Candesar comp 16/12.5 mg - 14 Tablet

Angiotensin II receptor blocker and thiazide diuretic combination therapy used in the treatment of hypertension.

-Administer without regard to meals.

-Side effects due to candesartan: Hypotension, renal function abnormality, dizziness, hyperkalemia, back pain, upper respiratory tract infection, pharyngitis, rhinitis, headache, exacerbation of renal disease (children & adolescents) and increased serum creatinine. -Side effects due to hydrochlorothiazide: Skin photosensitivity, hypokalemia, hypomagnesemia, hypercalcemia, and hyponatremia, hyperuricemia, myopia and acute angle-closure glaucoma, hypersensitivity angiitis, hypotension (including orthostatic), alopecia, skin rash, toxic epidermal necrolysis, urticaria, glycosuria, hypomagnesemia, abdominal cramps, anorexia, constipation, diarrhea, gastric irritation, nausea, vomiting, aplastic anemia, thrombocytopenia, anaphylaxis, dizziness, headache, paresthesia, restlessness, vertigo, asthenia, muscle spasm, blurred vision, xanthopsia, acute kidney injury and fever.

-Should not be given to patients suffering from hypersensitivity to candesartan or hydrochlorothiazide. -May cause hyperkalemia, risk factors include renal dysfunction, diabetes mellitus, concomitant use of potassium-sparing diuretics, potassium supplements and/or potassium containing salts. -Gout can be precipitated by hydrochlorothiazide, especially in patients with a history of gout, a familial predisposition to gout, or chronic renal failure. -Hypersensitivity reactions may occur with hydrochlorothiazide. -Symptomatic hypotension may occur upon initiation in patients who are salt or volume depleted. -Hydrochlorothiazide may cause acute transient myopia and acute angle-closure glaucoma, typically occurring within hours to weeks following initiation. -Photosensitization may occur. -May be associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow (eg, renal artery stenosis, heart failure). -Use with caution in patients with significant aortic/mitral stenosis. -Use hydrochlorothiazide with caution in patients with prediabetes or diabetes mellitus. -Dosage adjustment is required in patients with moderate hepatic impairment. -Thiazide diuretics may decrease renal calcium excretion; consider avoiding use in patients with hypercalcemia. -Use candesartan with caution in patients with unstented unilateral/bilateral renal artery stenosis. -Hydrochlorothiazide can cause SLE exacerbation or activation. -Hydrochlorothiazide is not effective in patients with a creatinine clearance <30 mL/minute; therefore, it may not be a useful agent in many elderly patients. -In case of over dose be ready to tell or show what was taken, how much and when it happened, and seek immediate medical attention. For additional information call us on 16676. Always tell your physician your detailed medical history.

-Store at room temperature. -Interactions due to hydrochlorothiazide: -Alcohol (Ethyl): May enhance the orthostatic hypotensive effect of thiazide diuretics. -Allopurinol: Thiazide diuretics may enhance the potential for allergic or hypersensitivity reactions to allopurinol. -Angiotensin-converting enzyme inhibitors: Thiazide diuretics may enhance the hypotensive effect of angiotensin-converting enzyme inhibitors. -Antidiabetic Agents: Thiazide diuretics may diminish the therapeutic effect of antidiabetic agents. -Multivitamins/Minerals (containing vitamins ADEK, Folate, Iron): Thiazide diuretics may enhance the hypercalcemic effect of Multivitamins/Minerals (containing vitamins ADEK, Folate, Iron). -Nonsteroidal Anti-Inflammatory Agents: Thiazide diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. -Vitamin D Analogs: Thiazide diuretics may enhance the hypercalcemic effect of Vitamin D Analogs. -Lithium: Thiazide diuretics may decrease the excretion of lithium. -Licorice: May enhance the hypokalemic effect of thiazide diuretics. -Ivabradine: Thiazide diuretics may enhance the arrhythmogenic effect of ivabradine. -Calcium Salts: Thiazide diuretics may decrease the excretion of calcium salts. -Beta2-Agonists: May enhance the hypokalemic effect of thiazide diuretics.

-Interactions due to Candesartan: -Alfuzosin: May enhance the hypotensive effect of blood pressure lowering agents. -Angiotensin-converting enzyme inhibitors: Angiotensin II receptor blockers may enhance the adverse/toxic effect of angiotensin-converting enzyme inhibitors. -Antipsychotic agents: blood pressure lowering agents may enhance the hypotensive effect of Antipsychotic Agents. -Dapoxetine: May enhance the orthostatic hypotensive effect of angiotensin II receptor blockers. -Duloxetine: blood pressure lowering agents may enhance the hypotensive effect of duloxetine. -Heparin: May enhance the hyperkalemic effect of angiotensin II receptor blockers. -Levodopa-containing products: blood pressure lowering agents may enhance the hypotensive effect of Levodopa-containing products. -Lithium: Angiotensin II receptor blockers may increase the serum concentration of Lithium. -Nicorandil: May enhance the hyperkalemic effect of angiotensin II receptor blockers. -Nonsteroidal Anti-Inflammatory Agents: Angiotensin II receptor blockers may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. -Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of blood pressure lowering agents. -Potassium Salts: May enhance the hyperkalemic effect of angiotensin II receptor blockers. -Potassium-sparing diuretics: Angiotensin II receptor blockers may enhance the hyperkalemic effect of potassium-sparing diuretics. -Trimethoprim: May enhance the hyperkalemic effect of angiotensin II receptor blockers. -For the rest of interactions refer to Storage.

-Drugs that act on the renin-angiotensin system can cause injury to the developing fetus.The use of drugs which act on the renin-angiotensin system are associated with oligohydramnios. The use of angiotensin II receptor blockers is generally not recommended to treat chronic hypertension in pregnant women. -It is not known if candesartan is excreted in breast milk. Thiazides are excreted in breast milk. Due to the potential for serious adverse reactions in the nursing infant, a decision whether to discontinue nursing or to discontinue the drug, should consider the importance of treatment to the mother. -Ask your physician before taking any medication during pregnancy or lactation.

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