with other medications that can also cause increased levels of potassium in the blood. These include, for example, heparin or the antibiotic cotrimoxazole. The antihypertensive effect and thus also the side effects of candesartan can be enhanced by other drugs with antihypertensive properties, which is why attention must be paid to interactions here as well.
4 Typical contraindications of the active substance
The following contraindications apply to the use of candesartan:
- The drug should not be used in case of hypersensitivity to candesartan or any of the other ingredients of the drug.
- Also, affected individuals with severe liver function impairment and bile stasis (cholestasis) should not use candesartan for the treatment of arterial hypertension.
- In addition, use of the drug is not recommended in children younger than one year of age.
- Caution is also advised in those with kidney disease or with fluid deficiency. Candesartan could then exacerbate kidney problems. Therefore, candesartan should be used in these two cases only with close medical supervision.
Candesartan use and dosage
Candesartan is available in the form of tablets. It is often prescribed for long-term therapy of hypertension and taken for a period of several years. The drug should be taken once daily with or without food. The recommended starting dose of candesartan is 8 mg once daily in adults. Children and adolescents between 6 and 18 years of age, however, should start with a lower dose of 4 mg of candesartan per day.The usual dosage in the course of therapy is between 8 and 32 mg a day; in most cases, 8 to 16 mg of candesartan once a day is sufficient. When does candesartan take effect? Most of the antihypertensive effect is obtained within 4 weeks.
Discontinuation of Candesartan
If the use of an antihypertensive drug such as candesartan is stopped suddenly, it may lead to a significant deterioration of blood pressure as well as heart function. Therefore, discontinuation is recommended only in close consultation with the treating physician. In addition, a slow reduction of the dose is more advisable than abrupt discontinuation. One symptom of inadequately treated heart failure can be weight gain, for example. Particularly in the case of heart problems, this may indicate that the body is storing water. Such edema can cause weight gain of 500 g to several kilos. In these cases, the medication of blood pressure and heart failure should definitely be checked again by a doctor and possibly changed or extended.
Alternatives to candesartan
Another agent that is also used in the treatment of hypertension is ramipril. Ramipril helps block the renin-angiotensin-aldosterone system in a similar way to candesartan. It blocks the ACE receptor and in this way dilates the blood vessels. There are also beta-blockers (for example, bisoprolol and metaprolol) that are used to treat high blood pressure. They can be taken in addition to candesartan. Candesartan is also often combined with other medications such as calcium channel antagonists (for example, amlopdipine) or diuretics (for example, hydrochlorothiazide).
