How it works
Candesartan Cilexetil: Candesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is, therefore, independent of the pathways for angiotensin II synthesis.Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used in the treatment of hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because candesartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Candesartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation. Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic. Thiazides affect the renal tubular mechanisms of electrolyte reabsorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. Indirectly, the diuretic action of hydrochlorothiazide reduces plasma volume, with consequent increases in plasma renin activity, increases in aldosterone secretion, increases in urinary potassium loss, and decreases in serum potassium. The renin-aldosterone link is mediated by angiotensin II, so co-administration of an angiotensin II receptor antagonist tends to reverse the potassium loss associated with these diuretics. The mechanism of the antihypertensive effect of thiazides is unknown.
Generics
Candesartan Cilexetil , Hydrochlorothiazide
used for
Hypertension
Indication
Candesartan Cilexetil + Hydrochlorothiazide is indicated for the treatment of hypertension. The fixed dose combination is not indicated for initial therapy.
Side Effects
Common : Back pain, dizziness, flu-like symptoms, headache, upper respiratory infection.Less Common : Abdominal pain, change in amount of urine, increased sweating, unusual thirst, fainting, gastrointestinal disorders, mood swings.Rare : Persistent sore throat, cough, fever, unusual fatigue, unusual bleeding or bruising, pale skin and eyes, dark urine, chest pain, irregular heartbeats, joint pain.
Dosage
The usual starting dose of Candesartan Cilexetil + Hydrochlorothiazide is one tablet per day with or without food. To minimize dose dependent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy. Dose Titration : A patient whose blood pressure is not controlled on 25mg of hydrochlorothiazide once daily can expect an incremental effect from Candesartan Cilexetil + Hydrochlorothiazide. A patient whose blood pressure is controlled on 25mg of hydrochlorothiazide but is experiencing decreases in serum potassium can expect the same or incremental blood pressure effects from Candesartan Cilexetil + Hydrochlorothiazide and serum potassium may improve. Hepatic Impaired Patients: The usual regimens of therapy with Candesartan Cilexetil + Hydrochlorothiazide may be followed in patients with mild hepatic impairment. In patients with moderate hepatic impairment, consideration should be given to initiation of Candesartan Cilexetil at a lower dose, such as 8mg. If a lower starting dose is selected for candesartan cilexetil, Candesartan Cilexetil + Hydrochlorothiazide is not recommended for initial titration because the appropriate initial starting dose of candesartan cilexetil cannot be given. Always consult to your doctor or pharmacist for dose adjustments.
Storage yes or /no
Store this medicine at room temperature, away from direct light and heat.
Precautions
In patients with an activated renin-angiotensin system, such as volume and/or salt-depleted patients (e.g., those being treated with diuretics), symptomatic hypotension may occur. These conditions should be corrected prior to administration , or the treatment should start under close medical supervision.