Candesartan and Hydrochlorothiazide

Overview

Candesartan and hydrochlorothiazide combination is a drug that is used to treat people whose blood pressure is too high. In the US, candesartan and hydrochlorothiazide combination is sold under the brand name Atacand HTC.

Hypertension makes the heart and arteries work harder than they should do normally. If the condition persists for a long time damage can occur to the arteries that supply the heart, brain, and kidneys. This pressure overload can cause a heart attack, kidney failure, or a stroke. The likelihood of complete heart failure is also much increased in patients who have high blood pressure.

Candesartan is a drug known as an ARB, or angiotensin II receptor blocker. The medication works by interfering with a substance that is produced by the body that causes the blood vessels to tighten, reversing this effect and making the vessels relax instead. The overall effect is a lowering of the blood pressure and an increase in the supply of blood and oxygen to the patient’s heart.

The second element of the combination, hydrochlorothiazide, is a thiazide diuretic, or ‘water pill’. The drug lowers the water levels in the body by causing the production of urine to increase, helping to lower the blood pressure.

Candesartan and hydrochlorothiazide combination should be the first drug therapy that you are prescribed for your condition. It is intended as a second line of treatment if other drugs have not worked or have caused unpleasant side effects. Patients who are prescribed candesartan and hydrochlorothiazide combination for high blood pressure control may have to take this medication for the rest of their lives.

Candesartan and hydrochlorothiazide combination is a prescription-only medication, and it comes in tablet form.

Conditions treated

  • hypertension

Type of medicine

  • ARB - angiotensin II receptor blocker
  • thiazide diuretic
  • tablet

Side effects

Although taking candesartan and hydrochlorothiazide combination will help and improve your condition, it is possible that you may experience a few side effects when you first begin taking it. Tell your doctor if you have a history of allergic reactions to any other form of medication or if you are allergic to any particular foods, food preservatives, animal derivatives, or food colorings.

The following side effects are sometimes reported by patients taking this medication. If you notice any of these effects, you should tell your treating physician.

  • weakness
  • weak pulse
  • vomiting
  • unusual tiredness
  • sore throat
  • nausea
  • muscle cramps
  • lightheadedness
  • irregular heartbeat
  • increased thirst
  • fever
  • dryness of the mouth
  • dizziness
  • cough

There are also a variety of side effects in patients taking this medication that are seen occasionally, including:

  • shortness of breath
  • hive-like swellings on the face, eyelids, tongue, lips, throat, legs, hands, feet, or genitals
  • fast or irregular heartbeat
  • chest tightness
  • chest pain
  • arm pain
  • trouble sleeping
  • sweating

Some of the side effects listed below that are caused by candesartan and hydrochlorothiazide combination will disappear without the need for medical intervention, as your body settles down and becomes used to the new medication. If any of the effects are persistent or particularly troublesome, ask your doctor’s advice on how to prevent or manage them:

  • back pain
  • sneezing
  • runny nose
  • muscle aches and pains
  • loss of appetite
  • joint pain
  • headache
  • diarrhea

This index of side effects that have been reported by people taking this medication is not necessarily exhaustive. If you think that your condition is not showing signs of improvement, ask your doctor for advice. You must also tell your GP if you begin to feel worse.

Dosage

Candesartan and hydrochlorothiazide combination is only available from your doctor on prescription. The medication comes in tablet form.

The dose of candesartan and hydrochlorothiazide combination that is prescribed by your doctor will vary between patients. You must follow your doctor’s instructions or the directions that are shown on the dispensed product label. The dosage levels given below only reflect the average recommended dose for this medication. You must not change the dose that you have been told to take by your treating physician unless you are instructed otherwise.

You should take candesartan and hydrochlorothiazide combination exactly as you are directed to by your treating physician. Do not take more of the medicine than prescribed. Do not take the medicine more often, or for a longer duration than instructed. If you do, you could increase the risk of unpleasant or serious side effects.

Your prescription will be supplied to you with patient guidelines enclosed in the packaging. Read the guidelines thoroughly before you commence your course of treatment, and speak to your doctor if you have any questions.

You must not give your candesartan and hydrochlorothiazide combination to anyone else.

Candesartan and hydrochlorothiazide combination should be the first drug therapy that you are prescribed for your condition. It is intended as a second line of treatment if other drugs have not worked or have caused unpleasant side effects.

Your treating physician may include a weight control element in your treatment regimen and may change your diet, suggesting that you cut out foods that have a high salt content.

You must take your prescription exactly as directed, even if you feel much better and have no signs of high blood pressure. You must also keep all your check-up appointments, even if you feel fine.

The medication will work best if the levels in your blood remain constant. It is therefore important that you take your medication at the same time every day. If you do miss out a dose, try to take it straight away. If it is nearly time for your next dose, omit the missed one and revert to your regular dosing schedule. Do not take double the dose.

You can take your candesartan and hydrochlorothiazide combination tablets with or without food.

For high blood pressure

  • adults: initially, take one tablet once or twice daily, as directed by your doctor.
  • children: use and dosage should be determined by the treating physician

An overdose of this drug can cause serious symptoms, including loss of consciousness or breathing difficulties. In the event of an overdose, call 911 immediately.

Major drug interactions

Some drugs should not be used together. However, in some cases, certain medications can be used together, even if an interaction is known to occur. If this is the case, your doctor may change the dose of one or more of your prescribed drug treatments or may advise you to take other precautions.

If you are prescribed candesartan and hydrochlorothiazide combination, it is extremely important that you tell your doctor if you are already taking any of the medication listed below. The following drugs are known to have an interaction with candesartan and hydrochlorothiazide combination:

  • Dofetilide
  • Valdecoxib
  • Trimethoprim
  • Trandolapril
  • Tolmetin
  • Tolfenamic Acid
  • Tiaprofenic Acid
  • Tenoxicam
  • Sulindac
  • Sotalol
  • Sodium Salicylate
  • Salsalate
  • Salicylic Acid
  • Rofecoxib
  • Ramipril
  • Quinapril
  • Proscillaridin
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Piroxicam
  • Piketoprofen
  • Phenylbutazone
  • Perindopril
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Ouabain
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Naproxen
  • Nabumetone
  • Morniflumate
  • Moexipril
  • Metildigoxin
  • Methotrexate
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lithium
  • Lisinopril
  • Levomethadyl
  • Ketorolac
  • Ketoprofen
  • Ketanserin
  • Indomethacin
  • Ibuprofen
  • Fosinopril
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Flecainide
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Enalaprilat
  • Enalapril
  • Droxicam
  • Droperidol
  • Dipyrone
  • Digoxin
  • Digitoxin
  • Digitalis
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Deslanoside
  • Cyclophosphamide
  • Clonixin
  • Choline Salicylate
  • Celecoxib
  • Captopril
  • Bufexamac
  • Bromfenac
  • Benazepril
  • Aspirin
  • Arsenic Trioxide
  • Amtolmetin Guacil
  • Amphetamine
  • Acetyldigoxin
  • Acemetacin
  • Aceclofenac

Using this drug with any of the following medications can increase the risk of some side effects. However, using both medications may be the best treatment option in your case. Your doctor may change the dose or frequency of one or both of the medications:

  • Topiramate
  • Licorice
  • Gossypol
  • Ginkgo
  • Cholestyramine
  • Carbamazepine
  • Bepridil

This list is not necessarily exhaustive. If you are already taking a drug that is not included in the above list, tell your doctor before you begin taking candesartan and hydrochlorothiazide combination.

Warnings

As well as telling your doctor about any allergies you have and other drugs that you are taking, you should also mention any existing health conditions that you suffer from. When deciding to use this medication, you should weigh up the risks and benefits of taking it. Your doctor will discuss the risks and benefits of using candesartan and hydrochlorothiazide combination with you in more detail.

Tell your doctor if you have ever experienced any allergic reactions to any form of prescription or non-prescription medication, herbal remedies, or vitamin supplements. In addition, tell your treating physician about any bad reactions that you have had to particular foods, preservatives, dyes, or animal derivatives.

While you are taking this medication, you will need to have regular blood tests and check-up appointments. This is necessary in order to monitor your progress and to check for any side effects that the medication may be causing.

There are some medical conditions that may affect the use of candesartan and hydrochlorothiazide. This drug should not be used in patients who have the following conditions:

  • anuria
  • diabetics who are taking aliskiren (Tekturna®)
  • people with kidney disease who are taking aliskiren (Tekturna®)
  • sulfa drug allergy

This medication should not be used in people with a history of asthma, as it can cause an allergic reaction.

Candesartan and hydrochlorothiazide combination should be used with caution in people with the following conditions, as it could cause the blood pressure to drop too far:

  • severe congestive heart failure
  • major surgery or anesthesia
  • kidney problems
  • hypovolemia (low blood volume)
  • hyponatremia (low sodium in the blood)
  • heart or blood vessel disease
  • diarrhea
  • dehydration

This medication should not be used with the following conditions, as it could cause them to become worse:

  • diabetes
  • edema
  • electrolyte imbalance
  • fluid imbalance caused by excessive perspiration, vomiting, or diarrhea
  • glaucoma, secondary angle closure
  • gout
  • hypercalcemia
  • hyperlipidemia
  • liver disease
  • systemic lupus erythematosus (SLE)

This drug should not be used in patients with kidney disease, as the effects could be increased due to the slower removal of the drug from the body.

Candesartan and hydrochlorothiazide combination can be harmful to a fetus. Tell your doctor if you are pregnant before you begin using this medication. Use effective contraceptive methods to prevent pregnancy during the course of your treatment.

It is not known whether this medication can pass into breast milk. Ask your doctor for advice if you are currently breastfeeding.

You may feel dizzy or lightheaded after taking your first dose of this medication. Before you drive or operate machinery, be sure that you know how your body will react to the drug. If you begin feeling dizzy, sit down so that you do not pass out. Allow a few minutes before you stand up, and do so slowly.

If you begin to feel confused, dizzy, weak, achy, or you develop a very rapid heartbeat, consult your doctor immediately.

If the weather is very warm or you are exercising, you must drink extra fluids to prevent you from becoming dehydrated. This also applies if you are suffering from diarrhea or sickness. Dehydration can also cause an imbalance of electrolytes within the body.

If you notice changes in your vision, including blurring, double vision, problems with reading, or eye pain, you should consult your doctor immediately. You may be referred to an eye specialist for a check-up.

If you are due to attend your dentist or if you are scheduled to have surgery, you must tell your treating physician that you are taking this medication. You may be asked to stop using the drug a few days before attending for treatment.

Avoid drinking alcohol while you are taking this medication. Alcohol can exacerbate low blood pressure, leading to fainting and dizziness.

You should be aware that candesartan and hydrochlorothiazide combination can affect your blood sugar levels. This can cause a change in the results of your blood or urine sugar tests. If you are diabetic, talk to your doctor about this potential effect before you begin your course of treatment.

You should not take any other forms of medication while taking candesartan and hydrochlorothiazide combination unless you have discussed this with your doctor or specialist. This particularly includes potassium or salt supplements. These substances can change your blood potassium levels. You should also avoid using non-prescription medications designed for appetite control, coughs and colds, asthma, hay fever, or sinus conditions; all these products contain ingredients that can increase your blood pressure.

Storage

Always keep your candesartan and hydrochlorothiazide combination tablets in a sealed, airtight container, at room temperature. Do not place the medication in the fridge or freezer. Do not expose this drug to direct sunlight or to sources of extreme heat. Do not allow the tablets to get wet.

Keep candesartan and hydrochlorothiazide combination out of reach of children and pets. In the event that a pet consumes the drug, you should seek veterinary advice immediately.

Do not flush unwanted medicine down the toilet or the drain. Do not throw any unused tablets out with your trash, where it could be found by small children or pets. If you are not sure how to dispose of your unwanted medication, ask your pharmacist for guidance.

Summary

Candesartan and hydrochlorothiazide combination is a drug that is used for patients suffering from hypertension. In the US, candesartan and hydrochlorothiazide combination is sold under the brand name, Atacand HTC. This medication is used after other treatments have been tried that have failed to work or have caused unmanageable side effects.

There are a number of recognized side effects in people who are taking this medication. You should be aware that it is not unusual for patients to begin to feel dizzy and lightheaded when they first begin treatment. However, this issue usually resolves itself within a couple of weeks of commencing your course of treatment. There is also a considerable number of historical and existing medical conditions that can be made worse by the use of this drug. Always tell your doctor if you have a history of diabetes, liver or kidney disease. This drug can also cause faintness and dizziness, which could be problematic for some patients in jobs that involve driving or operating machinery. Talk to your doctor for advice on how to overcome these side effects.

Candesartan and hydrochlorothiazide combination has been shown to be highly effective in the treatment and management of hypertension. In order to get the most benefit from your course of treatment with this drug, you must be sure to attend regular check-ups with your doctor or specialist. These reviews are important as they give your treating physician the opportunity to work out the correct dose for this medication. They also give you the opportunity to talk about any side effects that you have experienced while taking the medication. Your doctor may also want to carry out urine and blood tests to be sure that the medication is working as it should be. These are particularly important if you are diabetic as the drug can affect your blood sugar levels. Your blood pressure will also be closely monitored to make sure that the medication is controlling it.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017