Atakand, 32 mg tablets 28 pcs

Atacand has a hypotensive effect.

It selectively blocks angiotensin II receptors (type AT1).

Indications

Arterial hypertension.

Active ingredient

Composition

1 tablet contains candesartan cilexetil 32 mg.

How to take, the dosage

Atacand is recommended to be prescribed in a dose of 8 mg once daily. Maximum therapeutic effect is achieved after 4 weeks of therapy. In the absence of the necessary clinical effect, the dose can be increased to 16 mg/day.

The tablets are taken once daily regardless of meals.

When the drug is prescribed to the elderly, patients with mild to moderate renal dysfunction (CK>30 ml/min/1.73 m2) or with mild to moderate chronic liver disease no dosage adjustment is required.
When the drug is prescribed to patients with severe renal impairment (KK2) the starting dose should be 4 mg.

There are no clinical data on the use of the drug in patients with severe liver disease (cirrhosis). In this regard, in these patients it is recommended to start treatment with a daily dose of 4 mg.

The drug can be used both as monotherapy and in combination with other antihypertensive agents (thiazide diuretics, calcium channel blockers).

Special Instructions

When prescribing Atacand to patients with renal artery stenosis (bilateral or single artery stenosis), it should be taken into account that drugs affecting the renin-angiotensin-aldosterone system (ACE inhibitors) may increase serum urea and creatinine concentrations. There is a possibility (unconfirmed) that similar effects may be observed with angiotensin II antagonists.

Patients treated with 12.5 mg hydrochlorothiazide tolerate well the subsequent use of Atacand at a dose of 8 mg. Patients also tolerate concomitant therapy with hydrochlorothiazide at a dose of up to 25 mg and Atacand at a dose of 8-16 mg for 8 weeks well. However, with a pronounced decrease of the RBC (when using diuretics in high doses), symptomatic hypotension may occur, which is also typical for other drugs affecting the renin-angiotensin-aldosterone system. Obviously, this condition needs to be corrected before using Atacand.

The concomitant use of Atacand with potassium-saving diuretics that do not eliminate potassium from the body can theoretically lead to increased serum potassium concentrations. Caution should be exercised if such a combination is necessary.

Pediatric use

The clinical efficacy and safety of Atacand in children has not been established.

Contraindications

Hypersensitivity; pregnancy, lactation; childhood.

Side effects

CNS disorders: often (more than 2%) – headache, dizziness.

Laboratory parameters: increase in AST activity (slightly higher than in the groups taking placebo). In general, there were no clinically significant changes in laboratory parameters when taking Atacand.

Others: often (more than 2%) – back pain.

The clinical trials showed good tolerability of the drug, the incidence of side effects was comparable to placebo, it did not depend on the dose of the drug, as well as on the age and sex of the patient. In general, the side effects were moderate and temporary. The number of drug discontinuation cases due to side effects was similar to that of the candesartan cilexetil and placebo groups.

A causal relationship between Atacand administration and the side effects described has not been established.

Overdose

Symptoms
Analysis of the pharmacological properties of the drug suggests that the main manifestations of overdose may be clinically pronounced decreased BP and dizziness. Individual cases of overdose of the drug (up to 672 mg of candesartan cilexetil) have been described, which ended in the recovery of patients without severe consequences.

Treatment

If clinically pronounced arterial hypotension develops, symptomatic treatment should be administered and the patient’s condition monitored. Place the patient, elevate the head end of the bed. If necessary, increase the volume of circulating plasma, e.g., by intravenous administration of isotonic sodium chloride solution. Sympathomimetic drugs may be administered if necessary. Excretion of candesartan by hemodialysis is unlikely.

Pregnancy use

The drug is contraindicated in pregnancy.

In experimental studies it has been found that the use of candesartan leads to impaired renal function in the fetus in the late developmental period, as well as in the neonatal period. The mechanism of this action is probably related to the effect of the drug on the renin-angiotensin-aldosterone system.

In humans, fetal renal perfusion, which depends on the renin-angiotensin-aldosterone system, begins in the second trimester of pregnancy. Thus, the risk to the fetus increases when the drug is taken in the second trimester.

It has not been determined whether candesartan is excreted with breast milk.

Breast-feeding must be stopped if the drug is to be used during lactation because of the potential for adverse side effects in the baby.

Candesartan has been found in the milk of lactating rats in experimental studies.

Similarities