Atacand (candesartan cilexetil) is an angiotensin II receptor blocker (ARB) indicated for the treatment of hypertension in adults. It works by blocking the action of certain natural substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication may be used alone or in combination with other antihypertensive agents, offering a well-tolerated option for long-term management of high blood pressure. Proper use under medical supervision helps reduce the risk of strokes, heart attacks, and kidney problems.

Features

• Active ingredient: Candesartan cilexetil
• Drug class: Angiotensin II receptor blocker (ARB)
• Available in tablet form: 4 mg, 8 mg, 16 mg, 32 mg strengths
• Once-daily dosing for consistent 24-hour blood pressure control
• Bioavailability: ~15% (candesartan cilexetil is a prodrug hydrolyzed to active candesartan)
• Half-life: ~9 hours; duration of action extends beyond 24 hours
• Excretion: Primarily renal and biliary

Benefits

• Effectively lowers systolic and diastolic blood pressure with once-daily dosing
• Reduces cardiovascular morbidity and mortality in hypertensive patients
• Demonstrates renal protective effects, particularly in patients with type 2 diabetes and nephropathy
• Generally well-tolerated with a low incidence of side effects such as cough compared to ACE inhibitors
• Suitable for use as monotherapy or in combination with other antihypertensive agents
• Provides sustained 24-hour blood pressure control with smooth reduction and minimal peak-trough variation

Common use

Atacand is primarily prescribed for the management of hypertension. It may be used as initial therapy or added to existing treatment regimens when blood pressure remains uncontrolled. In some cases, it is indicated for the treatment of heart failure (NYHA Class II-IV) in combination with other heart failure therapies, as well as for renal protection in patients with type 2 diabetes and albuminuria. The medication is typically part of a comprehensive cardiovascular risk reduction strategy that may include lifestyle modifications.

Dosage and direction

The recommended initial dose for hypertension is 16 mg once daily when used as monotherapy. Dosage may be titrated to 32 mg once daily based on blood pressure response. For patients with intravascular volume depletion, consider starting with 8 mg once daily. For heart failure, the recommended initial dose is 4 mg once daily, which should be doubled at intervals of at least 2 weeks to the target maintenance dose of 32 mg once daily as tolerated. Tablets may be taken with or without food. Consistency in daily administration time is recommended.

Precautions

Monitor blood pressure regularly during therapy. Use with caution in patients with renal impairment, hepatic impairment, or renal artery stenosis. Periodic assessment of renal function is recommended. Volume-depleted patients (e.g., those receiving high-dose diuretics) may experience symptomatic hypotension; correct volume depletion prior to administration. Potassium levels should be monitored, particularly in patients with renal impairment or diabetes, and those taking potassium supplements or potassium-sparing diuretics. Not recommended during pregnancy due to potential fetal harm.

Contraindications

Hypersensitivity to candesartan or any component of the formulation. Concomitant use with aliskiren in patients with diabetes. Pregnancy (second and third trimesters). Severe hepatic impairment or biliary cirrhosis. Bilateral renal artery stenosis or stenosis to a solitary kidney.

Possible side effects

Common adverse reactions (≥2%) include: dizziness, upper respiratory tract infection, pharyngitis, rhinitis, back pain, headache. Serious but less frequent side effects may include: hypotension, hyperkalemia, renal impairment, angioedema (rare). Laboratory abnormalities may include elevated serum creatinine and BUN. Patients should report any symptoms of infection, unusual fatigue, swelling, or difficulty breathing to their healthcare provider.

Drug interaction

Potassium supplements, potassium-sparing diuretics, salt substitutes containing potassium (increased risk of hyperkalemia). NSAIDs may reduce antihypertensive effect and increase risk of renal impairment. Lithium levels may increase (monitor serum lithium levels). Dual blockade of the renin-angiotensin system with ACE inhibitors or aliskiren increases risk of hypotension, hyperkalemia, and renal impairment. Alcohol, barbiturates, or narcotics may potentiate hypotensive effect.

Missed dose

If a dose is missed, take it as soon as remembered on the same day. If it is near the time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent daily dosing for optimal blood pressure control.

Overdose

Symptoms may include hypotension, tachycardia, bradycardia, dizziness, and renal failure. Treatment is supportive and symptomatic. Correct hypotension by intravenous administration of normal saline. Hemodialysis may not be effective due to high protein binding. Monitor vital signs, electrolyte levels, and renal function closely. Contact poison control center or emergency medical services immediately.

Storage

Store at room temperature (20-25°C or 68-77°F) in the original container. Keep tightly closed and protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication according to local regulations.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual patient responses may vary. Proper diagnosis and monitoring by a physician are essential for safe and effective use. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions.

Reviews

Clinical studies demonstrate Atacand’s efficacy in blood pressure reduction with once-daily dosing. In randomized controlled trials, candesartan showed significant BP reduction compared to placebo and was non-inferior to other ARBs. Patient satisfaction surveys indicate good tolerability profile with low discontinuation rates due to adverse effects. Long-term studies support its cardiovascular and renal protective benefits, particularly in high-risk populations. Real-world evidence confirms its position as a well-established option in hypertension management algorithms.