Candesartan-Hydrochlorothiazide

Candesartan-Hydrochlorothiazide is a combination medication used for the treatment of hypertension. 

• Candesartan-Hydrochlorothiazide is available under various brand names: Atacand HCT

Common side effects of Candesartan-Hydrochlorothiazide include:

• dizziness,
• cold or flu symptoms, and
• back pain

Serious side effects of Candesartan-Hydrochlorothiazide include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• muscle pain,
• tenderness,
• weakness,
• fever,
• unusual tiredness,
• dark-colored urine,
• eye pain,
• vision problems,
• lightheadedness,
• little or no urinating,
• yellowing of the skin or eyes (jaundice),
• easy bruising,
• unusual bleeding,
• increased thirst or urination,
• leg cramps,
• constipation,
• vomiting,
• irregular heartbeats,
• fluttering in your chest,
• numbness or tingling,
• muscle weakness,
• limp feeling,
• loss of coordination,
• confusion, and
• feeling unsteady

Rare side effects of Candesartan-Hydrochlorothiazide include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 16 mg/12.5 mg
• 32 mg/12.5 mg
• 32 mg/25 mg

Hypertension

Adult dosage

• 16-32 mg candesartan/12.5-25 mg HCTZ orally every day; optimum therapeutic effect expected within 4 weeks

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Candesartan-Hydrochlorothiazide has severe interactions with the following drug:
  • aliskiren
• Candesartan-Hydrochlorothiazide has serious interactions with at least 23 other drugs.
• Candesartan-Hydrochlorothiazide has moderate interactions with at least 219 other drugs.:
• Candesartan-Hydrochlorothiazide has minor interactions with at least 124 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to candesartan, hydrochlorothiazide, or sulfonamides
• Pregnancy (2nd and 3rd trimesters): Significant risk of fetal/neonatal morbidity and mortality
• Gout
• Refractory hypercalcemia
• Refractory hypokalemia
• Severe hepatic impairment and/or cholestasis
• Do not coadminister aliskiren in patients with diabetes mellitus
• As initial therapy

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Candesartan-Hydrochlorothiazide?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Candesartan-Hydrochlorothiazide?”

Cautions

• Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or without a history of allergy or bronchial asthma but are more likely in patients with such a history
• Acute transient myopia and acute angle-closure glaucoma have been reported, particularly with a history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)
• Photosensitivity may occur; instruct patients taking hydrochlorothiazide to protect skin from the sun and undergo regular skin cancer screening
• Monitor serum electrolytes periodically; drugs that inhibit the renin-angiotensin system can cause hyperkalemia; hydrochlorothiazide can cause hypokalemia and hyponatremia; hypomagnesemia can result in hypokalemia which appears difficult to treat despite potassium repletion
• Thiazides decrease urinary calcium excretion and may cause mild elevation of serum calcium; avoid therapy in patients with hypercalcemia
• Dual blockade of the renin-angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes (including acute renal failure) compared to monotherapy
• Caution in aortic mitral stenosis, hepatic impairment, hypercholesterolemia, hypercalcemia, parathyroid disease, pre-existing renal insufficiency, systemic lupus erythematosus, bilateral renal artery stenosis or anuria
• Hydrochlorothiazide may alter glucose tolerance and raise serum levels of cholesterol and triglycerides
• Thiazides may decrease urinary calcium excretion
• Symptomatic hypotension is most likely to occur in patients who have been volume and/or salt depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting may require temporarily reducing dose or volume repletion; volume and/or salt depletion should be corrected before initiating therapy
• In patients with heart failure, therapy may cause excessive hypotension, which may lead to oliguria, azotemia, and (rarely) with acute renal failure and death; in such patients, therapy should be started under close medical supervision; monitor closely for the first 2 weeks of treatment and whenever dose of candesartan or diuretic is increased
• Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function
• Hydrochlorothiazide may raise serum uric acid level due to reduced clearance of uric acid and may cause or exacerbate hyperuricemia and precipitate gout in susceptible patients
• Thiazide diuretics reported to cause exacerbation or activation of systemic lupus erythematosus

Pregnancy & Lactation

• Use with caution if benefits outweigh risks during 1st trimester
• Use in LIFE-THREATENING emergencies when no safer drug is available during 2nd and 3rd trimester.
• Lactation
  • Enters breast milk/contraindicated