Chronic heart failure (CHF) and arterial hypertension (AH) are problems that pose a danger to humans. You can save your life, improve your well-being with the help of Candesartan, but you cannot make a decision on taking this medication on your own. First you need to contact the doctors. If experts recommend the drug, all that remains is to buy it and read the instructions for use, reviews about Candesartan.
Release form and constituent components
The drug "Candesartan" is made in the form of tablets of 32, 16 and 8 mg. The active ingredient is candesartan cilexetil. Additional components - sodium lauryl sulfate, microcrystalline cellulose, pregelatinized starch, low-substituted hyprolose, sodium croscarmellose, magnesium stearate, lactose monohydrate.
Pharmacokinetics and pharmacodynamics
Candesartan cilexetil, when ingested, is absorbed in the digestive tract. During this process, this substance is transformed. It becomes candesartan, which is a selective angiotensin II type I receptor antagonist (blocker).
Angiotensin II is one of the components of the renin-angiotensin-aldosterone system (RAAS), a hormone. When exposed to AT1-receptors, it causes a number of physiological effects - stimulation of cell growth, vasoconstriction (narrowing of blood vessels), stimulation of aldosterone production, regulation of water and electrolyte homeostasis. Thus, angiotensin II plays a significant role in the occurrence and development of CHF, hypertension and other diseases associated with the heart and blood vessels.
Candesartan in the body blocks only AT1-angiotensin II receptors, does not affect the receptors of other hormones, does not act as a blocker of ion channels that are involved in the regulation of functions performed by the cardiovascular vascular system. The result of blocking AT1-receptors is a decrease in the level of aldosterone in the 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 appears approximately 2 hours after taking a dose of the drug. Arterial pressure begins to gradually decrease. The medicine works for more than 24 hours. For maximum reduction in blood pressure, long-term therapy with tablets infixed dose. Usually this result is achieved within 1 month from the start of treatment.
In CHF, candesartan helps to reduce the total peripheral vascular resistance, capillary pressure in the lungs, increases the concentration of angiotensin II in the blood plasma and renin activity, reduces the level of aldosterone. Thanks to the use of Candesartan, the frequency of hospitalizations and deaths due to this disease is reduced.
Judging by the reviews of Candesartan, the tablets can be taken at any time, regardless of meals. Food does not affect the bioavailability of the drug. The drug is excreted mainly unchanged by the kidneys and bile. Its small part is metabolized in the liver. The half-life is 9 hours. The body does not accumulate the active substance.
Indications and contraindications for use
Judging from the instructions and reviews, "Kandesartan" is assigned:
- with hypertension, when the pressure exceeds 140/90 mm Hg. Art.;
- with CHF and impaired systolic function performed by the left ventricle.
Treatment should not be carried out if there is hypersensitivity to the main substance or additional components.
Pregnancy is another contraindication for use indicated in the instructions. "Candesartan" can adversely affect the fetus (for example, disrupt the functioning of the kidneys). If pregnancy occurs, you should immediately stop taking the drug and consult a doctor in order to select another therapy. During the period of breastfeeding, you should also not drink Candesartan tablets. It is not known whether the active ingredient of the drug can penetrate into breast milk in the human body, since human studies have not been conducted. However, the experiments were performed on rats. The results showed that the active component of Candesartan is excreted in the milk of animals.
The list of contraindications does not end with hypersensitivity, pregnancy and breastfeeding. It also includes:
- age under 18;
- severe liver dysfunction;
- cholestasis;
- glucose-galactose malabsorption syndrome;
- lack of lactase in the body;
- lactose hypersensitivity.
Several contraindications associated with the simultaneous use of other medicines. In the instructions and reviews of the tablets "Candesartan" it is noted that people with diabetes mellitus, severe or moderate impaired renal function cannot be combined with the named drug with drugs that have aliskiren in their composition. For patients suffering from diabetic nephropathy, the combination of Candesartan and angiotensin-converting enzyme (ACE) inhibitors is harmful.
Who should be careful about taking pills?
Reviews about Candesartan, written by experts, suggest that a number of patients should be careful when using this medication. Caution needed:
- With impaired kidney function (severe). If there is such a problem,the patient, specialists should monitor the level of potassium and creatinine in the blood.
- With stenosis of the renal arteries. Candesartan may increase serum creatinine and urea levels.
- For hemodynamically significant mitral and/or aortic valve stenosis.
- For hypertrophic obstructive cardiomyopathy.
- If you have a history of kidney transplant. In this case, caution is needed due to the limited clinical experience in prescribing the drug to people who have undergone such an operation.
- When on hemodialysis. Careful monitoring of blood pressure is required. During hemodialysis, the volume of blood plasma decreases. Because of this, blood pressure begins to react strongly to blocking AT receptors1.
- With hyperkalemia. Need regular monitoring of potassium levels in the blood.
- With cerebrovascular disorders of ischemic origin and coronary heart disease. In these pathological conditions, due to the intake of an antihypertensive drug, blood pressure may drop sharply. This is fraught with the development of a stroke or myocardial infarction.
- With reduced blood volume.
- For primary hyperaldosteronism.
How to use for hypertension
It is recommended to start therapy with Candesartan with a minimum dose of 8 mg. If further pressure reduction is required, then the daily dose should be increased to 16 mg. The reviews of Candesartan say that the drug gives the maximum effect within 4 weeks. If during the period of taking the drugmeans the pressure is not sufficiently reduced, it is necessary to increase the dose to 32 mg per day.
In the reviews, patients who took the drug "Candesartan", note that the treatment has some features:
- At any prescribed dosage, Candesartan is drunk once a day.
- If the drug does not reduce blood pressure to the optimum level, doctors prescribe an additional drug to patients - a thiazide diuretic. Thanks to the diuretic, the pharmacological effect of Candesartan is enhanced - the pressure drops more.
- For patients with mild to moderate renal impairment, the initial dose of Candesartan is 4mg.
- Patients with mild to moderate hepatic impairment are also given a small daily dose of 4mg. If necessary, the dose may be increased.
- 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?
In this disease, treatment with Candesartan begins with a dose of 4 mg per day. If necessary, the dose is increased to 32 mg per day, but this is not done immediately. First, the applied initial dose is increased by 2 times. Doubling is performed at intervals of at least two weeks.
In reviews of Candesartan, experts write that additional instructions should be taken into account when taking the drug:
- The initial dose of the drug does not change if the patient has a malfunctionkidneys and liver. Old age also does not require dose adjustment.
- Candesartan can be used in conjunction with other medicines that are used in the treatment of CHF.
- Children and adolescents candesartan is not prescribed, as the safety and efficacy of the drug have not been established for this group of patients.
Side effects
In the instructions for use, reviews of "Candesartan" there is information about side effects. People taking the drug for hypertension most often encounter such undesirable symptoms as weakness, headache, dizziness, back pain, and respiratory infections. In rare cases, fixed:
- decrease in the number of leukocytes in the blood;
- decrease in the number of neutrophils circulating in the blood;
- decrease in the level of granulocytes in the blood;
- exceeding the normal level of potassium in the blood;
- too low concentration of sodium ions in blood plasma;
- cough;
- nausea;
- liver dysfunction (may develop hepatitis);
- skin rashes;
- skin itching;
- urticaria;
- angioedema;
- joint pain;
- muscle pain;
- impaired kidney function (e.g. pills can cause kidney failure).
With CHF, the most commonly reported side effects that occur due to taking Candesartan are an increase in the level of potassium in the blood, impaired renal function, and a marked decrease in blood pressure. Thesesymptoms are mainly observed in people over 70 years of age, in the presence of diabetes mellitus, the use of other medications that affect the renin-angiotensin-aldosterone system. Very rarely, patients diagnosed with CHF due to taking Candesartan experience headache, dizziness, weakness.
Some patients get diarrhea while 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, such a side symptom is not indicated. The occurrence of diarrhea may not be due to the medicine, but to nutrition. However, in any case, it is recommended to consult a doctor.
Occurrence of an 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 reviews of Candesartan describe 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 necessary medical care was provided to patients.
If you ignore the recommendations indicated in the instructions and take too high a dose, you need to see a doctor. In reviews of Candesartan, cardiologists write that the necessary measures in case of an overdose are symptomatic therapy and monitoring the condition of a sick person. The patient must be in a supine position. Foot end of the bedshould be raised. If necessary, a 0.9% solution of sodium chloride is injected through a vein and sympathomimetic drugs are prescribed. There is no hemodialysis procedure. With the help of it, the active substance of the drug is not excreted from the body.
Drug Interactions
Many patients are interested in the question of the compatibility of Candesartan and alcohol. In the reviews, some people write that you should not take alcoholic beverages, as they negatively affect the body. Experts confirm this. Alcohol adversely affects the work 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 insufficiency should not take Candesartan with aliskiren and aliskiren-containing medicines. Other people should also avoid this combination, as the drugs, interacting, have 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 increase side effects such as lowering blood pressure, impaired kidney function, and increased potassium levels in the blood.
Simultaneous administration 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 measurenecessary for the reason that the joint appointment of these drugs can develop toxic reactions.
While taking angiotensin II receptor blockers and non-steroidal anti-inflammatory drugs, you may notice a deterioration in the antihypertensive effect. Other possible consequences of a combination of such drugs are a violation of the kidneys, the occurrence of acute renal failure, an increase in the level of potassium in the blood. Special care is recommended when taking the elderly and people with reduced circulating blood volume.
Reviews about Candesartan from patients and doctors: evaluation of the drug
Assessing "Candesartan", experts say that the drug has a small price. At the same time, it gives a good effect. Compared to other angiotensin II receptor blockers, candesartan has a pronounced antihypertensive effect, lowering blood pressure for a long time. The drug is quite effective when administered once a day. There are many side effects listed in the instructions, but a significant part of them occur very rarely. In general, Candesartan is well tolerated by people.
Cardiologists in the reviews of Candesartan note that the drug has been carefully studied. 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 long action in the intervals between doses,there is a drop in blood pressure, reducing the risk of stroke.
Patients in reviews of Candesartan write basically that the drug really helps them, improves their well-being, and does not provoke any suspicious symptoms. Some people after taking the medicine experienced dizziness, a sharp drop in blood pressure. In such cases, it is necessary to consult a doctor, because a dose adjustment may be required. With hypersensitivity reactions, Candesartan is canceled. Instead, the doctor may prescribe some suitable analogue.
Similar drugs
The list of analogues of Candesartan is quite wide. In reviews, for example, some people mention Hyposart. This medicine is in the form of tablets, 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 full analogues for example are Atakand, Ordiss.
"Aprovel" - medicine in tablet form, nosological analogue of "Candesartan". The reviews and instructions indicate that the main substance is irbesartan. This component is a selective blocker of type II angiotensin receptors AT1. Irbesartan blocks the physiological effects of the hormone, which are realized through AT1 receptors. This action of the main substance allows the use of the drug "Aprovel" in arterial hypertension (as inmonotherapy, and in combination with other antihypertensive drugs) and with nephropathy diagnosed in persons with arterial hypertension, type 2 diabetes mellitus (for this indication, Aprovel is one of the elements of combined antihypertensive therapy). Recommended doses:
- In arterial hypertension, the initial dose of the drug is 150 mg 1 time per day. If necessary, the doctor may prescribe a higher dose - up to 300 mg 1 time per day.
- For 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 angiotensin II receptor antagonist (type AT 1). The indications for the use of the drug are essential hypertension and a decrease in mortality and the incidence of cardiovascular diseases in 2 groups of patients:
- with cardiovascular diseases of atherothrombotic origin (for example, stroke, coronary heart disease);
- with type 2 diabetes mellitus with target organ damage.
"Telzap" for arterial hypertension is prescribed at a dose of 1 tablet (40 mg) 1 time per day. Some patients also benefit from a reduced dose of 20 mg per day. If necessary, the dose can be increased to a maximum - up to 80 mg 1 time per day. With such an indication as a decrease in mortality and the incidence of cardiovascular disease, the prescribed dose is 80 mg 1 time per day.
You can find useful information in the instructions and reviews about Candesartan, but you should not rely only on it. Regarding doses, simultaneous intake of other drugs, it is necessary to consult a doctor so as not to harm your he alth and not worsen your well-being.
