Atacand (candesartan cilexetil) is an angiotensin II receptor blocker (ARB) prescribed for the management of hypertension and heart failure. It works by blocking the action of certain natural substances that tighten blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication is trusted by healthcare professionals for its efficacy in reducing cardiovascular risk and improving patient outcomes in appropriate clinical settings. Available in tablet form, Atacand is typically used as part of a comprehensive treatment plan that may include diet, exercise, and other medications.

Features

• Active ingredient: candesartan cilexetil
• Available in 4 mg, 8 mg, 16 mg, and 32 mg tablets
• Angiotensin II receptor blocker (ARB) class
• Once-daily oral administration
• Bioavailability approximately 15%
• Peak plasma concentration reached within 3–4 hours
• Half-life of approximately 9 hours
• Excreted primarily via urine and feces

Benefits

• Effectively lowers blood pressure to reduce strain on the heart and arteries
• Decreases the risk of stroke, heart attack, and kidney problems associated with hypertension
• Improves survival and reduces hospitalizations in patients with heart failure
• Well-tolerated profile with a lower incidence of cough compared to ACE inhibitors
• Convenient once-daily dosing supports medication adherence
• Can be used as monotherapy or in combination with other antihypertensive agents

Common use

Atacand is primarily indicated for the treatment of hypertension in adults and children aged 1 year and older. It may be used alone or in combination with other antihypertensive agents. Additionally, Atacand is approved for the treatment of heart failure (NYHA Class II-IV) in adults with left ventricular systolic dysfunction, to reduce cardiovascular death and hospitalization. In some cases, it may be used off-label for other cardiovascular or renal conditions under specialist supervision.

Dosage and direction

The recommended initial dose for hypertension in adults is 16 mg once daily when used as monotherapy. The dosage can be increased to 32 mg once daily based on blood pressure response. For heart failure, the recommended initial dose is 4 mg once daily, which should be doubled at intervals of at least 2 weeks to a target maintenance dose of 32 mg once daily as tolerated. Pediatric dosing for hypertension is based on body weight. Tablets should be taken with or without food, at approximately the same time each day. Dosage adjustments may be necessary for patients with renal impairment or hepatic dysfunction.

Precautions

Patients should be monitored for hypotension, especially after initiation or dose escalation. Renal function should be assessed periodically, particularly in patients with pre-existing renal impairment, heart failure, or volume depletion. Potassium levels should be monitored in patients at risk of hyperkalemia. Use with caution in patients with hepatic impairment. Not recommended during pregnancy due to potential fetal harm. Patients should avoid becoming pregnant while taking Atacand. Caution is advised when driving or operating machinery until the patient’s response to treatment is known.

Contraindications

Atacand is contraindicated in patients with known hypersensitivity to candesartan cilexetil or any component of the formulation. It is contraindicated during pregnancy, particularly in the second and third trimesters, due to the risk of fetal injury and death. Concomitant use with aliskiren in patients with diabetes is contraindicated. Should not be used in patients with severe hepatic impairment or biliary cirrhosis.

Possible side effects

Common side effects (≥1%) include dizziness, upper respiratory tract infection, pharyngitis, rhinitis, back pain, and headache. Less common side effects may include hyperkalemia, increased serum creatinine, fatigue, nausea, abdominal pain, and diarrhea. Rare but serious side effects include angioedema, renal impairment, hypotension, and hepatotoxicity. Patients should report any signs of allergic reactions, unusual swelling, or symptoms suggesting liver problems immediately.

Drug interaction

Atacand may interact with other medications that affect blood pressure, including diuretics and other antihypertensive agents, potentially increasing the risk of hypotension. Concurrent use with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium may lead to hyperkalemia. NSAIDs may reduce the antihypertensive effect and increase the risk of renal impairment. Lithium levels may increase when co-administered with Atacand. Use with aliskiren is not recommended in patients with diabetes.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is almost time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistency in dosing is important for maintaining stable blood pressure control.

Overdose

Symptoms of overdose may include hypotension, dizziness, tachycardia, bradycardia, and renal failure. In case of suspected overdose, symptomatic and supportive treatment should be initiated. The patient should be placed in a supine position with elevated legs. Volume expansion with intravenous normal saline may be administered for hypotension. Hemodialysis may not be effective due to high protein binding. Close monitoring of vital signs and electrolyte balance is essential.

Storage

Store at room temperature between 15-30°C (59-86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not store in bathrooms or other damp areas. Properly dispose of any unused medication according to local regulations.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The prescribing physician should be informed of all medical conditions and medications being taken. Individual responses to medication may vary.

Reviews

Clinical studies have demonstrated Atacand’s efficacy in reducing both systolic and diastolic blood pressure with once-daily dosing. In the CHARM program, candesartan significantly reduced cardiovascular death and hospitalizations for heart failure. Many clinicians report good patient tolerance and adherence with this medication. Some patients note effective blood pressure control with minimal side effects, though individual experiences may vary. Long-term follow-up studies support its sustained antihypertensive effects and cardiovascular protective benefits.