Candesartan

For adults with high blood pressure, the usual recommended starting dose of candesartan is 16 mg once daily. Reductions in blood pressure are often seen within 2 weeks, and the full effects on blood pressure are seen in about 4 weeks. Your doctor may decide to increase the dose to 32 mg once a day if your blood pressure has not decreased enough. A diuretic (water pill) may also be added to help reduce blood pressure.

For children with high blood pressure, the dose of candesartan is based on body weight. The usual starting dose for children weighing less than 50 kg is 4 mg once daily. This dose may be increased to a maximum daily dose of 8 mg. For children weighing more than 50 kg, the usual starting dose is 8 mg once daily. This dose may be increased to a maximum daily dose of 16 mg.

For adults with heart failure the usual recommended starting dose of candesartan is 4 mg once daily. Depending on how well you tolerate the medication, the dose may be doubled every 2 weeks to a maximum daily dose of 32 mg.

Candesartan should be taken at approximately the same time each day, with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Candesartan be taken exactly as prescribed by your doctor. If you miss a dose but remember within 12 hours, take it as soon as possible and continue with your regular schedule. If more than 12 hours have passed since your usual dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

It is important to take Candesartan regularly and to follow your doctor's instructions regarding monitoring your blood pressure to ensure that you receive the maximum benefit from the medication.

Store Candesartan at room temperature (in a dry place and not in the bathroom) in its original package and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; on occasion, it may cause a dry cough - contact your pharmacist or doctor if it becomes bothersome. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

4 mg
Each white, round, biconvex tablet debossed with “4” on one side and scored on the other side, contains 4 mg of candesartan cilexetil. Nonmedicinal ingredients: carrageenan, cornstarch, croscarmellose sodium, lactose monohydrate, magnesium stearate, and povidone.

8 mg
Each pink, mottled, round biconvex tablet, debossed with “8” on one side and scored on the other side, contains 8 mg of candesartan cilexetil. Nonmedicinal ingredients: carrageenan, cornstarch, croscarmellose sodium, ferric oxide red, lactose monohydrate, magnesium stearate, povidone, and titanium dioxide.

16 mg
Each pink, mottled, round biconvex tablet, debossed with “16” on one side and scored on the other side, contains 16 mg of candesartan cilexetil. Nonmedicinal ingredients: carrageenan, cornstarch, croscarmellose sodium, ferric oxide red, lactose monohydrate, magnesium stearate, povidone, and titanium dioxide.

32 mg
Each pink, round, biconvex scored tablet marked with "CD" above "32" on one side and an arrow logo on the other side, contains 32 mg of candesartan cilexetil. Nonmedicinal ingredients: carmellose calcium, corn starch, hydroxypropyl cellulose, iron oxide, lactose, magnesium stearate, and stearic acid.

Do not take candesartan if you:

• are allergic to candesartan or any of the ingredients of the medication
• are or planning to become pregnant
• are breastfeeding
• have Diabetes or moderate-to-severe Kidney Disease and are taking the medication Aliskiren
• have galactose intolerance or glucose malabsorption (a rare hereditary disease)

Candesartan should not be used in children less than 1 year of age.

There may be an interaction between candesartan and any of the following:

• Aldesleukin
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• aliskiren
• amifostine
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• angiotensin-converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• barbiturates (e.g., secobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Canagliflozin
• Celecoxib
• ciprofloxacin
• Cyclosporine
• Dipyridamole
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• drospirenone
• Eplerenone
• Guanfacine
• Heparin
• Hepatitis C antiviral combinations (e.g., ombitasvir - paritaprevir - ritonavir - dasabuvir, ombitasvir - paritaprevir - ritonavir)
• Hydralazine
• levodopa
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• Methylphenidate
• Minoxidil
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., Naproxen, Ibuprofen)
• other angiotensin receptor blockers (ARBs; e.g., Irbesartan, Losartan)
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• potassium supplements or medications that increase potassium in the blood
• Rituximab
• Ropinirole
• second-generation anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Duloxetine, Fluoxetine, Paroxetine, Sertraline)
• sodium phosphates
• tolcapone
• Tolvaptan
• Trimethoprim

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: Candesartan may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Kidney problems: Candesartan can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe Congestive Heart Failure). The use of diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase the risk of kidney problems for people already at risk. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how Candesartan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Candesartan, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of Candesartan.

Candesartan should not be taken by people with severely decreased kidney function.

Liver function: Candesartan is removed from the body by the liver. Rarely, it may cause liver problems. If you have liver disease or decreased liver function, discuss with your doctor how Candesartan may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Candesartan, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low Blood Pressure: Occasionally, a larger-than-expected decrease in blood pressure occurs after taking candesartan. In some cases, this happens after the first dose. It is more likely to occur if you take diuretics or the medication aliskiren, have a reduced salt intake, are on dialysis, or are experiencing diarrhea or vomiting. Blood pressure should be monitored more often in these situations. Those with low blood pressure or those just starting to take Candesartan should move slowly from a reclining to an upright position to reduce the risk of dizziness.

Potassium levels: Candesartan may affect potassium levels in the blood, especially when used for heart failure, or when taken with other medications called ACE inhibitors or diuretics such as Spironolactone. Your doctor will monitor your potassium levels while on Candesartan. Avoid using salt substitutes that contain potassium while you are taking candesartan.

Pregnancy: Candesartan may cause severe harm to a fetus and should not be used during pregnancy. If you discover you are pregnant while taking Candesartan, stop taking it and tell your doctor at once.

Women taking candesartan who are planning or trying to become pregnant should discuss other, more appropriate medications to control blood pressure with their doctor.

Breast-feeding: It is not known if candesartan passes into breast milk. If you are a breast-feeding mother and are taking Candesartan, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Candesartan have not been established for the treatment of hypertension in children less than 6 years of age and for the treatment of heart failure in children less than 18 years of age.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you remember missing a dose within 12 hours of the time it is usually taken, take it as soon as you remember, then take the next dose at the regularly scheduled time. If the dose is missed by more than 12 hours, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.