Other drug names:	A-Am  An-Az  B  C-Ch  Ci-Cz  D-Dh  Di-Dz  E  F  G  H  I-J  K-L  M-Mh  Mi-Mz  N-Nh  Ni-Nz  O  P-Pl  Pm-Pz  Q-R  S-Sn  So-Sz  T-To  Tp-Tz  U-V  W-Z  0-9

In the U.S.—

Atacand HCT

• Antihypertensive

Candesartan belongs to the class of medicines called angiotensin II receptor antagonists. Hydrochlorothiazide belongs to a class of medicines called thiazide diuretics. When these two medicines are combined, they are used to treat high blood pressure (hypertension).

This medicine is available only with your doctor's prescription, in the following dosage forms:

Oral
• Tablets (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the combinations of candesartan and hydrochlorothiazide, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to candesartan, hydrochlorothiazide, or any sulfonamide-type medicines. Also tell your health care provider if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Use of candesartan and hydrochlorothiazide combination during pregnancy, especially during the second and third trimesters (after the first 3 months) can cause adverse effects in the newborn. Therefore, it is important that you check with your doctor immediately if you think that you may have become pregnant. Be sure that you have discussed this with your doctor before taking this medicine.

Breast-feeding—It is not known whether candesartan passes into human breast milk. However, it is distributed into animal milk. Thiazides, including hydrochlorothiazide, are distributed into human breast milk.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of candesartan and hydrochlorothiazide combination in children with use in other age groups.

Older adults—This medicine has been tested in patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking candesartan and hydrochlorothiazide combination, it is especially important that your health care professional know if you are taking any of the following:

• Lithium (e.g., Eskalith)—Concurrent use may reduce the amount of lithium that is removed from the body, which may lead to lithium toxicity.
• Sympathomimetic agents such as norepinephrine—Hydrochlorothiazide may causse a decreased response to these substances.

Other medical problems—The presence of other medical problems may affect the use of candesartan and hydrochlorothiazide combination. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy or
• Asthma, bronchial—May have an increased risk of allergic reaction to hydrochlorothiazide
• Congestive heart failure, severe—Lowering of blood pressure by candesartan and hydrochlorothiazide combination may make this condition worse
• Diabetes mellitus— Insulin dosage may need to be adjusted.
• Fluid or electrolyte (e.g., potassium, chloride, sodium) imbalance (due to excessive perspiration, vomiting, diarrhea, etc.)—The side effects of candesartan and hydrochlorothiazide may be increased
• Kidney disease or
• Liver disease—These conditions may be aggravated by candesartan and hydrochlorothiazide
• Sympathectomy—Blood pressure-lowering effects may be increased
• Systemic lupus erythematosus—Candesartan and hydrochlorothiazide combination may trigger or worsen this condition.

Dosing—

For patients taking this medicine for high blood pressure:

• This medicine works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.
• In addition to the use of the medicine your doctor has prescribed, treatment for your high blood pressure may include weight control and care in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet.
• Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well.
• Remember that this medicine will not cure your high blood pressure but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life . If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.
• This medicine may be taken with or without food.

The dose of candesartan hydrochlorothiazide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of candesartan and hydrochlorothiazide combination. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking candesartan and hydrochlorothiazide .

• For oral dosage form (tablets):
  • For high blood pressure:
    • Adults—1 tablet once a day. Your doctor may increase your dose if needed.
    • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Check with your doctor immediately if you think that you may be pregnant. Candesartan and hydrochlorothiazide may cause birth defects or other problems in the baby if taken during pregnancy.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes that contain potassium, since they may change your blood potassium levels, or over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

Dizziness or light-headedness may occur. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you experience these effects.

Check with your doctor right away if you become sick while taking this medicine, especially with severe or continuing nausea and vomiting or diarrhea. These conditions may cause you to lose too much water and lead to low blood pressure.

Dizziness, light-headedness, or fainting also may occur if you exercise or if the weather is hot. Heavy sweating can cause loss of too much water and result in low blood pressure. Use extra care during exercise or hot weather.

Avoid alcoholic beverages until you have discussed their use with your doctor. Alcohol may make the low blood pressure effect worse and/or increase the possibility of dizziness or fainting.

For diabetic patients:

• Hydrochlorothiazide may raise blood sugar levels. Check with your doctor if any changes in your blood sugar levels occur.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Less frequent
  • Cough;  dizziness;  dryness of mouth;  fever;  increased thirst ;  irregular heartbeat;  light-headedness;  muscle cramps;  nausea;  sore throat;  unusual tiredness;  vomiting;  weak pulse;  weakness 
  
  

• Rare
  • Arm pain;  chest pain;  chest tightness;  fast or irregular heartbeat;  large, hive like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs;  shortness of breath  
  
  

Side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

• Less common
  • Back pain;  chills;  diarrhea;  headache;  joint pain;  loss of appetite;  muscle aches and pains;  nausea;  runny nose;  sneezing;  sweating ;  trouble sleeping ;  unusual tiredness ;  vomiting 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 01/08/2001