1 tablet 8mg

40 cents

  • Hypertension

  • Congestive heart failure (Note: Candesartin cilexetil is indicated for the treatment of heart failure (NYHA class II-IV) in patients with left ventricular systolic dysfunction (ejection fraction <40%) to reduce cardiovascular death and to reduce heart failure hospitalizations. Candesartin cilexetil also has an added effect on these outcomes when used with an ACE inhibitor.)

PO / NG:
Atacand 4mg (white), 8mg (light pink), 16mg (pink), 32mg (pink)
Crush tablets for NG administration


ADULT DOSE
PO/NG:
Initially 4mg once daily, increasing gradually to 32mg once daily

PAEDIATRIC DOSE
0.1-0.3mg/kg daily
Note: Safety and effectiveness in paediatric patients have not been established.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Dose in renal impairment [GFR (ml/min)]
<10 initial dose 2mg and increase dose according to response
10-20 initial dose 2mg and increase dose according to response
>20-50 dose as in normal renal function

Dose in renal replacement therapy
CAPD initial dose 2mg and increase dose according to response
HD initial dose 2mg and increase dose according to response
CVVHDF initial dose 2mg and increase dose according to response

Candesartan cilexetil (atacand) is a prodrug which is hydrolysed to candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist.

CONTRAINDICATIONS:

  • Hypersensitivity to candesartan (atacand)

  • Cardiogenic shock


WARNINGS
Hypotension in Heart Failure Patients
Caution should be observed when initiating therapy in patients with heart failure. Patients with heart failure given candesartin cilexetil commonly have some reduction in blood pressure. In patients with symptomatic hypotension this may require temporarily reducing the dose of candesartin cilexetil, or diuretic, or both, and volume repletion
Impaired Hepatic Function
A lower initiating dose should be considered for patients with moderate hepatic impairment.
Hyperkalaemia
In heart failure patients treated with candesartin cilexetil, hyperkalaemia may occur, especially when taken concomitantly with ACE inhibitors and potassium-sparing diuretics such as spironolactone.

PRECAUTIONS
General
See WARNINGS

Laboratory Tests:
No tests additional to standard ICU investigations are required

Drug/Laboratory Test Interactions :
None known

An increase in serum lithium concentration has been reported during concomitant administration of lithium with candesartan cilexetil, so careful monitoring of serum lithium levels is recommended during concomitant use.

Body as a Whole:
Asthenia, fever.
Nervous System:
Paraesthesia, vertigo.
Gastrointestinal System:
Dyspepsia, gastroenteritis.
Cardiovascular System:
Tachycardia, palpitation, hypotension.
Metabolic and Nutritional System:
Creatine phosphokinase increased, hyperglycaemia, hypertriglyceridaemia, hyperuricaemia.
Musculoskeletal System:
Myalgia.
Respiratory System:
Dyspnea.
Urinary System:
Haematuria.

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