Drug Index

Candesartan

 
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Mechanism :

Candesartan selectively blocks the binding of angiotensin II to AT1 in many tissues including vascular smooth muscle and the adrenal glands. This inhibits the AT1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin II and results in an overall decrease in blood pressure. Candesartan is greater than 10,000 times more selective for AT1 than AT2. Inhibition of aldosterone secretion may increase sodium and water excretion while decreasing potassium excretion.


Indication :

• Hypertension


Contraindications :

Hypersensitivity, Severe hepatic impairment, Do not coadminister with aliskiren in patients with diabetes.


Dosing :

1-6 years: Start with 0.2 mg/kg orally once daily or in two divided doses. Dose range: 0.05-0.4 mg/kg/day orally.

6-17 years, <50 kg: Start with 4-8 mg/day orally once a day. Dose Range:

Adjust within 2 weeks to dose range 2-16 mg/day orally once a day; Max: 32 mg/day.

6-17 years, >50 kg: Start with 8-16 mg/day PO. Dose range: Adjust within 2 weeks to dose range 4-32 mg/day PO; not to exceed 32 mg/day.


Adverse Effect :

Hives, difficulty breathing, angioedema, rhabdomyolysis.


Interaction :

Aliskiren: Increases the toxicity of both the drugs.
ACE Inhibitors: Increases the toxicity by pharmacodynamic synergism.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Initial dose 2 mg and increase according to response
<10Initial dose 2 mg and increase according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as for GFR<10 mL/min
HDNot dialysed. Dose as for GFR<10 mL/min
HDF/High fluxNot dialysed. Dose as for GFR<10 mL/min
CAV/VVHDUnlikely to be dialysed. Dose as for GFR=10–20 mL/min

Hepatic Dose :

Mild hepatic impairment: No dosage adjustments are recommended.
Moderate hepatic impairment: Dose reduction may be required. Adjust dose as per clinical response.
Severe hepatic impairment: Avoid using the drug.
05/25/2020 03:30:32 Candesartan
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