Candesartan cilexetil is a prescription medication used to manage certain cardiovascular conditions. It belongs to a class of drugs known as angiotensin II receptor blockers, or ARBs. This medication is taken orally and is available under several brand names, including Atacand.
Medical Uses for Candesartan Cilexetil
Candesartan cilexetil is primarily prescribed to treat high blood pressure, also known as hypertension, in adults and children over the age of six. Hypertension is a condition where the force of blood against artery walls is consistently too high, increasing the risk of heart attacks and strokes. This medication can be used on its own or in combination with other agents to manage high blood pressure.
The medication is also approved for the treatment of heart failure in adult patients. It is used for individuals with reduced heart muscle function, which impairs the heart’s ability to pump blood efficiently. It is often prescribed when a patient cannot tolerate another class of drugs called ACE inhibitors, or it may be used in addition to them if symptoms continue. Clinical trials have demonstrated that candesartan can reduce hospitalizations related to heart failure.
Beyond its main approved uses, candesartan is sometimes used off-label to manage other conditions. These can include delaying the progression of diabetic nephropathy, a type of kidney disease that affects people with diabetes. Research has also explored its potential in preventing migraines and managing left ventricular hypertrophy, which is a thickening of the muscle of the heart’s main pumping chamber.
How Candesartan Cilexetil Works
Candesartan cilexetil functions as a prodrug, which means it is administered in an inactive form. Once ingested, it is rapidly converted into its active form, called candesartan, during absorption in the gastrointestinal tract.
The active compound, candesartan, works by targeting the renin-angiotensin-aldosterone system (RAAS), a hormone system that regulates blood pressure and fluid balance. It blocks the action of angiotensin II, a potent chemical that causes blood vessels to constrict.
By selectively blocking angiotensin II from binding to its AT1 receptors, candesartan prevents this narrowing. These receptors are found in many tissues, including the smooth muscle of blood vessels and the adrenal glands. This blockade allows the blood vessels to relax and widen, a process called vasodilation.
This vasodilation leads to a decrease in overall blood pressure. This also reduces the workload on the heart, making it easier to pump blood. The drug is highly selective for the AT1 receptor, which ensures its targeted action.
Potential Side Effects
Like all medications, candesartan cilexetil can cause side effects, which range from common and mild to less frequent but more serious. Among the more commonly reported side effects are dizziness, lightheadedness, and headache. These symptoms can occur as the body adjusts to lower blood pressure.
Other side effects can include back pain, sore throat, or cold-like symptoms like a runny or stuffy nose. While generally not severe, these effects should be monitored. If they persist or become bothersome, it is advisable to discuss them with a healthcare provider.
More serious side effects require prompt medical attention. A severe allergic reaction, though rare, can occur, with signs including swelling of the face, lips, tongue, or throat, which can cause difficulty breathing. Another serious issue is high potassium levels in the blood, which can cause muscle weakness or a slow, irregular heartbeat.
In rare instances, candesartan can lead to problems with kidney function, which could progress to kidney failure. Symptoms that might indicate a kidney issue include a significant decrease in the amount of urine. The medication may also cause a reduction in white blood cells, which can lower resistance to infection and lead to tiredness, fever, or other signs of illness.
Important Safety Considerations and Interactions
A significant safety warning associated with candesartan cilexetil concerns its use during pregnancy. The medication has a black box warning from the FDA because it must not be taken by women who are more than three months pregnant. Use during the second and third trimesters can cause serious harm or even death to a developing fetus. It is also recommended to avoid the medication during early pregnancy.
Certain pre-existing medical conditions require caution when taking candesartan. Individuals with kidney or liver problems, or those on dialysis, should discuss their condition with their doctor before starting treatment. The doctor may need to monitor kidney function, blood pressure, and electrolyte levels, such as potassium, at regular intervals.
The medication can interact with other drugs, which can alter its effectiveness or increase the risk of adverse effects. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can reduce the blood pressure-lowering effect of candesartan and may increase the risk of kidney problems. Combining it with potassium supplements or other drugs that increase potassium can lead to dangerously high levels in the blood.
If a dose of candesartan is missed, it should be taken as soon as it is remembered, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped to avoid taking a double dose. Patients should not stop taking the medication abruptly without consulting their doctor, even if they feel well, as hypertension often has no symptoms.