Atacand (candesartan cilexetil) is an angiotensin II receptor blocker (ARB) prescribed for the management of hypertension and heart failure. It works by blocking the action of certain natural substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication is trusted by healthcare professionals worldwide for its proven efficacy in reducing cardiovascular risk and improving patient outcomes in appropriate clinical settings.

Features

• Active ingredient: Candesartan cilexetil
• Available in tablet form: 4 mg, 8 mg, 16 mg, 32 mg strengths
• Once-daily dosing for consistent 24-hour blood pressure control
• FDA-approved for hypertension and heart failure (NYHA Class II-IV)
• Demonstrated reduction in cardiovascular death and hospitalizations in heart failure patients

Benefits

• Effectively lowers high blood pressure, reducing strain on the heart and arteries
• Decreases risk of stroke, heart attack, and kidney problems associated with hypertension
• Improves survival and reduces hospitalizations in patients with heart failure
• Provides smooth 24-hour blood pressure control with once-daily dosing
• Generally well-tolerated with a favorable side effect profile
• Can be used alone or in combination with other antihypertensive agents

Common use

Atacand is primarily indicated for the treatment of hypertension in adults and children 1 year of age and older. It is also approved for the treatment of heart failure (NYHA class II-IV) in adults with left ventricular systolic dysfunction (ejection fraction ≤40%), to reduce cardiovascular death and to reduce heart failure hospitalizations. In clinical practice, it may be used off-label for certain renal protective effects in diabetic patients with proteinuria, though this use should be determined by a healthcare provider based on individual patient assessment.

Dosage and direction

Hypertension in adults: Initial dose is 16 mg once daily when used as monotherapy. Dosage may be increased to 32 mg once daily based on blood pressure response. Maximum dose: 32 mg daily.

Heart failure: Initial dose is 4 mg once daily. Double the dose at intervals of at least 2 weeks to the highest tolerated dose, up to 32 mg once daily, as tolerated.

Pediatric hypertension (1-17 years): Dose is based on body weight. Starting dose is 0.2 mg/kg (maximum 16 mg) once daily. Dose may be increased to 0.4 mg/kg (maximum 32 mg) once daily, then up to 0.6 mg/kg (maximum 32 mg) once daily as needed.

Take with or without food. Tablets should be swallowed whole with a glass of water. Dosage adjustments may be necessary for patients with renal impairment or hepatic impairment.

Precautions

• Monitor blood pressure regularly during therapy
• Assess renal function before and during treatment
• Use caution in patients with renal artery stenosis
• Monitor for hypotension, especially in volume-depleted patients
• Use with caution in patients with severe congestive heart failure
• May cause hyperkalemia; monitor potassium levels
• Not recommended during pregnancy due to potential fetal harm
• Use with caution in elderly patients who may have reduced renal function
• Avoid use in patients with biliary obstruction disorders
• May cause dizziness or lightheadedness; caution patients about driving or operating machinery

Contraindications

• Hypersensitivity to candesartan or any component of the formulation
• Concomitant use with aliskiren in patients with diabetes
• Pregnancy (second and third trimesters)
• Severe hepatic impairment
• Bilateral renal artery stenosis or stenosis to a solitary kidney

Possible side effect

Common side effects (≥1%):

• Dizziness
• Upper respiratory tract infection
• Back pain
• Pharyngitis
• Rhinitis

Less common side effects:

• Headache
• Fatigue
• Nausea
• Abdominal pain
• Diarrhea
• Hyperkalemia
• Increased serum creatinine
• Hypotension
• Rash
• Angioedema (rare)
• Increased liver enzymes

Drug interaction

• Potassium supplements or potassium-sparing diuretics: increased risk of hyperkalemia
• Lithium: increased lithium concentrations
• NSAIDs: may reduce antihypertensive effect and increase risk of renal impairment
• Other antihypertensive agents: additive hypotensive effects
• Aliskiren: increased risk of renal impairment, hypotension, and hyperkalemia (contraindicated in diabetes)
• Digoxin: monitoring recommended as candesartan may increase digoxin levels
• Warfarin: minor interaction reported

Missed dose

If a dose is missed, take it as soon as remembered on the same day. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent dosing timing for optimal blood pressure control.

Overdose

Symptoms may include hypotension, dizziness, tachycardia, bradycardia, and renal failure. In case of suspected overdose, seek immediate medical attention. Treatment is supportive and symptomatic. Hemodialysis may not be effective due to high protein binding. Monitor vital signs, electrolyte balance, and renal function closely.

Storage

Store at room temperature (20-25°C or 68-77°F). Keep in original container with lid tightly closed. Protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Do not store in bathroom or other humid areas.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual medical conditions and treatment responses may vary. Only a healthcare provider can determine the appropriate treatment based on individual patient characteristics and medical history.

Reviews

Clinical studies demonstrate Atacand’s efficacy in blood pressure reduction and heart failure management. In the CHARM program, candesartan reduced cardiovascular death by 12% and heart failure hospitalizations by 21% in patients with chronic heart failure. For hypertension, clinical trials show dose-dependent reductions in systolic and diastolic blood pressure. Patient satisfaction surveys indicate good tolerability and convenience of once-daily dosing. Many clinicians report positive experiences with Atacand as part of comprehensive cardiovascular risk management strategies.