Home Drug Guide Candesartan Cilexetil

Drug Guide

Generic Name

Candesartan Cilexetil

Brand Names Atacand

Classification

Therapeutic: Antihypertensive

Pharmacological: Angiotensin II Receptor Blocker (ARB)

FDA Approved Indications

  • Hypertension
  • Heart failure (as adjunct to other therapies)

Mechanism of Action

Candesartan Cilexetil selectively blocks the angiotensin II type 1 (AT1) receptor, preventing vasoconstriction and aldosterone-mediated volume expansion, thereby lowering blood pressure and reducing the workload on the heart.

Dosage and Administration

Adult: Typically, 8-32 mg once daily. Dose may be adjusted based on response.

Pediatric: Not approved for use in children.

Geriatric: Use with caution; start at lower doses and titrate as needed.

Renal Impairment: Use with caution; dosage adjustments may be necessary based on renal function.

Hepatic Impairment: Use with caution; monitor for adverse effects. No specific dose adjustment available.

Pharmacokinetics

Absorption: Well absorbed orally, with bioavailability approximately 40%.

Distribution: Vast volume of distribution; protein binding more than 99%.

Metabolism: Prodrug metabolized in the gastrointestinal tract and liver to active metabolites.

Excretion: Excreted mainly via feces and urine; active metabolites eliminated renally.

Half Life: Approximately 9 hours for candesartan; active metabolites may have longer half-lives.

Contraindications

  • Hypersensitivity to candesartan or other ARBs
  • Pregnancy (especially 2nd and 3rd trimesters)
  • History of angioedema related to previous use of ACE inhibitors or ARBs

Precautions

  • Use cautiously in patients with renal artery stenosis
  • Monitor renal function and potassium levels during therapy
  • Pregnancy category D; discontinue at confirmed pregnancy

Adverse Reactions - Common

  • Dizziness (Common)
  • Headache (Common)
  • Hyperkalemia (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Angioedema (Rare)
  • Hypotension (Rare)
  • Renal dysfunction (Rare)

Drug-Drug Interactions

  • Other antihypertensives (additive hypotension)
  • Potassium-sparing diuretics and potassium supplements (risk of hyperkalemia)
  • NSAIDs (may reduce antihypertensive efficacy and affect renal function)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function, and serum potassium levels.

Diagnoses:

  • Risk for decreased cardiac output
  • Risk for electrolyte imbalance

Implementation: Administer medication consistently; monitor for adverse effects; educate patient on signs of hypotension and hyperkalemia.

Evaluation: Assess blood pressure response; ensure renal function remains stable.

Patient/Family Teaching

  • Take medication exactly as prescribed, usually once daily.
  • Notify healthcare provider if symptoms of angioedema (swelling of face, lips, tongue) occur.
  • Be cautious about potassium-rich foods and salt substitutes containing potassium.
  • Avoid sudden position changes to reduce dizziness risk.

Special Considerations

Black Box Warnings:

  • Fetal toxicity: Discontinue as soon as pregnancy is detected.

Genetic Factors: No specific genetic considerations identified.

Lab Test Interference: May affect renal function and serum potassium levels; regular monitoring required.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, tachycardia.

Treatment: Place patient in supine position; administer IV fluids; use vasopressors if necessary. Dialysis in severe cases may be considered.

Storage and Handling

Storage: Store at room temperature (20°C to 25°C), away from moisture and light.

Stability: Stable under recommended storage conditions; check expiration date before use.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.