Atacand vs. Micardis for Heart Failure and Hypertension: Important Differences and Potential Risks.

Key takeaways

Candesartan (Atacand) and telmisartan (Micardis) are both angiotensin II receptor blockers (ARBs) used to treat high blood pressure. However, there are some differences between the two. Candesartan is available for both adults and children, while Telmisartan is only for adults. Telmisartan also has an additional use for lowering the risk of death, stroke, or heart attack in certain adults with heart problems, which is not a labeled use for candesartan. The typical starting dose for candesartan is 16 mg once daily, whereas for telmisartan, it's 40 mg once daily. Both medications can cause side effects like upper respiratory infections and back pain, but telmisartan may also cause leg pain and skin ulcers. Both medications are available as lower-cost generics and should be avoided during pregnancy due to potential harm to the unborn baby.

Candesartan

(Atacand)

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Telmisartan

(Micardis)

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Summary for Atacand

Prescription only

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.

Indications for Atacand

High blood pressure in adults and children
Lower the risk of worsening heart failure in adults

Pros and Cons for Atacand

Pros

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

Cons

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

Common Side Effects for Atacand

Upper respiratory tract infection (i.e., common cold; 6%)
Dizziness (4%)
Back pain (3%)

Warnings for Atacand

Harm to unborn baby
Low blood pressure
Kidney damage
High potassium levels

Summary for Micardis

Prescription only

Telmisartan (Micardis) is an angiotensin II receptor blocker (ARB). It's a prescription medication used to treat high blood pressure in adults. Telmisartan (Micardis) is also used to lower the risk of death or heart attack in certain people with heart problems. This medication is taken by mouth, typically once a day. Side effects aren't common, but people taking telmisartan (Micardis) have reported ones like upper respiratory infection and back pain.

Indications for Micardis

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)

Pros and Cons for Micardis

Pros

Available as a lower-cost generic medication
Typically taken once a day
Lowers the risk of heart attack or death due to heart problems in people with CAD
Less likely to cause dry cough compared to ACE inhibitors

Cons

Can’t take while pregnant
Might require regular blood work and lab tests to make sure your kidneys are functioning normally
Not safe for use in children
Can take up to 4 weeks to see the full effect on high blood pressure