Generic
Candesartan Cilexetil + Hydrochlorothiazide
1 brands available in the market
At a glance
Candesartan Cilexetil + Hydrochlorothiazide is a combination medication used in the treatment of hypertension and congestive heart failure. Candesartan blocks angiotensin II receptors to dilate blood vessels, and Hydrochlorothiazide acts as a diuretic to remove excess water and salt from the body, lowering blood pressure.
Description
Candesartan Cilexetil + Hydrochlorothiazide is a combination medication used for hypertension and congestive heart failure. It contains Candesartan Cilexetil (an angiotensin II receptor blocker) and Hydrochlorothiazide (a thiazide diuretic).
Candesartan Cilexetil is an ester prodrug that is hydrolysed to active Candesartan during absorption. It blocks AT1 receptors, inhibiting the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in distal tubules, increasing excretion of sodium, water, and potassium. The combination effectively controls blood pressure.
Indications
- Hypertension
- Congestive heart failure
Therapeutic class
Combined antihypertensive preparations
Pharmacological class
Angiotensin II Receptor Blocker + Thiazide Diuretic Combination
Pharmacology
Candesartan Cilexetil is a prodrug that is converted to active Candesartan after absorption. Candesartan blocks AT1 receptors, inhibiting the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Hydrochlorothiazide inhibits Na⁺ and Cl⁻ reabsorption in distal tubules, increasing excretion of Na⁺, water, and K⁺ and H⁺ ions, reducing plasma volume and lowering blood pressure. Coadministration of Candesartan tends to reverse the potassium loss associated with Hydrochlorothiazide.
Mechanism of action
Candesartan blocks AT1 receptors, preventing the vasoconstrictive effects of angiotensin II and dilating blood vessels. Hydrochlorothiazide acts as a diuretic, removing excess water and salt from the body to lower blood pressure.
Dosage
Adults: 1 tablet once daily (Candesartan 16-32 mg/HCTZ 12.5-25 mg).
Elderly: No dosage adjustment needed.
Hepatic impairment: Mild-moderate: Dose titration recommended; Severe hepatic impairment and/or cholestasis: Do not use.
Renal impairment: Mild-moderate (CrCl 30-80 mL/min/1.73 m²): Dose titration recommended; Severe (CrCl <30 mL/min/1.73 m²): Do not use.
Children: Safety and efficacy have not been established.
Administration
May be taken with or without food, preferably at a fixed time each day. Avoid taking within 4 hours of bedtime to prevent frequent urination at night. Swallow tablets whole; do not chew, crush, or break. Follow the dose and duration as advised by your physician.
Missed dose
If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not double the dose.
Side effects
Common side effects: Headache, dizziness, fatigue, nausea, diarrhea, abdominal pain, taste change, decreased blood pressure, increased uric acid, electrolyte imbalance, glucose intolerance, increased blood lipids.
Upper respiratory tract infection, back pain, influenza-like symptoms (side effects are generally mild and transient; overall incidence comparable to placebo).
Serious (rare): Angioedema, hyperkalemia, renal failure, hyponatremia.
Precautions & warnings
- May cause dizziness; rise slowly from sitting or lying position.
- Drink plenty of fluids to prevent dehydration; inform your doctor if you develop extreme thirst, very dry mouth, or muscle weakness.
- Do not use potassium supplements or salt substitutes without your doctor's advice (risk of hyperkalemia).
- Not recommended during pregnancy and lactation (Category D).
- Do not stop suddenly (may cause rebound hypertension).
- Avoid alcohol consumption (increases risk of hypotension and dizziness).
- Diabetic patients should monitor blood glucose regularly (may cause glucose intolerance).
Contraindications
- Hypersensitivity to any component
- Anuria
- Hypersensitivity to other sulfonamide-derived drugs
- Severe hepatic impairment and/or cholestasis
- Severe renal impairment (CrCl <30 mL/min/1.73 m²)
- Pregnancy and lactation
Drug interactions
- NSAIDs: May reduce antihypertensive, diuretic, and natriuretic effects and cause deterioration of renal function (including acute renal failure).
- Lithium: May increase serum lithium concentration.
- Potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium: Increased risk of hyperkalemia.
- Aliskiren (in diabetic patients): Increased risk of renal impairment, hypotension, and hyperkalemia (potentially fatal).
- Alcohol, barbiturates, narcotics: Potentiation of orthostatic hypotension.
- Antidiabetic drugs (oral agents and insulin): Dosage adjustment may be required.
- Other antihypertensive drugs: Additive effect or potentiation.
- Skeletal muscle relaxants (tubocurarine): Possible increased responsiveness to the muscle relaxant.
Food interactions
Alcohol may cause excessive drowsiness and hypotension; avoid alcohol consumption.
Use in pregnancy
Unsafe during pregnancy (Category D). Definite evidence of risk to the developing baby. Discontinue as soon as pregnancy is detected. May be used in life-threatening situations if benefits outweigh risks.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Probably safe during breastfeeding (if prescribed). Limited human data suggests the drug does not pose significant risk to the baby. However, use during pregnancy and lactation is not recommended.
Pediatric use
Safety and efficacy in pediatric patients have not been established.
Geriatric use
No dosage adjustment needed for elderly patients.
Renal / hepatic impairment
Hepatic impairment: Mild-moderate: Dose titration recommended; Severe hepatic impairment and/or cholestasis: Do not use.
Overdose effects
Overdose symptoms: Severe hypotension, dizziness, tachycardia, electrolyte imbalance (hypokalemia, hyponatremia), renal failure. Treatment: Gastric lavage, IV fluids, vasopressors, electrolyte monitoring. Consult your doctor immediately if overdose is suspected.
Storage conditions
Store in a cool and dry place, protected from light and moisture. Keep out of reach of children.
Chemical structure
Candesartan Cilexetil + Hydrochlorothiazide