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Home > Drug Category > Blood Pressure Medication (Angiotensin Receptor Blocker) > Atacand and Equivalent

Atacand (Candesartan Cilexetil) Information

Atacand, which contains the active ingredient candesartan cilexetil, is an Angiotensin II Receptor Blocker (ARB). It is primarily indicated for the treatment of hypertension (high blood pressure), either alone or in combination with other antihypertensive agents. It is also indicated for the treatment of heart failure (NYHA class II-IV) in patients with left ventricular systolic dysfunction, usually given as adjunct therapy with other heart failure treatments like beta-blockers and diuretics. Candesartan cilexetil is an orally administered prodrug that is rapidly and completely converted to the active drug, candesartan, during gastrointestinal absorption. Unlike many antihypertensives, its dosing is typically once daily, which supports patient adherence to the treatment regimen.

The mechanism of action for candesartan is precise and involves blocking the effects of the powerful hormone Angiotensin II. Angiotensin II causes vasoconstriction (narrowing of blood vessels) and stimulates the release of aldosterone, which causes the body to retain sodium and water. Candesartan works by selectively blocking the binding of Angiotensin II to the AT1 receptor found in many tissues, including vascular smooth muscle and the adrenal glands. By blocking this receptor, candesartan effectively counteracts Angiotensin II's actions: it promotes vasodilation (widening of blood vessels), thereby reducing systemic vascular resistance, and decreases aldosterone secretion, promoting the excretion of sodium and water. These effects collectively result in sustained reductions in blood pressure and heart workload, which are beneficial in heart failure.

Atacand Side Effects

Atacand is generally well-tolerated, but side effects related to its potent blood pressure-lowering effect may occur. Common side effects often reported include dizziness, particularly when standing up quickly (postural dizziness), headache, upper respiratory tract infection, back pain, and pharyngitis (sore throat). In patients treated for heart failure, typical side effects can also include hypotension (low blood pressure) and elevated blood creatinine levels. However, more serious side effects can occur, leading to significant monitoring protocols. If any of the following symptoms are experienced, the patient should stop taking the medication and seek immediate medical attention:

• Angioedema: A rare but severe and potentially life-threatening swelling of the face, lips, tongue, or throat, which can impair breathing. This requires immediate emergency medical attention.
• Fetal Toxicity (Boxed Warning): Use during pregnancy is associated with significant harm to the developing fetus, including fetal death, hypotension, renal failure, and skull hypoplasia. The drug must be discontinued immediately upon confirmed pregnancy.
• Hyperkalemia (High Potassium): This potentially life-threatening electrolyte abnormality may occur, particularly in patients with kidney problems, and requires immediate management.
• Renal Impairment/Failure: In patients whose kidney function is dependent on the renin-angiotensin system (e.g., those with severe heart failure or bilateral renal artery stenosis), candesartan may cause acute kidney failure or worsening renal function.
• Symptomatic Hypotension: Excessive lowering of blood pressure, especially in patients who are volume-depleted (e.g., on high-dose diuretics), which may lead to fainting (syncope).

Atacand Precautions

Due to the risk of fetal harm, Atacand carries a Boxed Warning regarding use during pregnancy and must be discontinued as soon as pregnancy is detected. It is contraindicated in patients with a history of hypersensitivity to candesartan or a history of angioedema related to previous ARB or ACE inhibitor therapy. Caution is advised when initiating therapy in volume-depleted patients (e.g., those on high-dose diuretics) or salt-depleted patients, as they are at a greater risk for symptomatic hypotension, which may require correction before starting the drug. The concurrent use of Atacand with the drug aliskiren is contraindicated in patients with diabetes or moderate to severe renal impairment (GFR less than 60 mL/min). Patients with severe heart failure or bilateral renal artery stenosis require careful and frequent monitoring of serum creatinine and potassium levels, as they are prone to significant renal function changes and hyperkalemia while on ARBs.

Do I need a prescription to order Atacand?

Yes, a prescription is required from your physician to order Atacand.