Expert Opin Pharmacother. Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Candesartan is highly bound to plasma proteins (>99%) and does not penetrate red blood cells. In some patients, symptoms may include fatigue, headaches, dizziness, confusion, sweating, chest pain and vision problems. Table 2. high blood pressure in 2017. Rats received the drug by gavage, whereas mice received the drug by dietary administration. Maximum dose: 32 mg/day. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Ferric oxide (reddish brown) is added to the 8-mg, 16-mg, and 32-mg tablets as a colorant. J Hypertens Suppl. CHARM Added in patients already receiving ACE inhibitors. Candesartan has a very low maintenance dose. Systolic and diastolic are the two readings in which blood pressure is The prodrug candesartan cilexetil undergoes rapid and complete ester hydrolysis in the intestinal wall to form the active drug, candesartan. Atacandmay cause serious side effects including: Get medical help right away, if you have any of the symptoms listed above. Plasma concentrations of angiotensin I and angiotensin II, and plasma renin activity (PRA), increased in a dose-dependent manner after single and repeated administration of candesartan cilexetil to healthy subjects, hypertensive, and heart failure patients. Food with a high fat content has no effect on the bioavailability of candesartan from candesartan cilexetil. The usual starting dose for hypertension is 16 mg daily, and Comments: Consider administration of a lower initial dose in volume depleted patients. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Monitor serum lithium levels. Check out the center below for more medical references on hypertension, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness. ATACAND can cause you to feel dizzy or tired. [, Backman JT, Filppula AM, Niemi M, Neuvonen PJ: Role of Cytochrome P450 2C8 in Drug Metabolism and Interactions. The increase in Cmax for candesartan was 56% in patients with mild hepatic impairment and 73% in patients with moderate hepatic impairment. Candesartan is mainly excreted unchanged in urine and feces (via bile). In heart failure patients with renal impairment, AUC0-72h was 36% and 65% higher in mild and moderate renal impairment, respectively. Elimination of candesartan is primarily as unchanged drug in the urine and, by the biliary route, in the feces. InChI=1S/C33H34N6O6/c1-3-42-32-34-28-15-9-14-27(31(40)43-21(2)44-33(41)45-24-10-5-4-6-11-24)29(28)39(32)20-22-16-18-23(19-17-22)25-12-7-8-13-26(25)30-35-37-38-36-30/h7-9,12-19,21,24H,3-6,10-11,20H2,1-2H3,(H,35,36,37,38), 1-{[(cyclohexyloxy)carbonyl]oxy}ethyl 2-ethoxy-1-{[2'-(1H-1,2,3,4-tetrazol-5-yl)-[1,1'-biphenyl]-4-yl]methyl}-1H-1,3-benzodiazole-7-carboxylate, CCOC1=NC2=C(N1CC1=CC=C(C=C1)C1=CC=CC=C1C1=NN=NN1)C(=CC=C2)C(=O)OC(C)OC(=O)OC1CCCCC1, Use our structured and evidence-based datasets to. If you get pregnant while taking ATACAND, tell your doctor right away. Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Candesartan cilexetil and hydrochlorothiazide tablets, USP, 16 mg/12.5 mg, are peach, capsule shaped, scored, biconvex, non-film coated tablets, engraved "APO" with notch on one side and "16" bisect "12.5" on the other side . Inactive ingredients in ATACAND tablets and ATACAND oral suspension are: hydroxypropyl cellulose, polyethylene glycol, lactose, corn starch, carboxymethylcellulose calcium, and magnesium stearate. ATACAND is contraindicated in patients who are hypersensitive to candesartan. 4 mg are white to off-white, circular/biconvex-shaped, non-film-coated scored tablets, coded ACF on one side and 004 on the other. In mice given single oral doses of the primary metabolite, candesartan, the minimum lethal dose was greater than 1000 mg/kg but less than 2000 mg/kg. There were too few individuals in the age group of 1 -6 years old to determine whether Blacks respond differently than other patients to ATACAND. Do not keep medicine that is out of date or that you no longer need. 1996 Jun;19(2):75-81. [, Baguet JP, Barone-Rochette G, Neuder Y: Candesartan cilexetil in the treatment of chronic heart failure. sore throat. Candesartan cilexetil is an ARB that has been shown to provide effective blood pressure reduction alone 1 - 4 or in combination with hydrochlorothiazide (HCTZ). Last reviewed on RxList: 12/13/2022 It happens rarely, but some people have serious side effects after taking candesartan. DESCRIPTION. Take ATACAND exactly as prescribed by your doctor. The best ACE inhibitors for hypertension include Trandolapril, Enalapril, and Ramipril. Its empirical formula is C33H34N6O6, and its structural formula is: ATACAND is available for oral use as tablets containing either 4 mg, 8 mg, 16 mg, or 32 mg of candesartan cilexetil and the following inactive ingredients: hydroxypropyl cellulose, polyethylene glycol, lactose, corn starch, carboxymethylcellulose calcium, and magnesium stearate. From the dose-ranging studies of candesartan cilexetil, there was a dose related increase in plasma candesartan concentrations. There is also an AT2 receptor found in many tissues, but AT2 is not known to be associated with cardiovascular homeostasis. ACE activity was not altered in healthy subjects after repeated candesartan cilexetil administration. Prepare the final volume by adding the remaining vehicle. Proper Use. weakness or heaviness of the legs. In the CHARM program, comparing ATACAND in total daily doses up to 32 mg once daily (n=3803) with placebo (n=3796), 21.0% of patients discontinued ATACAND for adverse events vs. 16.1% of placebo patients. These effects are usually reversible. [, Takara K, Kakumoto M, Tanigawara Y, Funakoshi J, Sakaeda T, Okumura K: Interaction of digoxin with antihypertensive drugs via MDR1. Adjust the dosage according to blood pressure response. Candesartan cilexetil (Atacand) is a medication prescribed to treat high blood pressure. Candesartan cilexetil is better tolerated than enalapril, primarily because of a reduced incidence of cough, and was not associated with the hypokalaemia or hyperuricaemia seen with hydrochlorothiazide in a study in patients aged > or = 75 years. The overall incidence of adverse events reported with ATACAND was similar to placebo. They are supplied in bottles of 30 tablets (NDC 62559-640-30). The primary end point in both trials was time to either cardiovascular death or hospitalization for heart failure. High Blood Pressure. Candesartan is an oral drug that's used to treat high blood pressure (hypertension) and heart failure. If you take more ATACAND than prescribed, call your doctor, local poison control center, or go to the nearest emergency room. This has been generally true for angiotensin II antagonists and ACE inhibitors. The antihypertensive effects of candesartan cilexetil and losartan potassium at their highest recommended doses administered once-daily were compared in two randomized, double-blind trials. It is important to know what to do to help your child if he/she has a febrile seizure. Following oral administration, candesartan cilexetil undergoes hydrolysis at the ester link to form the active drug, candesartan, which is achiral. The primary method of analysis was slope of the change in systolic blood pressure (SBP) as a function of dose. Drug information provided by: Merative, Micromedex This medicine comes with a patient information insert. ATACAND must not be used in children less than 1 year of age for high blood pressure. These considerations may guide selection of therapy. Atacand is available for oral use as tablets containing either 4 mg, 8 mg, 16 mg, or 32 mg of candesartan cilexetil and the following inactive ingredients: hydroxypropyl cellulose, polyethylene glycol, lactose, corn starch, carboxymethylcellulose calcium, and magnesium stearate. Unlike ACE inhibitors, ARBs do not affect bradykinin-induced vasodilation. Candesartan may be used to treat hypertension, isolated systolic hypertension, left ventricular hypertrophy and diabetic nephropathy. Candesartan And Hydrochlorothiazide (Oral Route) - Mayo Clinic Skin and Appendages Disorders: Pruritus, rash and urticaria. The prodrug is cleaved by esterases within the intestine to liberate the active molecule. Atacand (candesartan cilexetil), a prodrug, is hydrolyzed to candesartan during absorption from the gastrointestinal tract. Candesartan is used alone or together with other medicines to treat high blood pressure (hypertension) in adults and children 1 to 16 years of age. Do not drive, operate machinery, or do other dangerous activities until you know how ATACAND affects you. 32 mg are pink, circular/biconvex-shaped, non-film-coated scored tablets, coded ACL on one side and 032 on the other. Learn about other high blood pressure medications. abnormal kidney test. May be used as a first line agent to delay progression of diabetic nephropathy. Candesartan has much greater affinity (>10,000-fold) for the AT1 receptor than for the AT2 receptor. Candesartan cilexetil, 16 mg once daily, produces a significantly greater reduction in blood pressure than losartan, 50 mg once daily. treat high blood pressure in adults and children, 1 to 17 years of age, are dehydrated (decreased body fluids) due to vomiting and diarrhea, swelling of your face, lips, tongue or throat, cold or flu symptoms (upper respiratory tract infection), nasal congestion and stuffiness (rhinitis), Prepare the vehicle by adding equal volumes of Ora-Plus. Minor hepatic metabolism of candesartan (<20%) occurs by O-deethylation via cytochrome P450 2C9 to form an inactive metabolite. Candesartan | Side Effects, Dosage, Uses & More - Healthline Table 1. High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Candesartan Dosage Guide + Max Dose, Adjustments - Drugs.com No lethality was observed in acute toxicity studies in mice, rats and dogs given single oral doses of up to 2000 mg/kg of candesartan cilexetil or in rats given single oral doses of up to 2000 mg/kg of candesartan cilexetil in combination with 1000 mg/kg of hydrochlorothiazide. Avoid use of aliskiren with ATACAND in patients with renal impairment (GFR <60 mL/min) [see CONTRAINDICATIONS]. The incidence of abnormal renal function (e.g., creatinine increase) leading to drug discontinuation in ATACAND-treated patients was 6.3% compared with 2.9% in placebo-treated patients. An experimental study in rats. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. It is estimated that one in every 25 children will have at least one febrile seizure. After single and repeated administration, the pharmacokinetics of candesartan are linear for oral doses up to 32 mg of candesartan cilexetil. Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. Total plasma clearance of candesartan is 0.37 mL/min/kg, with a renal clearance of 0.19 mL/min/kg. Dispense into suitably sized amber PET bottles. To prepare 160 mL of a 1-mg/mL suspension, use equal volumes (80 mL each) of Ora-Plus and Ora-Sweet SF or use 160 mL of Ora-Blend SF. Store at room temperature (below 30C/86F). Inhibition of aldosterone secretion may increase sodium and water excretion while decreasing potassium excretion. stage of the disease. Know the warning signs and symptoms of high blood High blood pressure puts you at risk for a number of other conditions. Candesartan cilexetil. 1996-2021 MedicineNet, Inc. All rights reserved. Candesartan is a selective AT1 subtype angiotensin II receptor antagonist. 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. skin rash. arteries of the body is elevated. What causes high blood pressure (hypertension)? This monograph has been modified to include the generic and brand name in many instances. Following an intravenous dose of 14C-labeled candesartan, approximately 59% of radioactivity is recovered in urine and approximately 36% in feces. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Candesartan is used to treat high blood pressure (hypertension). Studies performed in recent years suggest that AT2 antagonizes AT1-mediated effects and directly affects long-term blood pressure control by inducing vasorelaxation and increasing urinary sodium excretion. What are the side effects of candesartan? The volume of distribution of candesartan is 0.13 L/kg. Candesartan cannot be removed by hemodialysis. Check out the center below for more medical references on high blood pressure, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness. In these two studies, the benefit of ATACAND in reducing the risk of CV death or heart failure hospitalization (18% p<0.001) was evident in major subgroups (see Figure), and in patients on other combinations of cardiovascular and heart failure treatments, including ACE inhibitors and beta-blockers. Do not use after the expiration date stated on the bottle. Telephone numbers of certified poison control centers are listed in the Physicians Desk Reference (PDR). nosebleeds. I use periodically and it takes only a few days to drop my blood pressure. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. dizziness, Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system. Its empirical formula is C33H34N6O6, and its structural formula is. Improve clinical decision support with information on. The metabolism of Acenocoumarol can be decreased when combined with Candesartan cilexetil. Candesartan cilexetil is the prodrug form of the potent angiotensin II receptor antagonist, candesartan. Active ingredient: candesartan cilexetil. The antihypertensive effects of ATACAND were evaluated in hypertensive children 1 to < 6 years old and 6 to < 17 years of age in two randomized, double-blind multicenter, 4-week dose ranging studies. Candesartan cilexetil given to pregnant rabbits at an oral dose of 3 mg/kg/day (approximately 1.7 times the MRHD on a mg/m basis) caused maternal toxicity (decreased body weight and death) but, in surviving dams, had no adverse effects on fetal survival, fetal weight, or external, visceral, or skeletal development. Initially 4 mg once daily, increased to up to 32 mg once daily, dose to be increased at intervals of at least 2 weeks to 'target' dose of 32 mg once daily or to maximum tolerated dose. As a result, candesartan relaxes the blood vessels. In a total of 1268 patients with mild to moderate hypertension who were not receiving other antihypertensive therapy, candesartan cilexetil 32 mg lowered systolic and diastolic blood pressure by 2 to 3 mm Hg on average more than losartan potassium 100 mg, when measured at the time of either peak or trough effect. sores, ulcers, or white spots on the lips or in the mouth. Typically, a concentration of 1 mg/mL will be suitable for the prescribed dose. the starting dose for treating heart failure is 4 mg once daily. Blood pressure readings above 180/120 mmHg are considered stroke-level and require immediate medical attention. 2006 Oct 2;406(1-2):92-6. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure and death. Angiotensin II increases blood pressure by increasing total peripheral resistance, increasing sodium and water reabsorption in the kidneys via aldosterone secretion, and altering cardiovascular structure. gets lower, and taking these pills drop it too low and I get a little dizzy at times. In heart failure patients, candesartan 8 mg resulted in decreases in systemic vascular resistance and pulmonary capillary wedge pressure. Triple combination of ATACAND with an ACE-inhibitor and a mineralocorticoid receptor antagonist is generally not recommended. The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity trial in patients intolerant of ACE inhibitors (CHARMAlternative), 2. Febrile seizure is not epilepsy. It has also been demonstrated in rats that candesartan passes across the placental barrier and is distributed in the fetus. In conclusion, candesartan cilexetil, 8 or 16 mg once daily, is an effective and well-tolerated antihypertensive treatment, with a trough-to-peak ratio close to 1.0. The most common reasons for discontinuation of therapy with ATACAND were headache (0.6%) and dizziness (0.3%). For children who weighed < 50 kg the doses of ATACAND were 2, 8, or 16 mg once daily. The target dose is 32 mg once daily, which is achieved by doubling the dose at approximately 2-week intervals, as tolerated by the patient. Patients with symptomatic hypotension may require temporarily reducing the dose of ATACAND, diuretic or both, and volume repletion. Most of the trials were of candesartan cilexetil as a single agent, but it was also studied as add-on to hydrochlorothiazide and amlodipine. It works by blocking the action of a substance in the body that causes the blood vessels to tighten. Volume and/or salt depletion should be corrected before initiating therapy with ATACAND. Am J Hypertens. Repeat, if necessary. Principles of Human Physiology (3rd ed.). Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. No lethality was observed in acute toxicity studies in mice, rats, and dogs given single oral doses of up to 2000 mg/kg of candesartan cilexetil. has no warning signs or symptoms. The mean daily dose of ATACAND was approximately 24 mg and 61% of subjects on treatment received 32 mg once daily. Benjamin-Cummings Publishing Company. Less commonly, a febrile seizure may only affect one side of the body. Ferric oxide (reddish brown) is added to the 8-mg, 16-mg, and 32-mg tablets as a colorant. hypertension (1 in 3 adults), and only half of them are able to manage it. Atacand (candesartan cilexetil) is a selective AT1 subtype angiotensin II receptor antagonist used to treat high blood pressure (hypertension) in adults and children 1 to less than 17 years of age. The antihypertensive effect was similar in men and women and in patients older and younger than 65. Marina Etinger, Boris Fedotev, Ben-Zion Dolitzky, "Preparation of candesartan cilexetil." You can report side effects to FDA at 1-800-FDA-1088. Eur J Pharmacol. In the CHARM program (heart failure patients), the incidence of hyperkalemia was 6.3% in patients treated with ATACAND versus 2.1% in patients treated with placebo. 2006 Mar;24(1):S23-30. Many patients will require more than one drug to achieve blood pressure goals. [, Vauquelin G, Fierens F, Van Liefde I: Long-lasting angiotensin type 1 receptor binding and protection by candesartan: comparison with other biphenyl-tetrazole sartans. Call your doctor for medical advice about side effects. Stay away from these foods. Tablets should be stored at room temperature, between 15-30 C (59-86 F). Fetal testing may be appropriate, based on the week of pregnancy. ATACAND can be administered once or twice daily with total daily doses ranging from 8 mg to 32 mg. Epub 2006 Aug 9. Candesartan cilexetil and hydrochlorothiazide tablets may be administered with or without food. fluid and water retention, After a median follow-up of 34 months, there was a 23% reduction in the risk of cardiovascular death or heart failure hospitalization on ATACAND (p<0.001), with both components contributing to the overall effect (Table 1). In mice given single oral doses of the primary metabolite, candesartan, the minimum lethal dose was greater than 1000 mg/kg but less than 2000 mg/kg. Store ATACAND oral suspension at room temperature below 86F (30C). If you miss a dose of ATACAND, take it as soon as you remember. Co-administration of ATACAND with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. In double-blind clinical trials in patients with primary hypertension, candesartan cilexetil 2-16 mg once-daily was associated with a low incidence To obtain up-to-date information about the treatment of overdose, consult your Regional Poison Control Center. The incidence of hyperkalemia leading to drug discontinuation in ATACAND-treated patients was 2.4% compared with 0.6% in placebo-treated patients. Whether this difference has clinical relevance is not yet known. atacand (candesartan cilexetil) drug. Revised: Jun 2020. Learn the four stages of hypertension, which include normal, elevated blood pressure, stage I hypertension, and stage II hypertension. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge. The mean age was 67 years and 32% were female, 48% were NYHA II, 49% were NYHA III, 4% were NYHA IV, and the mean ejection fraction was 30%. Candesartan cilexetil is similarly well tolerated as placebo, both when given as monotherapy, and in combination for example with hydrochlorothiazide. 75% of candesartan is excreted as unchanged drug in urine and feces. lungs, The tablets can be made into a suspension by a compounding pharmacy for people who have trouble swallowing . Abstract. [, Mendis B, Page SR: Candesartan: widening indications for this angiotensin II receptor blocker? Candesartan Monograph for Professionals - Drugs.com Candesartan is an angiotensin II receptor blocker (ARB). Monitoring of blood pressure is recommended during dose escalation and periodically thereafter. Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. RxList does not provide medical advice, diagnosis or treatment. Advise female patients of childbearing age should be told about the consequences of exposure to ATACAND during pregnancy. Candesartan cilexetil prevented bandinginduced prolonged action potential duration and reduced the occurrence of triggered activity in LV papillary muscles. ATACAND and other medicines may affect each other causing serious side effects. Candesartan blocks the angiotensin receptor and therby prevents the action of angiotensin. Febrile seizures, or convulsions caused by fever, can be frightening in small children or infants. Candesartan cilexetil (candesartan) is a drug used for treating high blood pressure (hypertension). Drugs that inhibit the renin-angiotensin system can cause hyperkalemia. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. ATACAND can cause harm or death to an unborn baby. High blood pressure (hypertension) means high pressure (tension) in the arteries. ATACAND is indicated for the treatment of heart failure (NYHA class II-IV) in adults with left ventricular systolic dysfunction (ejection fraction 40%) to reduce cardiovascular death and to reduce heart failure hospitalizations [see Clinical Studies]. blood pressure. What are the possible side effects of ATACAND? MedicineNet does not provide medical advice, diagnosis or treatment. Exchange transfusions or dialysis may be required as a means of reversing hypotension and/or substituting for disordered renal function. What should I tell my doctor before taking ATACAND? Amias (Eureco (Netherlands), Takeda (United Kingdom)), Chronic heart failure with reduced ejection fraction (NYHA Class II), Chronic heart failure with reduced ejection fraction (NYHA Class III), Chronic heart failure with reduced ejection fraction (NYHA Class IV), Agents Acting on the Renin-Angiotensin System, Antihypertensive Agents Indicated for Hypertension, Cytochrome P-450 CYP2C8 Inhibitors (strong), Predicted MS/MS Spectrum - 10V, Positive (Annotated), Predicted MS/MS Spectrum - 20V, Positive (Annotated), Predicted MS/MS Spectrum - 40V, Positive (Annotated), Predicted MS/MS Spectrum - 10V, Negative (Annotated), Predicted MS/MS Spectrum - 20V, Negative (Annotated), Predicted MS/MS Spectrum - 40V, Negative (Annotated). Candesartan has good bioavailibility and is the most potent by weight of the AT-1 . Rinse the mortar and pestle clean using the vehicle and add this to the vessel. This lowers blood pressure and increases the supply of blood and oxygen to the heart. Candesartan cilexetil produced a slow onset, long-lasting antihypertensive action at a dose range of 0.1-10 mg/kg with no rebound effect upon drug withdrawal. Candesartan is mainly excreted unchanged in urine and feces (via bile). 5 - 7 Its particular benefit, however, is related not only to its blood pressure-lowering effect but more to its protective effect on end-organs such as the heart, 8 - 11 kidneys . The metabolism of Candesartan cilexetil can be decreased when combined with Acetohexamide. Candesartan Cilexetil 8 mg Tablets - Summary of Product - medicines Candesartan is mainly excreted unchanged in urine and feces (via bile). In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Following administration of the candesartan cilexetil prodrug, the absolute bioavailability of candesartan was estimated to be 15%. What should I avoid while taking ATACAND? Do not use ATACAND for a condition for which it was not prescribed. unusual bleeding or bruising. There were 93 patients 1 to < 6 years of age, 74% of whom had renal disease, that were randomized to receive an oral dose of candesartan cilexetil suspension 0.05, 0.20 or 0.40 mg/kg once daily. 32 mg once daily. (2009). Closely observe infants with histories of in utero exposure to ATACAND for hypotension, oliguria, and hyperkalemia [see Use in Specific Populations]. ATACAND may be administered with or without food. ATACAND can cause symptomatic hypotension. As a result blood vessels expand and blood pressure is reduced. Hypertension occurs when blood pressure readings are 130/80 mmHg or higher. The American Academy of Cardiology defines high blood pressure slightly Serious side effects. Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. It may also be used as an alternative agent for the treatment of heart failure, systolic dysfunction, myocardial infarction and coronary artery disease. Its action is, therefore, independent of the pathways for angiotensin II synthesis. [. The pharmacokinetics in heart failure patients is similar to that in healthy elderly volunteers [see DOSAGE AND ADMINISTRATION].
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