Candesartan Cilexetil
Indications
Candesartan Cilexetil is indicated for hypertension, heart failure with impaired left ventricular systolic function.
Pharmacology
Candesartan Cilexetil is an ester prodrug
that is hydrolysed in the body to the active form Candesartan during
absorption from the gastro-intestinal tract. Candesartan is angiotensin
II receptor (type AT1) antagonist. 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 (eg, vascular smooth muscle, adrenal gland).
Dosage & Administration
Hypertention: initially 8
mg (hepatic impairment 2 mg, renal impairment or intravascular volume
depletion 4 mg) once daily, increased if necessary at intervals of 4
weeks to max 32 mg once daily; usual maintenance dose 8 mg once daily.
Heart failure: initially 4 mg once daily, increased at intervals of at least 2 weeks to target dose of 32 mg once daily or to max tolerated dose.
Heart failure: initially 4 mg once daily, increased at intervals of at least 2 weeks to target dose of 32 mg once daily or to max tolerated dose.
Interaction
No significant drug interactions have been
reported in studies of Candesartan Cilexetil given with other drugs such
as glyburide, nifedipine, digoxin, warfarin, hydrochlorothiazide and
oral contraceptives in healthy volunteers. Because candesartan is not
metabolised by the cytochrome P-450 system and has no effects on P-450
enzymes, interactions with drugs that inhibit, or are metabolised by,
those enzymes could not be expected.
Contraindications
Hypersensitivity to any component of this product. Pregnancy, breast-feeding, cholestasis.
Side Effects
Side-effects are usually mild. Symptomatic
hypotension including dizziness may occur, particularly in patients with
intravascular volume depletion (e.g. those taking high dose diuretics).
Hyperkalemia occurs occassionally; angioedema has also been reported
with some angiotension II receptor antagonist. Also vertigo, headache;
rarely hepatitis, blood disorders, hyponatraemia, back pain, arthralgia,
myalgia, rash, urticaria, pruritous.
Pregnancy & Lactation
When pregnancy is detected, Candesartan Cilexetil should be discontinued as soon as possible. It should be used in lactation.
Precautions & Warnings
Candesartan should be used with caution in
renal artery stenosis, aortic or mitral valve stenosis and in
obstructive hypertropic cardiomyopathy. Monitoring of plasma-potassium
concentration is advised, particularly in the elderly and in patients
with renal impairment; lower initial doses may be appropriate in these
patients.
Use in Special Populations
Use in pediatric: Safety and effectiveness in pediatric patients have not been established.
Therapeutic Class
Angiotensin-ll receptor blocker
Storage Conditions
Store in a cool & dry place. Protect from light and moisture
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