Trade Names:Atacand HCT- Tablets 16 mg candesartan, 12.5 mg hydrochlorothiazide- Tablets 32 mg candesartan, 12.5 mg hydrochlorothiazideAtacand Plus (Canada)
Antagonizes the effect of angiotensin II (vasoconstriction and aldosterone secretion) by blocking the angiotensin II receptor (AT 1 receptor) in vascular smooth muscle and the adrenal gland, producing decreased BP.Hydrochlorothiazide
Increases chloride, sodium, and water excretion by interfering with transport of sodium ions across renal tubular epithelium.
Treatment of hypertension.
Any component of product; patients with anuria or hypersensitivity to sulfonamide-derived drugs.
PO Atacand HCT may be substituted for previously titrated individual components. The daily dose range for Atacand HCT tablets is candesartan 16 mg combined with hydrochlorothiazide 12.5 mg to candesartan 32 mg combined with hydrochlorothiazide 25 mg.
Give every day in the morning, with or without food. Administer with food if GI upset occurs.
Store tablets at controlled room temperature (59° to 86°F). Keep container tightly closed.
Increased risk of orthostatic hypotension.Antidiabetic agents (oral and insulin agents)
Dosage adjustment of antidiabetic agent may be necessary.Corticosteroids, ACTH
Increased electrolyte depletion, increasing risk of hypokalemia.NSAIDs
The diuretic, natriuretic, and hypertensive effects of loop, potassium-sparing, and thiazide diuretics may be reduced.Pressor amines (eg, norepinephrine)
Decreased responsiveness of the pressor amine.Skeletal muscle relaxants, nondepolarizing (eg, tubocurarine)
Increased responsiveness of the muscle relaxant.Hydrochlorothiazide Bile acid sequestrants
May reduce hydrochlorothiazide absorption; give hydrochlorothiazide at least 2 h before sequestrant.Diazoxide
May cause hyperglycemia.Digitalis glycosides
Diuretic-induced hypokalemia and hypomagnesemia may lead to digitalis-induced arrhythmias.Lithium
Because renal excretion of lithium may be reduced, avoid use if possible.Loop diuretics (eg, furosemide)
Synergistic effects may occur, resulting in profound diuresis and serious electrolyte abnormalities.Sulfonylureas (eg, chlorpropamide)
Hypoglycemic effect of sulfonylurea may be decreased, necessitating an increase in sulfonylurea dosage.
Hydrochlorothiazide may decrease serum protein-bound iodine levels without signs of thyroid disturbances; may cause diagnostic interference of serum electrolyte levels, blood and urine glucose levels, serum bilirubin levels, and serum uric acid levels.
Tachycardia; palpitation; extrasystoles; bradycardia; abnormal ECG.Hydrochlorothiazide
Hypotension (including orthostatic hypotension).
Dizziness; vertigo; paresthesia; hypesthesia; depression; insomnia; anxiety; somnolence.Hydrochlorothiazide
Eczema; increased sweating; pruritus; dermatitis; rash; urticaria.Hydrochlorothiazide
Erythema multiforme (including Stevens-Johnson syndrome); exfoliative dermatitis (including toxic epidermal necrolysis); alopecia.
Sinusitis; pharyngitis; rhinitis; conjunctivitis; tinnitus.Hydrochlorothiazide
Transient blurred vision; xanthopsia.
Nausea; abdominal pain; diarrhea; dyspepsia; gastritis; gastroenteritis; vomiting.Hydrochlorothiazide
Pancreatitis; sialadenitis; cramping; constipation; gastric irritation; anorexia.
UTI; hematuria; cystitis; albuminuria.Hydrochlorothiazide
Renal failure; renal function impairment; interstitial nephritis; impotence.
Epistaxis; neutropenia; leukopenia; agranulocytosis.Hydrochlorothiazide
Aplastic anemia; hemolytic anemia; thrombocytopenia.
Hepatic function impairment; increased transaminase levels.
Hyperuricemia; hyperglycemia; hypokalemia; increased BUN; increased creatine phosphokinase; hypertriglyceridemia.Hydrochlorothiazide
Electrolyte imbalance; glycosuria.
Upper respiratory tract infection; influenza-like symptoms; bronchitis; cough; dyspnea.Hydrochlorothiazide
Respiratory distress (including pneumonitis and pulmonary edema).
Back pain; fatigue; pain; chest pain; peripheral edema; asthenia; arthralgia; myalgia; arthrosis; arthritis; leg cramps; sciatica; infection; viral infection.Hydrochlorothiazide
Fever; weakness; anaphylactic reactions; necrotizing angiitis; photosensitivity; muscle spasm; purpura.
When used in pregnancy during the second and third trimesters, drugs that act directly on the renin-angiotensin system can cause injury and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.
Monitor blood sugar in diabetic patient when drug is started or dose is changed. Report significant changes to health care provider.BP
Monitor and record BP and pulse. Should hypotension result, hold medication and notify health care provider.Serum electrolytes
Ensure that serum electrolytes are monitored periodically.
Category D (second and third trimester); Category C (first trimester). Can cause injury and death to fetus if used during second or third trimester.
Candesartan: Undetermined; hydrochlorothiazide: excreted in breast milk.
Safety and efficacy in children younger than 18 yr of age not established.
Use with caution.
Use with caution.
May require adjustments of insulin or oral hypoglycemic agents; hyperglycemia may occur.
May occur, or acute gout may be precipitated.
Symptomatic hypotension may occur after initiation of therapy in patients who are intravascularly volume depleted. Correct these conditions prior to administration.
May be activated or exacerbated.
Hypotension, dizziness, tachycardia, bradycardia.Hydrochlorothiazide
Electrolyte depletion (eg, hypokalemia, hypochloremia, hyponatremia), dehydration.
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