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Does Atacand (candesartan) cause side effects?
Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells surrounding blood vessels.
Angiotensin's attachment to the receptors causes the muscle cells to contract and the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure. Atacand blocks the angiotensin receptor and thereby prevents the action of angiotensin. As a result, blood vessels expand and blood pressure is reduced.
Common side effects of Atacand include
Serious side effects of Atacand include
- high blood potassium (hyperkalemia),
- reduced renal function,
- allergic reactions, and rarely,
- inflammation and destruction of muscle (rhabdomyolysis) and swelling of soft tissues including those of the throat and larynx (angioedema).
Drug interactions of Atacand include other medications that can increase the concentration of potassium in the blood, such as hydrodiuril, spironolactone, and potassium supplements, because it may lead to dangerous increases in potassium blood levels.
- Combining Atacand or other ARBs with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.
- There have been reports that aspirin and other NSAIDs such as ibuprofen, indomethacin, and naproxen may reduce the effects of ARBs.
- An increase in lithium blood levels has been reported when lithium is combined with Atacand. Careful monitoring of lithium levels is recommended when Atacand and lithium are used concomitantly.
When used in the second or third trimester of pregnancy, ARBs can cause injury and even death to the fetus. Atacand should not be used during pregnancy. When pregnancy is first detected, Atacand should be stopped.
What are the important side effects of Atacand (candesartan) ?
The most common side effects of candesartan are:
Other important side effects include:
Atacand (candesartan) side effects list for healthcare professionals
Clinical Studies Experience
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.
- Atacand has been evaluated for safety in more than 3600 patients/subjects, including more than 3200 patients treated for hypertension.
- About 600 of these patients were studied for at least 6 months and about 200 for at least 1 year.
- In general, treatment with Atacand was well tolerated. The overall incidence of adverse events reported with Atacand was similar to placebo.
- The rate of withdrawals due to adverse events in all trials in patients (7510 total) was 3.3% (i.e., 108 of 3260) of patients treated with Atacand as monotherapy and 3.5% (i.e., 39 of 1106) of patients treated with placebo.
- In placebo-controlled trials, discontinuation of therapy due to clinical adverse events occurred in 2.4% (i.e., 57 of 2350) of patients treated with Atacand and 3.4% (i.e., 35 of 1027) of patients treated with placebo.
- The most common reasons for discontinuation of therapy with Atacand were headache (0.6%) and dizziness (0.3%).
- The adverse events that occurred in placebo-controlled clinical trials in at least 1% of patients treated with Atacand and at a higher incidence in candesartan cilexetil (n = 2350) than placebo (n = 1027) patients included
- Among children in clinical studies, 1 in 93 children age 1 to < 6 and 3 in 240 age 6 to < 17 experienced worsening renal disease.
- The association between candesartan and exacerbation of the underlying condition could not be excluded.
- The adverse event profile of Atacand in adult heart failure patients was consistent with the pharmacology of the drug and the health status of the patients.
- In the CHARM program, comparing Atacand in total daily doses up to 32 mg once daily (n=3803) with placebo (n=3796), 21.0% of patients discontinued Atacand for adverse events vs. 16.1% of placebo patients.
The following adverse reactions were identified during post-approval use of Atacand. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
The following have been very rarely reported in post-marketing experience:
- Digestive: Abnormal hepatic function and hepatitis.
- Hematologic: Neutropenia, leukopenia, and agranulocytosis.
- Immunologic: Angioedema.
- Metabolic and Nutritional Disorders: Hyperkalemia, hyponatremia.
- Respiratory System Disorders: Cough.
- Skin and Appendages Disorders: Pruritus, rash and urticaria.
Rare reports of rhabdomyolysis have been reported in patients receiving angiotensin II receptor blockers.
What drugs interact with Atacand (candesartan)?
Agents Increasing Serum Potassium
- Co-administration of Atacand with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. Monitor serum potassium in such patients.
- Increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with angiotensin II receptor antagonists, including Atacand. Monitor serum lithium levels.
Non-Steroidal Anti-Inflammatory Agents Including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors)
- In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including candesartan, may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Monitor renal function periodically in patients receiving candesartan and NSAID therapy.
- The antihypertensive effect of angiotensin II receptor antagonists, including candesartan may be attenuated by NSAIDs including selective COX-2 inhibitors.
Combination Blockade Of The Renin-Angiotensin System (RAS)
- Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy.
- Triple combination of Atacand with an ACE-inhibitor and a mineralocorticoid receptor antagonist is generally not recommended.
- Closely monitor blood pressure, renal function and electrolytes in patients on Atacand and other agents that affect the RAS.
- Do not co-administer aliskiren with Atacand in patients with diabetes.
- Avoid use of aliskiren with Atacand in patients with renal impairment (GFR <60 mL/min).
Atacand (candesartan) is an angiotensin receptor blocker (ARB) used to treat high blood pressure (hypertension). Common side effects of Atacand include headache, dizziness, fatigue, abdominal discomfort, diarrhea, and upper respiratory infections. When used in the second or third trimester of pregnancy, ARBs can cause injury and even death to the fetus. Atacand should not be used during pregnancy, even when pregnancy is first detected. Due to the possibility of harm to the nursing infant, if possible, Atacand should be discontinued by breastfeeding mothers.
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Related Disease Conditions
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Hypertension-Related Kidney Disease
Second Source WebMD Medical Reference
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
Pulmonary hypertension is elevated pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur. As pulmonary hypertension worsens, some people with the condition have difficulty performing any activities that require physical exertion. While there is no cure for pulmonary hypertension, it can be managed and treated with medications and supplemental oxygen to increase blood oxygen levels.
Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
Pseudotumor Cerebri (intracranial hypertension) is a condition where there is an increase in pressure of fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF) mimicing a brain tumor. The cause is unknown. The most common symptom is headache but also include eye-pain, vision loss and double vision. Pseudotumor cerebri is diagnosed with MRI or CAT scans and treated by discontinuing offending medications (if applicable), weight loss and diuretic medications. The condition can also be helped by repeated drainage of spinal fluid using the lumbar puncture.
Can High Blood Pressure Hurt My Eyes?
Unfortunately, yes. Suffering from untreated or poorly controlled high blood pressure for a long time can be detrimental to your eyes. Several eye diseases are directly or indirectly caused by high blood pressure (hypertension).
Preeclampsia (Pregnancy Induced Hypertension)
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
Hypertension-Induced Chronic Kidney Disease
Hypertension-induced chronic kidney disease (CKD) is a long-standing kidney condition that develops over time due to persistent or uncontrolled high blood pressure (hypertension).
High Blood Pressure Symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. In some patients, symptoms may include fatigue, headaches, dizziness, confusion, sweating, chest pain and vision problems.
What Is High Blood Pressure (Hypertension)?
High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Blood pressure readings above 180/120 mmHg are dangerously high and require immediate medical attention.
How Does High Blood Pressure Affect Pregnancy?
High blood pressure during pregnancy can cause serious complications. Learn more about the signs of and risks associated with the condition.
Treatment & Diagnosis
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Medications & Supplements
Prevention & Wellness
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.