candesartan/hydrochlorothiazide

Action and Spectrum

Actions and Spectrum:

Lowering blood pressure: The combination of candesartan and hydrochlorothiazide works to lower blood pressure by reducing the amount of fluid in the blood vessels and relaxing the blood vessels.

Improving heart function: By reducing blood pressure, candesartan/hydrochlorothiazide can improve the heart’s function, which can be beneficial in treating certain heart conditions.

Reducing the risk of stroke: By lowering blood pressure, candesartan/hydrochlorothiazide can also help reduce the risk of stroke, which is a potential complication of high blood pressure.

The spectrum of candesartan/hydrochlorothiazide refers to the range of conditions the medication can treat. candesartan/hydrochlorothiazide is primarily used to treat high blood pressure, but it may also treat other conditions, such as heart failure or kidney disease.

Drug Interaction

Adverse Reaction

Frequency undefined:

1-10%:

Upper respiratory tract infection (4%)

Headache (3%)

Dizziness (3%)

Flu-like syndrome (2%)

Back pain (3%)

Frequency undefined:

candesartan

Peripheral edema

Dizziness

Diarrhea

Nausea

Arthralgia

Back pain Fatigue

Abdominal pain

Bronchitis

Coughing

Rhinitis

URI

Albuminuria

Chest pain

Pharyngitis

hydrochlorothiazide

Anorexia

Epigastric distress

Anaphylaxis

Anemia

Confusion

Erythema multiforme

Hypotension

Orthostatic hypotension

Photosensitivity

Dizziness

Headache

Stevens-Johnson syndrome

Exfoliative dermatitis necrolysis

Hyperuricemia

Hypokalemia/hypomagnesemia

Black Box Warning

Black Box Warning:

If pregnancy is detected, discontinue the dose as soon as possible. The drug affects the RAS, causing oligohydramnios. It may result in injury/death of the fetus.

Contraindication / Caution

Contraindication/Caution:

• Hypersensitivity: candesartan/hydrochlorothiazide is contraindicated in patients with a known hypersensitivity to any component of the medication.
• Severe renal impairment: candesartan/hydrochlorothiazide is contraindicated in patients with severe renal impairment (creatinine clearance <30 mL/min).
• Anuria: candesartan/hydrochlorothiazide is contraindicated in patients with anuria (no urine output).
• Severe hepatic impairment: candesartan/hydrochlorothiazide is contraindicated in patients with severe hepatic impairment.
• Pregnancy and lactation: candesartan/hydrochlorothiazide is not recommended for use during pregnancy or lactation, as it may cause harm to the developing fetus or nursing baby.
• Electrolyte imbalances: candesartan/hydrochlorothiazide may cause electrolyte imbalances, such as low levels of potassium, sodium, and magnesium, which can be dangerous for some patients.
• Gout: candesartan/hydrochlorothiazide may exacerbate gout in some patients, so caution should be exercised in patients with a history of gout.
• Diabetes: candesartan/hydrochlorothiazide may cause hyperglycemia (high blood sugar), so caution should be exercised in patients with diabetes.
• Renal artery stenosis: candesartan/hydrochlorothiazide should be used with caution in patients with renal artery stenosis, as it may exacerbate the condition.

Pregnancy / Lactation

Pregnancy consideration:

The drug is not safe during pregnancy. Discontinue the drug if pregnancy is achieved.

Breastfeeding warnings:

The drug is excreted in the breast milk. Breastfeeding is contraindicated during drug therapy.

Pregnancy category:

• Category A: well-controlled and satisfactory studies do not show risk to the fetus in the first/later trimester.      
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
• Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
• Category N: No data is available for the drug under this category.

Pharmacology

Pharmacology:

candesartan is an angiotensin II receptor blocker (ARB). It works by blocking the action of angiotensin II, a hormone that narrows blood vessels and increases blood pressure. By blocking the effects of angiotensin II, candesartan causes the blood vessels to dilate, which reduces blood pressure. candesartan is well absorbed from the gastrointestinal tract and reaches peak plasma concentrations about 3-4 hours after oral administration.

hydrochlorothiazide is a thiazide diuretic. It works by increasing the excretion of salt and water from the body, which reduces blood volume and lowers blood pressure. This medication is usually taken once a day in the morning to avoid disrupting sleep. Pharmacodynamics:

candesartan is an angiotensin II receptor blocker (ARB). It works by selectively blocking the action of angiotensin II on its receptors, which results in the following effects:

• Vasodilation: By blocking the vasoconstrictive effects of angiotensin II, candesartan causes the blood vessels to dilate, which results in a decrease in blood pressure.
• Decreased aldosterone secretion: Angiotensin II stimulates the release of aldosterone, a hormone that increases sodium and water reabsorption in the kidneys. By blocking the action of angiotensin II, candesartan reduces aldosterone secretion, which leads to increased sodium and water excretion, further reducing blood volume and blood pressure.

hydrochlorothiazide is a thiazide diuretic that works by inhibiting the reabsorption of sodium and chloride ions in the distal renal tubules, which results in the following effects:

• Increased urine volume: By increasing the excretion of sodium and chloride ions, hydrochlorothiazide causes an osmotic diuresis, which increases urine volume and decreases blood volume.
• Decreased blood pressure: The reduction in blood volume leads to decreased blood pressure.

Pharmacokinetics:

The pharmacokinetics of candesartan/hydrochlorothiazide are related to the individual pharmacokinetic profiles of its two active ingredients, candesartan, and hydrochlorothiazide.

candesartan is well absorbed from the gastrointestinal tract after oral administration, with a bioavailability of approximately 15%. It undergoes minimal first-pass metabolism in the liver, and most of the drug is excreted unchanged in the feces. The drug has a half-life of approximately 9 hours, and steady-state concentrations are reached within 2-3 days of regular dosing. candesartan is highly bound to plasma proteins, and the drug is primarily eliminated through biliary excretion.

hydrochlorothiazide is also well absorbed from the gastrointestinal tract after oral administration, with a bioavailability of approximately 60-80%. It is eliminated primarily by the kidneys and has a half-life of approximately 6-15 hours. The drug is highly bound to plasma proteins, which can accumulate in the body over time, increasing the risk of side effects.

Adminstartion

Administration:

candesartan/hydrochlorothiazide is typically administered orally, usually once daily. The medication is a tablet and should be taken with a full glass of water. Take the dose with or without food, but it is essential to take the medication consistently.

The dosage may vary depending on the patient’s medical history and response to treatment. The medication is typically started at a low dose, gradually increasing as needed to achieve the desired therapeutic effect. The maximum recommended dose is 32 mg/25 mg (candesartan/hydrochlorothiazide). Although lower doses may be appropriate for certain patients.

Patient Information Leaflet

Patient information leaflet

Generic Name: candesartan/hydrochlorothiazide

Pronounced: KAN-de-SAR-tan HYE-droe-KLOR-oh-THYE-a-zide

Why do we use candesartan/hydrochlorothiazide?

It is the medication used to treat high blood pressure in adults who require treatment with the same. High blood pressure can increase the risk of severe health complications such as stroke, heart attack, and kidney damage, so it is essential to manage it effectively.