candesartan

C09CA06

Forms & Strengths

Adult Dosing

Hypertension: Initial 16 mg once daily; maintenance 8-32 mg once daily or divided in two doses
Heart Failure (NYHA Class II-IV): Initial 4 mg once daily, target 32 mg once daily (doubled at intervals of at least 2 weeks)

Pediatric Dosing

Hypertension (Children 1 to <6 years): 0.2 mg/kg/day initially, range 0.05-0.4 mg/kg/day
Hypertension (Children 6 to 17 years, <50 kg): Initial 4-8 mg once daily, max 16 mg daily
Hypertension (Children 6 to 17 years, >=50 kg): Initial 8-16 mg once daily, max 32 mg daily

Indications

Treatment of hypertension in adults and children >=1 year
Management of heart failure (NYHA Class II-IV) with left ventricular systolic dysfunction (LVEF <=40%) to reduce cardiovascular death and heart failure hospitalization

Mechanism of Action

Selective antagonist of angiotensin II AT1 receptor, blocking vasoconstriction and aldosterone-secreting effects of angiotensin II in vascular smooth muscle, adrenal glands, and other tissues

Contraindications

Hypersensitivity to candesartan or any component
Concomitant use with aliskiren in patients with diabetes mellitus
Pregnancy (direct toxicity to renin-angiotensin system can cause fetal injury and death)

Adverse Reactions

Drug Interactions

Non-steroidal anti-inflammatory drugs (NSAIDs) may increase risk of worsening renal function and attenuate antihypertensive effect
Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may increase risk of hyperkalemia
Lithium: increased serum lithium concentrations and risk of lithium toxicity
Dual blockade of the renin-angiotensin-aldosterone system with ACE inhibitors, ARBs, or aliskiren increases risk of hypotension, hyperkalemia, and renal changes

Curated Content: Needs Vetting Before Put to Clinical Use