"Candesartan": reviews, instructions for use, analogues

Chronic heart failure (CHF) and arterial hypertension (AH) are problems that pose a danger to humans. You can save your life and improve your well-being with the help of “Candesartan”, but you cannot decide on this medicine on your own. First you need to see a doctor. If experts recommend the drug, it remains only to buy it and get acquainted with the instructions for use, reviews about "Candesartan".

Release form and components

The drug "Candesartan" is made in the form of tablets of 32, 16 and 8 mg. The active substance in the composition is candesartan cilexetil. Additional components - sodium lauryl sulfate, microcrystalline cellulose, pregelatinized starch, low-substituted hyprolose, croscarmellose sodium, magnesium stearate, lactose monohydrate.

Pharmacokinetics and pharmacodynamics

Candesartan cilexetil, when ingested, is absorbed in the digestive tract. During this process, the substance is converted. It becomes candesartan, which is a selective antagonist (blocker) of type II angiotensin receptors.

Angiotensin II is one of the components that make up the renin-angiotensin-aldosterone system (RAAS), the hormone. When exposed to AT ₁ receptors, it causes a number of physiological effects - stimulation of cell growth, vasoconstriction (narrowing of blood vessels), stimulation of aldosterone production, regulation of water-electrolyte homeostasis. Thus, angiotensin II plays a significant role in the occurrence and development of heart failure, hypertension and other diseases associated with the heart and blood vessels.

Candesartan in the body blocks only the AT ₁ receptors of angiotensin II, does not affect the receptors of other hormones, does not act as a blocker of ion channels that take part in the regulation of the functions performed by the cardiovascular system. The result of blocking of AT ₁ receptors is a decrease in the level of aldosterone in blood plasma, a dose-dependent increase in the activity of angiotensin I, angiotensin II, renin.

The use of "Candesartan" in hypertension contributes to a drop in pressure. The antihypertensive effect is manifested approximately 2 hours after taking a dose of the drug. Blood pressure begins to gradually decrease. The medicine is effective for more than 24 hours. To maximize blood pressure reduction, long-term fixed-dose tablet therapy is required. Typically, this result is achieved within 1 month from the start of treatment.

In chronic heart failure, candesartan helps to reduce total peripheral vascular resistance, capillary pressure in the lungs, increases the concentration of angiotensin II in blood plasma and renin activity, and reduces aldosterone levels. Thanks to the reception of “Candesartan”, the frequency of hospitalizations and deaths due to this disease is reduced.

Judging from the reviews of Candesartan, tablets can be drunk at any time, regardless of meals. Food does not affect the bioavailability of the drug. The medicine is excreted mainly unchanged by the kidneys and with bile. Its small part is metabolized in the liver. The half-life is 9 hours. The active substance does not accumulate in the body.

Indications and contraindications for use

Judging from the instructions and reviews, Candesartan is appointed:

• in hypertension, when the pressure exceeds 140/90 mm RT. st .;
• with CHF and a violation of systolic function performed by the left ventricle.

You can not carry out treatment if there is hypersensitivity to the main substance or additional components.

Pregnancy is another contraindication to use, indicated in the instructions. Candesartan may adversely affect the fetus (for example, disrupt kidney function). When pregnancy occurs, you must immediately stop taking the drug and consult a doctor in order to select another therapy. During the period of breastfeeding, one can not drink Candesartan tablets. It is not known whether the active component of the drug can pass into breast milk in the human body, since no human studies have been conducted. However, experiments were performed on rats. The results showed that the active component of Candesartan is excreted in animal milk.

On hypersensitivity, pregnancy and the period of breastfeeding, the list of contraindications does not end there. It also includes:

• age before reaching 18 years;
• severe impaired liver function;
• cholestasis;
• glucose galactose malabsorption syndrome;
• lack of lactase in the body;
• hypersensitivity to lactose.

Several contraindications are associated with the simultaneous use of other medicines. The manual and reviews of the Candesartan tablets indicate that people with diabetes mellitus, severe or moderate impaired renal function should not combine the drug with drugs containing aliskiren. For patients suffering from diabetic nephropathy, a combination of “Candesartan” and angiotensin-converting enzyme (ACE) inhibitors is harmful.

Who should take pills with caution?

The reviews of "Candesartan" written by experts say that a number of patients should be careful when using this medication. Caution is required:

1. With impaired functioning of the kidneys (severe). If there is such a problem in a patient, specialists should monitor the level of potassium and creatinine in the blood.
2. With renal artery stenosis. Candesartan may increase serum creatinine and urea.
3. With hemodynamically significant stenosis of the mitral and / or aortic valves.
4. With hypertrophic obstructive cardiomyopathy.
5. If there is a history of kidney transplant. In this case, caution is needed because the clinical experience with prescribing the medicine to people who have undergone such an operation is limited.
6. When on hemodialysis. Careful monitoring of blood pressure is required. With hemodialysis, blood plasma volume decreases. Because of this, blood pressure begins to respond strongly to blocking receptors of type AT ₁ .
7. With hyperkalemia. We need regular monitoring of potassium levels in the blood.
8. With cerebrovascular disorders of ischemic origin and coronary heart disease. With these pathological conditions, blood pressure can sharply decrease due to taking an antihypertensive drug. This is fraught with the development of a stroke or myocardial infarction.
9. With a reduced volume of circulating blood.
10. With primary hyperaldosteronism.

How to use with arterial hypertension

It is recommended to start therapy with "Candesartan" with a minimum dose of 8 mg. If a further decrease in pressure is required, then the daily dose should be increased to 16 mg. In the reviews of "Candesartan" it is said that the drug gives the maximum effect within 4 weeks. If the pressure is not sufficiently reduced during the period of taking the drug, then it is necessary to increase the dose to 32 mg per day.

In the reviews, patients taking the drug "Candesartan" note that the treatment has some features:

1. At any prescribed dosage, Candesartan is drunk 1 time per day.
2. If the drug does not lead to a decrease in pressure to an optimal level, doctors prescribe an additional drug, a thiazide diuretic, to patients. Thanks to the diuretic, the pharmacological effect of “Candesartan” is enhanced - the pressure decreases more.
3. For patients with mild or moderate renal impairment, the initial dose of Candesartan is 4 mg.
4. Patients with mild or moderate hepatic impairment are also prescribed a small daily dose of 4 mg. If necessary, the dose may be increased.
5. With 4 mg per day, it is recommended to start therapy for hypovolemia (with a reduced volume of circulating blood).

How to use in chronic heart failure?

With this disease, treatment with Candesartan begins with a dose of 4 mg per day. If necessary, increase the dose to 32 mg per day, but do not do this right away. First, the applied initial dose is increased by 2 times. Doubling is performed at intervals of at least two weeks.

In the reviews of "Candesartan", experts write that when taking the drug, additional instructions must be taken into account:

1. The initial dose of the drug does not change if the patient has impaired renal and hepatic function. Elderly age also does not require dose adjustment.
2. "Candesartan" can be used together with other medicines that are used in the treatment of heart failure.
3. “Candesartan” is not prescribed for children and adolescents, since the safety and efficacy of the drug have not been established for this group of patients.

Side effects

In the instructions for use, reviews on "Candesartan" there is information about side effects. People taking the drug for hypertension most often experience undesirable symptoms such as weakness, headache, dizziness, back pain, and respiratory infections. In rare cases, the following are recorded:

• a decrease in the number of white blood cells in the blood;
• a decrease in the number of neutrophils circulating in the blood;
• a decrease in the level of granulocytes in the blood;
• excess of the normal level of potassium in the blood;
• too low concentration of sodium ions in blood plasma;
• cough;
• nausea;
• impaired liver function (hepatitis may develop);
• skin rashes;
• itchy skin;
• hives;
• angioedema;
• joint pain
• muscle pain
• impaired renal function (for example, tablets can provoke the occurrence of renal failure).

In CHF, the most frequently reported side effects that occur due to the use of Candesartan are an increase in the level of potassium in the blood, impaired functioning of the kidneys, and a marked decrease in blood pressure. These symptoms are mainly observed in people older than 70 years, in the presence of diabetes mellitus, the use of other medicines that affect the renin-angiotensin-aldosterone system. Very rarely, patients with a diagnosis of heart failure due to taking “Candesartan” experience headache, dizziness, and weakness.

Some patients experience diarrhea when taking the medicine. They begin to look for the answer to the question in the reviews: does Candesartan cause diarrhea or not? In the official instructions, just such a side symptom is not indicated. The occurrence of diarrhea may not be associated with a medicine, but with nutrition. However, in any case, it is recommended to consult a doctor.

Occurrence of overdose

Since Candesartan lowers blood pressure, it is easy to guess that when taking a large dose, this pharmacological effect of the drug becomes very pronounced, dizziness occurs. It is worth noting that doctors in the reviews of "Candesartan" described individual cases of overdose. Some patients took up to 672 mg of candesartan cilexetil. In all these cases, people recovered. Severe consequences did not arise, as the patients received the necessary medical care.

If you ignore the recommendations specified in the instructions, and taking too high a dose, you should consult a doctor. In the reviews of Candesartan, cardiologists write that the necessary measures for an overdose are symptomatic therapy and monitoring the condition of a sick person. The patient should be in a supine position. The foot end of the bed should be raised. If necessary, a 0.9% sodium chloride solution is injected through a vein and sympathomimetic drugs are prescribed. The hemodialysis procedure is not performed. With it, the active substance of the drug is not excreted from the body.

Drug interaction

Many patients are interested in the question of the compatibility of Candesartan and alcohol. In reviews, some people write that you should not take alcoholic beverages, as they negatively affect the body. Experts confirm this. Alcohol negatively affects the functioning of the heart muscle and increases blood pressure. For this reason, it is better not to drink alcohol while taking Candesartan.

It has already been noted above that patients with diabetes mellitus, severe or moderate renal failure should not take Candesartan with aliskiren and aliskiren-containing medicines. Other people should also avoid this combination, since drugs, when interacting, give a negative effect.

People with diabetic nephropathy are contraindicated and other people are not recommended to take ACE inhibitors and angiotensin II receptor blockers at the same time. The combination of medicines from these groups can enhance side effects such as decreased pressure, impaired renal function, and an increase in the concentration of potassium in the blood.

The simultaneous use of "Candesartan" and other antihypertensive drugs enhances the antihypertensive effect.

With the combined use of "Candesartan" and lithium preparations, it is necessary to monitor the concentration of lithium in the blood serum. This measure is necessary for the reason that with the joint prescription of these medicines, toxic reactions may develop.

With the simultaneous administration of angiotensin II receptor blockers and non-steroidal anti-inflammatory drugs, a deterioration in the antihypertensive effect can be noted. Other possible consequences of a combination of such drugs - impaired renal function, the occurrence of acute renal failure, an increase in the level of potassium in the blood. Particular caution when taking is recommended for older people and people with a reduced volume of circulating blood.

Reviews on "Candesartan" from patients and doctors: evaluation of the drug

Assessing Candesartan, experts say that the drug has a small price. Moreover, it gives a good effect. Compared to other angiotensin II receptor blockers, candesartan has a pronounced antihypertensive effect and lowers blood pressure for a long time. The drug is quite effective in the regimen of administration 1 time per day. A lot of side effects are listed in the instructions, but a significant part of them occurs very rarely. Generally, Candesartan is well tolerated by humans.

Cardiologists in reviews of "Candesartan" note that the drug has been thoroughly investigated. The results showed that the antihypertensive effect lasts up to 36 hours. This is an important plus of the drug, because not all people can take medicines on time. For example, someone may be busy, someone may forget. Due to the prolonged action in the intervals between doses, there is no difference in blood pressure, the risk of stroke is reduced.

Patients in reviews of “Candesartan” write mainly that the drug really helps them, improves their well-being, and does not provoke the appearance of any suspicious symptoms. After taking the medicine, some people experienced dizziness, a sharp drop in blood pressure. In such cases, you must always consult a doctor, because a dose adjustment may be required. In case of hypersensitivity reactions, Candesartan is canceled. Instead, the doctor may prescribe any suitable analogue.

Similar drugs

The list of Candesartan analogues is quite wide. In reviews, for example, some people mention Hyposart. This is a pill medicine in which the active substance is candesartan. Thus, “Hyposart” is a complete analogue of “Candesartan” with the same indications and contraindications for use, dosing regimens. Other complete analogues for example are Atakand, Ordiss.

Aprovel is a tablet medicine, a nosological analogue of Candesartan. The reviews and instructions indicate that the main substance is irbesartan. This component is a selective angiotensin II receptor blocker type AT ₁ . Irbesartan blocks the physiological effects of the hormone, which are realized through the AT ₁ receptors. This action of the main substance allows the use of the Aprovel drug for arterial hypertension (both in monotherapy and in combination with other antihypertensive drugs) and for nephropathy diagnosed in people with arterial hypertension, type 2 diabetes mellitus (with this indication, Aprovel is one from elements of combined antihypertensive therapy). Recommended Dosage:

1. With arterial hypertension, the initial dose of the drug is 150 mg once a day. If necessary, the doctor can prescribe a higher dose - up to 300 mg once a day.
2. With nephropathy, the preferred maintenance dose is 300 mg once daily.

“Telzap” is another nosological analogue of “Candesartan”. The reviews of doctors and patients and the instructions say that the main substance is telmisartan - a specific antagonist of angiotensin II receptors (type AT ₁ ). Indications for use of the drug - essential hypertension and a decrease in mortality and the incidence of cardiovascular disease in 2 groups of patients:

• with cardiovascular diseases of atherothrombotic origin (e.g., stroke, coronary heart disease);
• type 2 diabetes mellitus with target organ damage.

“Telzap” for arterial hypertension is prescribed in a dose of 1 tablet (40 mg) once a day. A reduced dose of 20 mg per day also helps some patients. If necessary, the dose can be increased to a maximum - up to 80 mg once a day. With such an indication as a decrease in mortality and the incidence of cardiovascular diseases, the prescribed dose is 80 mg once a day.

In the instructions and reviews about "Candesartan" you can find useful information, but you should not rely solely on it. As for the doses, while taking other drugs, you must always consult a doctor so as not to harm your health and not worsen your well-being.