Atacand (candesartan cilexetil) is an angiotensin II receptor blocker (ARB) indicated for the treatment of hypertension in adults. It works by blocking the action of certain natural substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication may be used alone or in combination with other antihypertensive agents, offering a well-tolerated option for long-term management of high blood pressure. Clinical studies have demonstrated its efficacy in reducing cardiovascular morbidity and mortality, particularly in patients with left ventricular hypertrophy.

Features

• Active ingredient: Candesartan cilexetil
• Available in tablet strengths: 4 mg, 8 mg, 16 mg, 32 mg
• Administration: Oral, once or twice daily
• Onset of action: Within 2 weeks, with full effect at 4 weeks
• Half-life: Approximately 9 hours
• Excretion: Primarily renal and biliary

Benefits

• Effectively lowers systolic and diastolic blood pressure
• Reduces risk of stroke, myocardial infarction, and cardiovascular death
• Demonstrates renal protective effects in patients with type 2 diabetes and nephropathy
• Well-tolerated profile with low incidence of side effects
• Once-daily dosing supports treatment adherence
• May be used as monotherapy or in combination with other antihypertensives

Common use

Atacand is primarily prescribed for the management of hypertension. It is also indicated to reduce cardiovascular mortality in clinically stable patients with symptomatic heart failure with reduced ejection fraction (NYHA class II-IV), when used in combination with standard therapy. Additionally, it is used for the treatment of diabetic nephropathy in type 2 diabetic patients with hypertension and evidence of renal impairment, particularly those with proteinuria.

Dosage and direction

The recommended initial dose for hypertension is 16 mg once daily when used as monotherapy. Dosage may be increased to 32 mg once daily based on blood pressure response. For patients with intravascular volume depletion, consider starting with 8 mg once daily. For heart failure, the recommended initial dose is 4 mg once daily, which may be doubled at intervals of at least 2 weeks to the target maintenance dose of 32 mg once daily as tolerated. Tablets should be swallowed whole with a glass of water, with or without food.

Precautions

Monitor renal function and electrolytes periodically, particularly in patients with renal impairment, heart failure, or those receiving concomitant diuretics. Use caution in patients with hepatic impairment, as candesartan exposure may be increased. Avoid use in pregnancy due to potential fetal harm. Monitor for hypotension, especially after initiation or dose escalation. Exercise caution in patients with bilateral renal artery stenosis or solitary kidney. Regularly assess blood pressure and adjust dosage accordingly.

Contraindications

Hypersensitivity to candesartan or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Pregnancy (second and third trimesters). Severe hepatic impairment. Bilateral renal artery stenosis. History of angioedema related to previous ACE inhibitor or ARB therapy.

Possible side effects

Common adverse reactions (≥2%) include: dizziness, upper respiratory tract infection, pharyngitis, rhinitis, back pain, headache. Less frequent side effects may include: hyperkalemia, increased serum creatinine, orthostatic hypotension, fatigue, gastrointestinal disturbances. Rare but serious adverse effects include: angioedema, renal impairment, hepatotoxicity, and severe hypotension.

Drug interaction

Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may increase risk of hyperkalemia. NSAIDs may reduce antihypertensive effect and increase risk of renal impairment. Lithium levels may increase when co-administered with Atacand. Dual blockade of the renin-angiotensin system with ACE inhibitors or aliskiren increases risk of hypotension, hyperkalemia, and renal impairment.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent blood pressure control.

Overdose

Symptoms may include hypotension, tachycardia, bradycardia, dizziness, and renal failure. Management involves supportive care with volume expansion with normal saline. Hemodialysis may be considered, though candesartan is not significantly removed by dialysis. Monitor vital signs and electrolyte balance closely.

Storage

Store at room temperature (20-25°C or 68-77°F) in original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual response to medication may vary, and proper medical supervision is essential for safe and effective treatment.

Reviews

Clinical trials demonstrate Atacand’s efficacy in blood pressure reduction with 65-70% of patients achieving target blood pressure goals. Long-term studies show consistent maintenance of antihypertensive effect over 24 months. Patient satisfaction surveys indicate good tolerability and convenience of once-daily dosing. Real-world evidence supports its effectiveness in diverse patient populations, including elderly patients and those with comorbid conditions.