Candesartan Cilexetil + Hydrochlorothiazide

Generic Details

Generic Name

Candesartan-Cilexetil-Hydrochlorothiazide

Other Names

  • Candesartan HCTZ

Drug Class

  • Angiotensin II Receptor Blocker
  • Thiazide Diuretic

Chemical Formula

C33H34N6O6S2.C20H25ClN6O3S

Molecular Weight

610.82 g/mol (candesartan cilexetil) + 421.02 g/mol (hydrochlorothiazide)

Mechanism of Action

  • Candesartan blocks the action of angiotensin II, causing blood vessels to dilate and reducing blood pressure.
  • Hydrochlorothiazide works by increasing the excretion of water and sodium by the kidneys.

Indications

  • Hypertension (high blood pressure)

Common Dosage Forms

  • Tablet

Typical Dosage

  • 16 mg/12.5 mg once daily

Pediatric Dosage

  • Not established

Geriatric Dosage

  • Dosage adjustment may be necessary based on renal function

Side Effects

  • Hypotension
  • Hyperkalemia
  • Renal impairment
  • Dizziness
  • Headache

Contraindications

  • History of angioedema with previous use of ACE inhibitors
  • Anuria
  • Severe renal impairment (CrCl <30 mL/min)
  • Hypersensitivity to sulfonamides

Pregnancy Category

  • D

Lactation Safety

  • May pass into breast milk, not recommended during breastfeeding

Drug Interactions

  • NSAIDs may reduce the antihypertensive effect
  • Potassium-sparing diuretics may lead to hyperkalemia

Overdose Symptoms

  • Hypotension
  • Electrolyte disturbances

Antidote for Overdose

  • Supportive treatment with close monitoring of electrolyte levels

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Bioavailability: Candesartan - 15%, Hydrochlorothiazide - 50-70%
  • Distribution: Candesartan - extensively bound to plasma proteins, Hydrochlorothiazide - crosses the placental barrier and is distributed into breast milk
  • Metabolism: Candesartan - converted to an active metabolite, Hydrochlorothiazide - minimal metabolism
  • Excretion: Candesartan - renal, Hydrochlorothiazide - renal

Precautions

  • Monitor renal function and electrolytes regularly
  • Avoid in patients with sulfonamide allergy

Warnings

  • Risk of hypotension and electrolyte imbalances

Others

  • May be available in fixed-dose combinations with other antihypertensive medications.