Candesartan

Candesartan Brand Name– Atacand

What is Candesartan

Candesartan is an oral angiotensin II receptor antagonist, also known as an angiotensin II receptor blocker (ARB).

Candesartin is used for the treatment of hypertension and for the treatment of heart failure in adults. As once daily monotherapy in adults with hypertension, candesartan 8 mg is as effective as losartan 50 mg or enalapril 10 to 20 mg.

Three placebo-controlled studies have reported favorable findings for candesartan in adults with heart failure (NYHA Class II to IV) in the following subpopulations: 1) patients with LVEF 40%or less with prior intolerance to ACE inhibitors (CHARM-Alternative) , 2) patients with LVEF 40% or less and receiving ACE inhibitors (CHARM-Added), and 3) patients with LVEF more than 40% (CHARM-Preserved).

The CHARM-Overall program combined the results of these 3 studies; the program reported reduced cardiovascular mortality and CHF hospitalizations with candesartan use, regardless of the baseline ejection fraction.

Interestingly, the CHARM-Added trial demonstrated a significant reduction in cardiovascular mortality and CHF hospitalizations by adding candesartan to an ACE inhibitor in patients with heart failure and LVEF 40% or less.

These findings for combination angiotensin II antagonist and ACE inhibitor therapy are in contrast to the results of the VALIANT trial.

The VALIANT trial has reported that the combination of an ARB with captopril increased the rate of adverse events without improving survival, while demonstrating comparable efficacy of the ARB vs. captopril monotherapy in myocardial infarction adults with heart failure and/or left ventricular dysfunction.

In a prior heart failure trial, candesartan was evaluated in combination with enalapril versus enalapril alone or candesartan alone in adults with congestive heart failure (RESOLVED study); this trial was stopped 2 months early due to increased mortality rates in the candesartan groups compared to enalapril monotherapy.

Analysis of the RESOLVED data revealed mortality rates of 8.7% for candesartan and enalapril combination therapy, 6.1% for candesartan monotherapy, and 3.7% for enalapril monotherapy; however, these differences were not significant.

Candesartan was FDA-approved for the treatment of hypertension on June 5, 1998. Based on the findings of the CHARM program, the FDA approved the use of candesartan for heart failure in February 2005.

In October 2009, candesartan was FDA-approved for the treatment of hypertension in adolescents and children 1 year of age and older.

Indications

  1. heart failure
  2. hypertension
  3. migraine prophylaxis

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. anaphylactoid reactions
  4. anemia
  5. angina
  6. angioedema
  7. anxiety
  8. arthralgia
  9. asthenia
  10. azotemia
  11. back pain
  12. chest pain (unspecified)
  13. cough
  14. depression
  15. diarrhea
  16. dizziness
  17. dyspepsia
  18. dyspnea
  19. elevated hepatic enzymes
  20. fatigue
  21. fever
  22. headache
  23. hepatitis
  24. hyperbilirubinemia
  25. hyperglycemia
  26. hyperkalemia
  27. hypertriglyceridemia
  28. hyperuricemia
  29. hyponatremia
  30. hypotension
  31. infection
  32. leukopenia
  33. myalgia
  34. myocardial infarction
  35. nausea
  36. neutropenia
  37. orthostatic hypotension
  38. palpitations
  39. paresthesias
  40. peripheral edema
  41. pharyngitis
  42. pruritus
  43. rash
  44. renal failure (unspecified)
  45. rhabdomyolysis
  46. rhinitis
  47. sinus tachycardia
  48. syncope
  49. teratogenesis
  50. thrombocytopenia
  51. urticaria
  52. vertigo
  53. vomiting

Monitoring Parameters

  • blood pressure

Contraindications

  • ACE-inhibitor induced angioedema
  • angioedema
  • Black patients
  • breast-feeding
  • children
  • geriatric
  • heart failure
  • hepatic disease
  • hyperkalemia
  • hypotension
  • hypovolemia
  • infants
  • pregnancy
  • renal artery stenosis
  • renal disease
  • renal failure
  • renal impairment
  • surgery

Interactions

  • Acarbose
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Alprostadil
  • Amifostine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amobarbital
  • Amphetamine; Dextroamphetamine Salts
  • Amyl Nitrite
  • Angiotensin II
  • Angiotensin-converting enzyme inhibitors
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Asenapine
  • Baclofen
  • Benzphetamine
  • Bosentan
  • Brexpiprazole
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Cabergoline
  • Calcium Phosphate, Supersaturated
  • Canagliflozin; Metformin
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chloroprocaine
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Clozapine
  • Co-Enzyme Q10, Ubiquinone
  • Cocaine
  • Codeine; Phenylephrine; Promethazine
  • Conivaptan
  • Cyclosporine
  • Dapagliflozin; Metformin
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Desloratadine; Pseudoephedrine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Diazoxide
  • Diethylpropion
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Elexacaftor; tezacaftor; ivacaftor
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enflurane
  • Ephedrine
  • Eplerenone
  • Epoprostenol
  • Ertugliflozin; Metformin
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Etomidate
  • Fenofibric Acid
  • Fexofenadine; Pseudoephedrine
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Fluoxetine; Olanzapine
  • Fospropofol
  • General anesthetics
  • Glipizide; Metformin
  • Glyburide; Metformin
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guaifenesin; Pseudoephedrine
  • Haloperidol
  • Halothane
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Ibuprofen; Pseudoephedrine
  • Iloperidone
  • Iloprost
  • Incretin Mimetics
  • Indapamide
  • Insulins
  • Intravenous Lipid Emulsions
  • Isocarboxazid
  • Isoflurane
  • Isoproterenol
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ivacaftor
  • Ketamine
  • Levodopa
  • Linagliptin; Metformin
  • Lisdexamfetamine
  • Lithium
  • Loop diuretics
  • Loratadine; Pseudoephedrine
  • Lovastatin; Niacin
  • Lumacaftor; Ivacaftor
  • Lurasidone
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Meglitinides
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methamphetamine
  • Methohexital
  • Methylphenidate
  • Miglitol
  • Milrinone
  • Naproxen; Pseudoephedrine
  • Nateglinide
  • Nefazodone
  • Nesiritide, BNP
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitrates
  • Nitroglycerin
  • Nitroprusside
  • Nonsteroidal antiinflammatory drugs
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Oritavancin
  • Oxymetazoline
  • Paliperidone
  • Pentoxifylline
  • Phenelzine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Potassium
  • Pramlintide
  • Prazosin
  • Procainamide
  • Procaine
  • Propofol
  • Pseudoephedrine
  • Quinidine
  • Rasagiline
  • Repaglinide
  • Risperidone
  • Selegiline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Silodosin
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Spironolactone
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfonylureas
  • Tetracaine
  • Tezacaftor; Ivacaftor
  • Thiazolidinediones
  • Thiopental
  • Thiothixene
  • Tizanidine
  • Tolvaptan
  • Tranylcypromine
  • Trazodone
  • Triamterene
  • Trimethoprim
  • Yohimbine
  • Ziprasidone
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top