Candesartan: This is how the antihypertensive works

Candesartan This is how the antihypertensive works

Candesartan is a commonly used drug used to  treat high blood pressure  . It dilates the blood vessels, thereby lowering blood pressure. Side effects can therefore be dizziness or low blood pressure up to  fainting  . Candesartan is often combined with other antihypertensives such as beta blockers or diuretics. Caution is advised if other medications are being taken at the same time or if kidney disease is present.

What is candesartan?

Candesartan is a drug that is mainly used to treat high blood pressure (arterial hypertension) and  heart failure  (heart failure). Candesartan therefore belongs to the group of antihypertensives, also known as  antihypertensive drugs  .

Candesartan is an active substance that is taken in the form of candesartan cilexetil in tablet form and is only converted to the active drug candesartan in the intestine.

Candesartan is sold by different manufacturers and is therefore available under different trade names, for example under the names Atacand® or Blopress®.

The advantage over other active ingredients is that candesartan  has relatively few side effects  in many people with heart and blood pressure problems .

How does candesartan work?

Like many antihypertensive drugs, candesartan lowers blood pressure via the renin-angiotensin-aldosterone system (RAAS). This system primarily influences the  metabolism  of our kidneys, salt metabolism and the size of our blood vessels.

Candesartan belongs to the subgroup of angiotensin II receptor antagonists. Angiotensin II is responsible for an increase in arterial blood pressure via various mechanisms: more sodium salt is retained in the blood and the vessels are constricted.

The angiotensin II receptor antagonists such as candesartan suppress the effect of the substance angiotensin II and thereby help to keep blood pressure low. There are other drugs from this drug group on the market, such as valsartan and losartan.

Side Effects of Candesartan

The side effects that can occur during therapy with candesartan are mainly related to the vasodilating and thus blood pressure-lowering effect of candesartan. Side effects can be:

  • dizziness
  • hypotension (low blood pressure)
  • headache
  • nausea  and digestive problems
  • cough
  • kidney failure
  • Changes in blood salts, especially an increase in the level of potassium in the blood

Interactions of candesartan

Candesartan affects salt metabolism in the blood, particularly that of  potassium . Therefore, it should only be taken with caution with other medications that can 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 increased by other drugs with blood pressure-lowering properties, which is why interactions must be taken into account here as well.

4 typical contraindications of the active substance

The following contraindications apply to the use of candesartan:

  1. The drug must not be used in case of hypersensitivity to candesartan or any of the other ingredients of the drug.
  2. Affected people with severe impairment of liver function and congestion of bile (cholestasis) should not use candesartan to treat arterial hypertension.
  3. In addition, the use of the drug is not recommended for children under the age of one year.
  4. Caution is also advised in those affected with kidney disease or dehydration. Candesartan could then worsen the kidney problems. Therefore, candesartan should only be used in these two cases under close medical supervision.

Application and dosage of candesartan

Candesartan is available in  tablet  form. It is often prescribed for long-term treatment of high blood pressure and is taken for a period of several years. The medicine should be taken once a day with or without food.

The recommended starting dose of candesartan is 8 mg once a day in adults. However, children and adolescents between 6 and 18 years of age should start with a lower dose of 4 mg candesartan 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 candesartan start working? Most of the antihypertensive effect is obtained within 4 weeks.

Discontinuation of candesartan

Suddenly stopping an antihypertensive drug such as candesartan can lead to a significant deterioration in blood pressure and heart function.

Discontinuation is therefore only recommended in close consultation with the doctor treating you. In addition,  reducing the dose slowly  is more advisable than stopping it abruptly.

A symptom of inadequately treated heart failure can be weight gain, for example. In the case of heart problems, this can indicate that the body is storing water. Such  edema  can cause a weight gain of 500 g to several kilos.

In these cases, the medication for blood pressure and cardiac insufficiency should definitely be checked again by a doctor and possibly changed or expanded.

Alternatives to candesartan

Another drug that is also used in the treatment of high blood pressure is  ramipril . Ramipril works in a similar way to candesartan to block the renin-angiotensin-aldosterone system. It blocks the ACE receptor and in this way widens the blood vessels.

There are also beta-blockers (such as  bisoprolol  and metaprolol) that are used to treat high blood pressure. They can be taken in addition to candesartan.

Candesartan is also often combined with other drugs such as calcium channel antagonists (e.g. amlopdipine) or diuretics (e.g. hydrochlorothiazide).

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