Candesartan is a widely used medication used for high blood pressure. It dilates the blood vessels, lowering blood pressure. Side effects can therefore be dizziness or too low blood pressure or even fainting. Often, candesartan is also combined with other antihypertensives such as beta-blockers or diuretics. Caution is advised when taking other medicines or kidney disease at the same time.
What is candesartan?
Candesartan is a drug used mainly for the treatment of high blood pressure (arterial hypertension) and heart failure (heart failure). Candesartan therefore belongs to the group of antihypertensives, in the jargon also called antihypertensive.
Candesartan is an active ingredient that is taken in the preform Candesartancilexetil in tablet form and is converted to the active drug candesartan in the gut.
Candesartan is distributed by different manufacturers and is therefore available under different trade names, for example under the name Atacand® or Blopress®.
The advantage over other drugs is that candesartan is relatively poor in many people with heart and blood pressure problems.
How does candesartan work?
Like many antihypertensive medications, candesartan has an antihypertensive effect via the renin-angiotensin-aldosterone system (RAAS). Above all, this system influences the metabolism of our kidneys, the salt metabolism and the width of our blood vessels.
Candesartan belongs to the subgroup of angiotensin II receptor antagonists. Angiotensin II is responsible for increasing arterial blood pressure through several mechanisms: more sodium salt is retained in the blood and vessels are narrowed.
The angiotensin II receptor antagonists, such as candesartan, suppress the action of the substance angiotensin II, thereby helping to keep blood pressure low. There are also other drugs from this group of drugs on the market, such as valsartan and losartan.
Side effects of candesartan
The side effects of candesartan therapy are mainly related to the vasodilating and hypotensive effects of candesartan. Side effects can be:
- Hypotension (low blood pressure)
- a headache
- Nausea and digestive problems
- kidney failure
- Change in blood salts, especially increase in potassium levels in the blood
Interactions of candesartan
Candesartan affects the salt metabolism in the blood, especially that of potassium. Therefore, it should only be used with caution when taking other medicines, which may also cause increased potassium levels in the blood. These include, for example, heparin or the antibiotic cotrimoxazole.
The antihypertensive effect and thus also the side effects of candesartan can be enhanced by other drugs with hypotensive properties, which is why here too attention must be paid to interactions.
4 typical contraindications of the active substance
The following contraindications apply to the use of candesartan:
- The product should not be used in case of hypersensitivity to candesartan or any of the other ingredients of the drug.
- Even those with severe hepatic impairment and congestion of bile (cholestasis) should not use candesartan to treat arterial hypertension.
- In addition, the use of the drug is discouraged in children under the age of one year.
- Caution is also advised in those with kidney disease or lack of fluids. Candesartan could then increase the kidney problems. Therefore candesartan should be used in these two cases only with close medical care.
Use and dosage of candesartan
Candesartan is available in the form of tablets. It is often prescribed for the long-term treatment of hypertension and taken for a period of several years. The medicine should be taken once daily with or without food.
The recommended starting dose of candesartan is 8 mg once daily in adults. On the other hand, children and adolescents aged 6 to 18 years should start with a lower dose of candesartan 4 mg per day.
The usual dosage in the course of therapy is between 8 and 32 mg a day, usually 8 to 16 mg candesartan once a day is sufficient.
When does the effect of candesartan occur? Most of the antihypertensive effect is achieved within 4 weeks.
Discontinuation of candesartan
If taking an antihypertensive drug such as candesartan is suddenly stopped, it can lead to a significant decrease in blood pressure and heart function.
Therefore, discontinuation is only recommended in close consultation with the attending physician. In addition, a slow dose reduction is more advisable than an abrupt withdrawal.
For example, a symptom of insufficiently treated heart failure may be weight gain. This may indicate that the body is storing water, especially in the case of heart problems. Such edema can cause a weight gain of 500 g to several kilos.
In these cases, the medication of blood pressure and heart failure should necessarily be checked again by a doctor and possibly converted or extended.
Alternatives to candesartan
Another active ingredient that is also used in the treatment of high blood pressure is ramipril. Ramipril contributes to the blockade of the renin-angiotensin-aldosterone system in a similar way as candesartan. It blocks the ACE receptor and thus dilates the blood vessels.
There are also beta-blockers (for example, bisoprolol and metaprolol) used to treat high blood pressure. They can be taken in addition to candesartan.
Frequently, candesartan is also combined with other drugs such as calcium channel antagonists (for example amlopdipine) or diuretics (for example hydrochlorothiazide).