Atacand

Atacand (candesartan cilexetil) is an angiotensin II receptor blocker (ARB) prescription medication designed for the treatment of hypertension (high blood pressure) and heart failure. It works by blocking the action of angiotensin II, a substance in the body that causes blood vessels to tighten, thereby relaxing blood vessels and allowing blood to flow more smoothly. This action helps to lower blood pressure, reduce the strain on the heart, and improve survival in certain heart failure patients when used as part of a comprehensive treatment plan under medical supervision.

Features

• Active ingredient: Candesartan cilexetil
• Drug class: Angiotensin II receptor blocker (ARB)
• Available in tablet form (multiple strengths: 4 mg, 8 mg, 16 mg, 32 mg)
• Once-daily oral administration
• Bioavailability: ~15% (following oral administration)
• Time to peak plasma concentration: 3–4 hours
• Elimination half-life: ~9 hours
• Primarily excreted unchanged in urine and feces
• Not significantly metabolized by the cytochrome P450 system

Benefits

• Effectively lowers high blood pressure, reducing the risk of strokes, heart attacks, and kidney problems.
• Improves survival and reduces hospitalizations in patients with heart failure when used in combination with other heart failure therapies.
• Provides 24-hour blood pressure control with a single daily dose, supporting consistent therapeutic coverage.
• Generally well-tolerated with a side effect profile comparable to placebo in many clinical studies.
• Does not usually cause a persistent dry cough, a common side effect associated with ACE inhibitors.
• Offers a valuable therapeutic option for patients who require an alternative or adjunct to ACE inhibitor therapy.

Common use

Atacand is primarily indicated for the management of hypertension in adults and children aged 1 year and older. It may be used alone or in combination with other antihypertensive agents. Additionally, it is approved for the treatment of heart failure (NYHA Class II–IV) in adults with reduced ejection fraction, to reduce cardiovascular death and hospitalization for heart failure. It is often incorporated into a broader treatment regimen that may include diuretics, digitalis, or beta-blockers, as determined by a healthcare provider based on individual patient assessment and clinical guidelines.

Dosage and direction

Dosage must be individualized based on the patient’s condition and response. For hypertension in adults, the usual starting dose is 16 mg once daily. The dosage can be increased to 32 mg once daily based on blood pressure response. For patients with possible volume depletion (e.g., those on diuretics), consider initiating therapy at 8 mg once daily. In pediatric hypertensive patients (aged 1 to <17 years), dosage is based on body weight. For heart failure, the recommended starting dose is 4 mg once daily. The target maintenance dose is 32 mg once daily, achieved by doubling the dose at intervals of at least 2 weeks as tolerated. Tablets should be taken with or without food, at approximately the same time each day.

Precautions

Monitor renal function and electrolytes in susceptible patients. Use with caution in patients with renal impairment, hepatic impairment, or bilateral renal artery stenosis. Volume- and/or salt-depletion should be corrected prior to administration to reduce the risk of symptomatic hypotension. Periodic assessment of serum potassium is recommended, especially in patients with impaired renal function or diabetes, and those using concomitant medications that may increase potassium. Not recommended during pregnancy due to potential risk of fetal injury or death. Use with caution in elderly patients, who may have increased sensitivity. Avoid use in patients with severe hepatic impairment.

Contraindications

Hypersensitivity to candesartan cilexetil or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Do not co-administer with ACE inhibitors in patients with diabetic nephropathy.

Possible side effect

Common side effects may include dizziness, upper respiratory tract infection, pharyngitis, rhinitis, back pain, and headache. Less frequently reported side effects include hyperkalemia, increased serum creatinine, fatigue, nausea, abdominal pain, diarrhea, and rash. Rare but serious side effects may include renal impairment, hypotension (especially in volume-depleted patients), angioedema (swelling of the face, lips, throat, or tongue), and elevated liver enzymes.

Drug interaction

Potassium supplements, potassium-sparing diuretics, salt substitutes containing potassium, or other drugs that may increase serum potassium (e.g., heparin) may lead to hyperkalemia. Concurrent use with NSAIDs (e.g., ibuprofen, naproxen) may diminish the antihypertensive effect and increase the risk of renal impairment. Use with lithium may increase lithium levels and risk of toxicity. Dual blockade of the renin-angiotensin system (e.g., with an ACE inhibitor) increases the risk of hypotension, hyperkalemia, and renal impairment.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is almost time for the next dose, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include hypotension, tachycardia, or bradycardia. Supportive treatment should be initiated, which may include intravenous normal saline. Hemodialysis may not be effective due to high protein binding.

Storage

Store at room temperature (20°C to 25°C/68°F to 77°F), with excursions permitted between 15°C and 30°C (59°F and 86°F). Keep in the original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

(Note: Fictional examples based on common clinical feedback patterns)

• “As a cardiologist, I have prescribed Atacand for over a decade. It offers consistent 24-hour BP control with a favorable side effect profile. My patients appreciate the once-daily dosing, and I value its proven outcomes in heart failure management.”
• “After struggling with a persistent cough on lisinopril, my physician switched me to Atacand. My blood pressure is now well-controlled without the bothersome side effect. It has been a reliable part of my regimen for three years.”
• “In my clinical practice, I find Atacand particularly useful in older hypertensive patients. It is generally well-tolerated and effective, though renal function must be monitored periodically, especially when used with diuretics.”
• “As part of a combination therapy for heart failure, Atacand has contributed to reduced hospitalization rates among my patients. The titration schedule is manageable, and most tolerate it well at the target dose.”