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Candesartan Cilexetil is a medicine used to treat high blood pressure and heart disease. Lowering blood pressure helps to prevent future heart attack and stroke. This medicine is also effective in preserving kidney function in patients with diabetes. Candesartan Cilexetil can be prescribed either alone or in combination with other medicines. It may be taken with or without food during the day or at night. However, try to take it at the same time each day to get the most benefit. It is important to continue taking it regularly even if you feel well or if your blood pressure is controlled. Most people with high blood pressure do not feel ill, but if you stop taking this medicine, your condition could get worse. This is a widely used medicine and is considered safe for long-term use. Making some changes in your lifestyle will also help lower your blood pressure. These may include regular exercise, losing weight, smoking cessation, reducing alcohol intake, and reducing the amount of salt in your diet as advised by your doctor. This medicine is tolerated well by most patients and has few side effects. Dizziness, particularly after the first dose, is known to occur in some people. This may be associated with headache. Let your doctor know if these side effects bother you or do not go away. No weight gain has been seen with the regular use of this medicine. Before taking this medicine, let your doctor know if you have any kidney or liver problems. Pregnant or breastfeeding mothers should also consult their doctor before taking it. Your doctor may check your kidney function, blood pressure and potassium levels in your blood at regular intervals while you are taking this medicine. Candesartan Cilexetil is an angiotensin receptor blocker (ARB). It relaxes the blood vessel by blocking the action of a chemical that usually makes blood vessels tighter. This lowers the blood pressure, allowing the blood to flow more smoothly to different organs and the heart to pump more efficiently.

• Hypertension (high blood pressure) • Heart failure • Prevention of heart attack and stroke

Candesartan inhibits the binding of angiotensin II to AT1 receptors in many tissues (e.g. vascular smooth muscles, adrenal gland) which leads to vasoconstriction blockade and aldosterone release.

Adult Dose: Oral Hypertension Adult: Initially, 8 mg once daily adjusted according to response. Maintenance: 8 mg once daily. Max: 32 mg/day as single or in 2 divided doses. Patients w/ intravascular volume depletion: Initially, 4 mg once daily. Heart failure Adult: Initially, 4 mg once daily, may be doubled at intervals of not <2 wk. Max: 32 mg once daily. Hepatic impairment: Mild to moderate: Initially, 4 mg once daily. Severe: Contraindicated. Child Dose: Oral Hypertension Child: 1 to 6 yr 50 kg: 8-16 mg/day, adjusted according response to 4-32 mg/day. All doses may be given as single or in 2 divided doses. Renal Dose: Renal Impairment No dose adjustment necessary for patients with mild renal impairment Initiate thearpy at lower dose if moderate renal impairment

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Candesartan Cilexetil may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose of Candesartan Cilexetil, skip it and continue with your normal schedule. Do not double the dose.

Common: • Dizziness • Back pain • Upper respiratory tract infection • Sore throat • Nasal congestion (stuffy nose)

[UNSAFE] Candesartan Cilexetil may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. It can make you feel dizzy for the first few days. Rise slowly if you have been sitting or lying down for a long time. Your doctor may get regular tests done to monitor the level of urea, creatinine, and potassium in your blood. Avoid taking anti-inflammatory medicines such as ibuprofen along with this medicine without consulting your doctor. Do not take Candesartan Cilexetil if you are pregnant or breastfeeding. Do not stop taking it suddenly without talking to your doctor.

Hypersensitivity. Pregnancy (2nd and 3rd trimester) and lactation.

NSAIDs may reduce antihypertensive effect and result in deterioration of renal function including possible acute renal failure. May increase serum lithium concentration. K-sparing diuretics, K supplements or salt substitutes containing K may increase risk of hyperkalaemia. Potentially Fatal: Coadministration w/ aliskiren in diabetic patients may increase risk of renal impairment, hypotension and hyperkalaemia.

[UNSAFE] It is unsafe to consume alcohol with Candesartan Cilexetil.

[CONSULT YOUR DOCTOR] Candesartan Cilexetil is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.

[SAFE IF PRESCRIBED] Candesartan Cilexetil is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[SAFE IF PRESCRIBED] Candesartan Cilexetil is safe to use in patients with kidney disease. No dose adjustment of Candesartan Cilexetil is recommended. However, talk to your doctor if you have any underlying kidney disease. Regular monitoring of blood pressure, kidney function test, and potassium levels may be advised. [CAUTION] Candesartan Cilexetil should be used with caution in patients with liver disease. Dose adjustment of Candesartan Cilexetil may be needed. Please consult your doctor. Use of Candesartan Cilexetil is not recommended in patients with severe liver disease.

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