Candesartan

It is a angiotensin II receptor (type AT1) antagonist and it acts by blocking the vasoconstrictor and aldosterone secreting effects of angiotensin II by selectively blocking the binding of angoitensin II to the AT1 receptor in many tissues such as vascular smooth muscle and the adrenal gland.

Indications

Treatment of hypertension either alone or in combination with other antihypertensive agents.

Dosage

Initially 16 mg once daily in patients who are not volume depleted. It may be given once or twice daily with total daily doses ranging from 8mg to 32mg.

Contra-Indications

-Hypersensitivity to candesartan or any component of the formulation -Pregnancy (especially in the second and third trimesters)

Special Precautions

Renal Impairment: Candesartan is primarily excreted by the kidneys. Patients with impaired renal function may require lower doses and careful monitoring due to the risk of accumulation and increased adverse effects. Monitor kidney function before and during treatment. Hepatic Impairment: In patients with mild to moderate hepatic impairment, a reduced dose may be necessary. Close monitoring is advised in these patients as they may have altered drug metabolism. Hypotension: Candesartan can cause hypotension, especially in patients who are volume-depleted (e.g., due to diuretic use, dehydration, or other medical conditions). Monitor blood pressure closely, particularly after initiating treatment or increasing the dose.

Side Effects

-Dizziness, nausea, diarrhoea, peripheral oedema, rhinitis, back pain, headache, URTI, coughing, fatigue, vomiting. -Rarely nausea, arthralgia, myalgia, angiooedema, rash have been observed.

Drug Interactions

No significant drug interactions have been reported when candesartan cilexetil is given with other drugs such as nifedipine, digoxin, warfarin, hydrochlorothiazide and oral contraceptives in healthy volunteers.