Generic Name: Candesartan-Hydrochlorothiazid Brand Name(s): Generics only. No brands available.

Uses

What is Candesartan-Hydrochlorothiazid used for?

Candesartan-Hydrochlorothiazid is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains 2 medications: candesartan and hydrochlorothiazide. Candesartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so blood can flow more easily. Hydrochlorothiazide is a “water pill” (diuretic). It increases the amount of urine you make, especially when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.

These medications are used together when 1 drug alone is not controlling your blood pressure. Your doctor may direct you to start taking the individual medications first, and then switch you over to this combination product if this is the best dose combination for you.

How should I take Candesartan-Hydrochlorothiazid?

Take this medication by mouth with or without food as directed by your doctor, usually once daily. It is best to avoid taking this medication within 4 hours of your bedtime to avoid having to get up to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. It may take up to 4 weeks before you get the full benefit of this drug.

If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 4 hours before or at least 4 to 6 hours after these medications.

Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

How do I store Candesartan-Hydrochlorothiazid?

Candesartan-Hydrochlorothiazid is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Candesartan-Hydrochlorothiazid in the bathroom or the freezer. There may be different brands of Candesartan-Hydrochlorothiazid that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Candesartan-Hydrochlorothiazid down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Candesartan-Hydrochlorothiazid?

Before taking this medication, tell your doctor or pharmacist if you are allergic to candesartan or hydrochlorothiazide; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease (such as renal artery stenosis), liver disease, loss of too much body water and/or minerals (dehydration), untreated mineral imbalance (such as low or high potassium), gout, lupus.

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Too much sweating, diarrhea, or vomiting may cause loss of too much body water (dehydration) and increase your risk of dizziness or lightheadedness. Report prolonged diarrhea or vomiting to your doctor. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you have diabetes, this medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This drug may affect your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Hydrochlorothiazide may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Older adults may be more sensitive to the side effects of this drug, especially dizziness and change in the amount of urine (kidney problems).

This medication is not recommended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Candesartan-Hydrochlorothiazid during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Candesartan-Hydrochlorothiazid. Candesartan-Hydrochlorothiazid is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Candesartan-Hydrochlorothiazid?

Dizziness and lightheadedness may occur as your body adjusts to the medication. If either of these effects persists or worsens, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This product may cause a loss of too much body water (dehydration) and salt/minerals. Tell your doctor right away if you have any symptoms of dehydration or mineral loss, including: extreme thirst, very dry mouth, muscle cramps/weakness, fast/slow/irregular heartbeat, confusion.

Tell your doctor right away if you have any serious side effects, including: fainting, signs of kidney problems (such as change in the amount of urine), toe/joint pain, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat), decrease in vision, eye pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Candesartan-Hydrochlorothiazid?

Some products that may interact with this drug include: aliskiren, dofetilide, lithium, drugs that may increase the level of potassium in the blood (such as ACE inhibitors including benazepril/lisinopril, birth control pills containing drospirenone).

Some products have ingredients that could raise your blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

This product may interfere with certain laboratory tests (including parathyroid test, protein-bound iodide test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Candesartan-Hydrochlorothiazid may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Candesartan-Hydrochlorothiazid?

Candesartan-Hydrochlorothiazid may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Candesartan-Hydrochlorothiazid?

Candesartan-Hydrochlorothiazid may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Candesartan-Hydrochlorothiazid.

What is the dose of Candesartan-Hydrochlorothiazid for an adult?

Usual Adult Dose for Hypertension

Candesartan 16 to 32 mg-Hydrochlorothiazide 12.5 to 50 mg orally daily in 1 to 2 divided doses

Comments:

-The recommended starting dose of candesartan is 16 mg orally once a day when used as monotherapy in patients who are not volume depleted; doses larger than 32 mg do not appear to have a greater blood pressure lowering effect.

-A patient whose blood pressure remains uncontrolled on candesartan 32 mg can expect an incremental effect from candesartan 32 mg-hydrochlorothiazide 12.5 mg

-A patient whose blood pressure remains uncontrolled on hydrochlorothiazide 25 mg can expect an incremental effect from candesartan 16 mg-hydrochlorothiazide 12.5 mg; a patient whose blood pressure is controlled on hydrochlorothiazide 25 mg but is experiencing decreases in serum potassium can expect the same or incremental blood pressure effects from candesartan 16 mg-hydrochlorothiazide 12.5 mg and serum potassium may improve.

-Maximal antihypertensive effect can be expected within 4 weeks of treatment initiation.

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl 30 to 90 mL/min): No adjustment recommended

Severe renal dysfunction (CrCl 30 mL/min or less): Safety and effectiveness have not been established

Liver Dose Adjustments

Mild liver dysfunction (Child-Pugh A): No adjustment recommended

Moderate to severe liver dysfunction (Child-Pugh B and C): Not recommended for initiation due to commercially unavailable dose

Other Comments

Administration advice: Administer with or without food.

General: Overall response to this drug was similar in black and non-black patients.

Monitoring:

-Monitor serum electrolytes and renal function periodically.

-Monitor congestive heart failure patients closely for the first 2 weeks of treatment with this drug and following a dose increase of candesartan or a diuretic.

-Monitor patients with impaired hepatic function since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

Patient advice:

-Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.

-Encourage patients to report any lightheadedness that may occur during treatment initiation and to stop taking this drug until consulting a physician if syncope occurs.

-Dehydration may lead to excess blood pressure reduction; inform patients to contact their healthcare provider if they experience excessive perspiration, vomiting, or diarrhea.

What is the dose of Candesartan-Hydrochlorothiazid for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Candesartan-Hydrochlorothiazid available?

Candesartan-Hydrochlorothiazid is available in the following dosage forms and strengths:

  • Oral tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Candesartan-Hydrochlorothiazid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 4, 2018 | Last Modified: June 4, 2018

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