CandesartanCandesartan cilexetil

About Candesartan

Candesartan blocks angiotensin II, the hormone that tightens blood vessels and holds on to salt, so vessels relax and blood pressure falls. The label covers high blood pressure in adults and in children from one to under seventeen, and heart failure in adults with a weakened pumping function, where it reduces cardiovascular death and hospital admission. Adults with high blood pressure usually start at 16 mg once daily; in heart failure the start is 4 mg, doubled about every two weeks toward 32 mg. A pharmacist can make an oral suspension from the tablets for a child who cannot swallow them.

The boxed warning is fetal toxicity: drugs that act on the renin-angiotensin system can injure and kill the developing fetus, so it is stopped as soon as pregnancy is detected. Headache and dizziness are the common side effects in high blood pressure; in heart failure, low blood pressure, worsening kidney function and high potassium are what most often lead to stopping, so potassium and kidney function are checked periodically, and it can drop blood pressure sharply at the start in people who are dehydrated or on high doses of diuretics. It is not combined with aliskiren in diabetes, and pairing it with an ACE inhibitor adds to the risk of low blood pressure, high potassium and kidney problems.

The combination adds the thiazide diuretic hydrochlorothiazide when one drug is not enough; it is not for starting treatment. It carries the thiazide’s cautions: no use with a sulfonamide allergy or when the kidneys make no urine, lower potassium, higher uric acid, possible activation of lupus, and rarely a sudden painful eye problem needing same-day care.

Taking Candesartan

How to take it

Once or twice a day as prescribed, with or without food, at the same times each day; the full effect takes about four to six weeks. A child’s suspension is used within thirty days of first opening and must not be frozen.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

At room temperature, tightly closed, away from heat and moisture, out of reach of children; a compounded suspension as the pharmacy directs.

Interactions to know about

Ibuprofen, naproxen and other NSAIDs can blunt its effect and strain the kidneys. Potassium supplements, potassium salt substitutes and potassium-sparing diuretics raise the risk of high potassium, and it raises lithium levels. It is not combined with aliskiren in diabetes or with an ACE inhibitor, and it must not be taken during pregnancy.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Candesartan differs from pharmacy to pharmacy

Generic candesartan has several makers, but far fewer than losartan, so it is less often on a flat-price list and quotes for the same tablet differ more between pharmacies; a prescription that names Atacand and blocks substitution is filled at a brand price. The combination has fewer generic makers again and two ways of filling it: one combination tablet with one dispensing fee, or candesartan plus hydrochlorothiazide with two fees; which comes out lower depends on the pharmacy.

Ways to pay less for Candesartan without insurance

• Ask for generic substitution, and for a ninety-day supply once your dose is stable.
• For the combination, ask the pharmacy to quote it against the two drugs as separate tablets.
• If candesartan is quoted high, ask the prescriber whether losartan or another ARB with more generic makers would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Candesartan

1. 1.When will my potassium and kidney function be checked?
2. 2.What should I do if I become pregnant or plan to?
3. 3.Which painkillers and salt substitutes should I avoid?
4. 4.Is the combination tablet cheaper here than two separate tablets?

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