Candesartan (Atacand) is an angiotensin II receptor blocker (ARB). It's one of the first-choice medication for treating high blood pressure in adults and children. It can also help lower the risk of worsening heart failure in adults. Candesartan (Atacand) comes as a tablet that's taken by mouth, typically once or twice daily. Most people don't experience many side effects while taking this medication, but some can include upper respiratory tract infections, headache, and back pain.
High blood pressure in adults and children
Lower the risk of worsening heart failure in adults
Candesartan (Atacand) is an angiotensin II receptor blocker (ARB). It lowers blood pressure by blocking angiotensin II, a hormone that's naturally found in the body.
Angiotensin II typically raises your blood pressure by squeezing the blood vessels. It also tells your body to release another hormone called aldosterone. Aldosterone raises the amount of water your body absorbs, which also raises your blood pressure.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Arm, back, or jaw pain
bleeding gums
chest pain or discomfort
chest tightness or heaviness
chills
cough or hoarseness
dizziness
fainting
fast or irregular heartbeat
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
lightheadedness
lower back or side pain
nosebleeds
pain or discomfort in the arms, jaw, back, or neck
painful or difficult urination
shortness of breath
sweating
swelling of the feet or lower legs
vomiting
Incidence not known
Abdominal or stomach pain
black, tarry stools
bloody urine
coma
confusion
convulsions
dark urine
decreased urine output
difficult or troubled breathing
general feeling of tiredness or weakness
headache
hives or welts
increased blood pressure
increased thirst
light-colored stools
loss of appetite
muscle pain or cramps
nervousness
numbness or tingling in the hands, feet, or lips
pale skin
redness of the skin
skin rash
sores, ulcers, or white spots on the lips or in the mouth
swelling of the face, ankles, or hands
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal or stomach pain
weakness or heaviness of the legs
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
First-choice medication for high blood pressure
Works similarly to angiotensin-converting enzyme (ACE) inhibitors, but with fewer side effects, like cough and swelling
Can be made into an oral suspension for people who have trouble taking tablets
A possible option for children
Must be avoided during pregnancy
Interacts with NSAIDs like ibuprofen (Advil)
Can take 4-6 weeks before you notice the full benefit
Can raise potassium levels as a side effect
Take candesartan (Atacand) with or without food at any time of day. If it hurts your stomach, taking it with food might help.
You might feel dizzy when you start taking candesartan (Atacand), and when the dose is raised. This should get better over time as you continue taking the medication and your body gets used to your new blood pressure.
Make sure to mark your calendar with your appointments to see your primary care provider (PCP) or cardiologist and to get any blood work done when you take candesartan (Atacand). Your care team will order tests (e.g., potassium level, kidney function, blood pressure) during treatment and might change your dose of candesartan (Atacand) based on your lab results.
After starting candesartan (Atacand), you'll probably start to notice a drop in blood pressure within 6 hours. But it can take 4-6 weeks to get the full blood pressure-lowering effect of the medication. Your prescriber will adjust your dose of candesartan (Atacand) to find a dose that works best for you. Continue taking candesartan (Atacand) as directed by your healthcare team.
It's recommended you measure and record your blood pressure at home and bring a record to your medical appointments. This will help your prescriber see how well the medication is working for you and guide any dose changes.
Take candesartan (Atacand) exactly as prescribed. Don't change your dose or suddenly stop taking the medication without talking to your prescriber first. Doing so can cause your blood pressure to rise quickly. If you want to stop candesartan (Atacand), ask your prescriber if it's safe to do so. You might need to lower your dose slowly over time before you can completely stop taking it.
Candesartan (Atacand) can raise your potassium levels, which can be serious. Ask your prescriber if you need to limit foods that are high in potassium. Contact your care team if you experience nausea, vomiting, or muscle weakness because these might be symptoms of high potassium levels.
Eating a healthy diet, including a low-salt diet, while taking candesartan (Atacand) can help control your blood pressure. Ask your care team to help you plan healthy meals, such as ones that include low-fat milk or yogurt, whole-grains, and vegetables.
Candesartan (Atacand) can interact with other medications, such as lithium (Lithobid) and other medications that can raise potassium. Make sure to tell your prescriber about all the medications you're taking before starting candesartan (Atacand). Also, don't start taking any new medications without talking to your prescriber or pharmacist first.
Don't take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), while taking candesartan (Atacand) unless your prescriber specifically said it was safe for you to do so. This is because taking NSAIDs and candesartan (Atacand) together can cause or worsen kidney problems.
Let your care team know if you're pregnant or thinking of becoming pregnant. Candesartan (Atacand) can cause severe harm to your unborn baby because it can affect how well an unborn baby's kidneys develop and work. Your care team can talk with you about safer medications to take during pregnancy.
Candesartan (Atacand) can pass into breast milk, but it's not clear how this might affect nursing babies. Talk to your prescriber about the risks and benefits if you're breastfeeding and taking candesartan (Atacand)
If you accidentally miss a dose of candesartan (Atacand), take it as soon as you remember. But if it's getting close to the time for your next dose, then skip the missed dose and take your next dose at your regularly scheduled time. Don't take two doses of candesartan (Atacand) at the same time to make up any missed doses because this can cause dangerously low blood pressure.
Candesartan (Atacand) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Don't take candesartan (Atacand) if you're pregnant because the medication can cause severe harm your unborn baby. This medication can affect how well the unborn baby's kidneys develop and work, which can be life-threatening.
Stop taking candesartan (Atacand) and let a member of your healthcare team know right away if you find out that you're pregnant during treatment. Discuss with your primary care provider or cardiologist about taking a different medication that's safer to treat your blood pressure if you're pregnant or thinking of becoming pregnant.
Risk factors: Not enough fluid in your body | Having diarrhea or vomiting for a long time | Low salt levels in your body | Taking higher doses of diuretic medications
Although rare, candesartan (Atacand) can cause your blood pressure to drop too much. This can make you feel dizzy, tired, or lightheaded. Having these symptoms of low blood pressure is more common when you first start candesartan (Atacand) or when your dose gets raised. You're also at risk if you're dehydrated or if you have medical conditions that cause you to become dehydrated, such as too much diarrhea or vomiting.
Make sure to stay well-hydrated. Be sure to sit down slowly while holding onto something if your blood pressure drops too much and you feel dizzy. Let your care team know if your blood pressure gets too low or if you feel dizzy, lightheaded, faint, tired, or confused while you're taking candesartan (Atacand). Get medical help right away if you fall and hit your head.
Risk factors: Severe heart failure | Kidney problems | Not enough fluid in your body | Taking other medications that can cause kidney damage
Although candesartan (Atacand) is sometimes used to protect the kidneys, it's also possible for the medication to affect your kidneys in a way that causes them to not work as well. This can happen to anyone. But the effects can be more serious in people with severe heart failure, people with certain kidney problems, or people who take medications that can worsen kidney function.
Your primary care provider or cardiologist might order lab tests every so often during treatment to make sure your kidneys are healthy and working properly. Your care team might recommend that you stop taking the medication if you develop kidney problems (or if your kidney problems worsen) while you're taking candesartan (Atacand). Let your primary care provider or cardiologist know if you're urinating less often than usual, as this could be a sign that your kidneys aren't working as well.
Risk factors: Taking other medications that can raise potassium levels | Kidney problems
ARBs like candesartan (Atacand) can cause high potassium levels. Your risk is higher if you take candesartan (Atacand) with other medications that can raise potassium, such as spironolactone (Aldactone) or eplerenone (Inspra). Tell your healthcare team right away if you experience signs of high potassium levels, such as nausea, muscle weakness, or abnormal heartbeat. You'll probably need your potassium levels checked. If left untreated, high potassium levels can be dangerous.
High blood pressure:
Adults:
The typical starting dose is 16 mg by mouth once daily. The typical maintenance dose ranges from 8 mg to 32 mg daily total, either taken once daily or split into smaller doses and taken twice daily.
Children (age 6 to 17 years old):
Less than 110 lbs (50 kg): The typical starting dose is 4 mg to 8 mg by mouth once daily. The typical maintenance dose ranges from 2 mg to 16 mg daily total, either taken once daily or split into smaller doses and taken twice daily.
110 lbs (50 kg) or more: The typical starting dose ranges is 8 mg to 16 mg by mouth once daily. The typical maintenance dose ranges from 4 mg to 32 mg daily total, either taken once daily or split into smaller doses and taken twice daily.
Children (age 1 to less than 6 years old):
Your child's pediatrician will determine the dose for your child based on their body weight. The usual starting dose is 0.2 mg/kg by mouth daily. The typical dose ranges from 0.05 mg/kg to 0.4 mg/kg by mouth daily.
Heart Failure:
Adults: The typical starting dose is 4 mg by mouth once daily. Your cardiologist will slowly raise your dose, usually ever 2 weeks. The typical recommended maintenance dose is 32 mg once daily.
Your dose might differ if you have kidney or liver problems.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Taking at the same time as aliskiren (Tekturna) in people with diabetes
High blood pressure in adults and children
Lower the risk of worsening heart failure in adults
Lower the risk of stroke in people with high blood pressure who have a thickened heart (left ventricular hypertrophy)
Slow down the worsening of kidney problems in people with Type 2 diabetes and high blood pressure
Lowering the risk of death, stroke, or heart attack in certain adults 55 years or older with a history of heart problems (e.g., coronary artery disease)
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Drugs and Lactation Database (LactMed®). (2020). Candesartan.
Fridman, K. U., et al. (1999). Candesartan cilexetil in hypertension: effects of six weeks' treatment on haemodynamics, baroreceptor sensitivity and the renin-angiotensin-aldosterone system. Blood Pressure.
Kobori, H. (2013). Angiotensin II Blockade and Renal Protection. Current Pharmaceutical Design.
Montford, J. R., et al. (2017). How dangerous is hyperkalemia? Journal of the American Society of Nephrology
Saavedra, J. M., et al. (2010). BLOCKADE OF BRAIN ANGIOTENSIN II AT1 RECEPTORS AMELIORATES STRESS, ANXIETY, BRAIN INFLAMMATION AND ISCHEMIA: THERAPEUTIC IMPLICATIONS. Psychoneuroendocrinology.
U.S. Food & Drug Administration. (2017). FDA Drug Safety Communication: No increase in risk of cancer with certain blood pressure drugs--Angiotensin Receptor Blockers (ARBs).
You and Your Hormones. (2019). Angiotensin.
You and Your Hormones. (2021). Aldosterone.
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