Candesartan

What is candesartan?

Candesartan is a treatment for high blood pressure and heart failure. It helps to reduce your chances of having a heart attack or stroke in the future. 

How does candesartan work?

Candesartan is an angiotensin II receptor blocker. Angiotensin II normally works on the vessels to cause constriction and an increase in blood pressure. This medication works by blocking that action and causing relaxation of the blood vessels, lowering the blood pressure and making it easier for your heart to pump blood around your body.

How long does it take for candesartan to work?

Candesartan should start to work in the first two hours after taking it but it can take several weeks for it to make a difference. For heart failure, it usually takes longer and you can expect to see an improvement after a couple of months.

What are the risks of not taking candesartan?

If you have high blood pressure, not taking a suitable medication such as candesartan leaves you at risk of suffering from a stroke or heart attack. You may also risk heart failure getting worse.

Active ingredients

Candesartan cilexetil is the active ingredient within candesartan tablets.

Inactive ingredients

In addition, the inactive ingredients are lactose monohydrate, maize starch, hydroxypropyl cellulose, croscarmellose sodium, magnesium stearate and triethyl citrate.

Please note: inactive ingredients could vary between different brands of generic candesartan.

How to take candesartan?

Candesartan is taken once a day, at a specified time each day. The tablet should be taken whole and swallowed with a glass of water and does not need to be taken with food.

Candesartan dosage

For high blood pressure, the starting dose is typically 8mg, which could be increased up to 32mg. You’ll always start with the lowest possible dose until your doctor can monitor how effective the medicine is. For heart failure, you’ll likely start with a 4mg dose which can also be increased if necessary.

Switching high blood pressure medication

If your blood pressure medication is proving ineffective or causing you to have side effects, then your doctor may switch you to a different type of medication. It’s common for candesartan to be prescribed as a second option if you have experienced side effects with an initial type of medication. If you are switching your high blood pressure medication, always consult your doctor and follow their guidance on how and what to take.

Candesartan side effects

Common side effects include: 

• Abdominal pain
• Physical weakness or lack of energy
• Back pain
• Cough
• Diarrhoea
• Dizziness, particularly after standing up
• Headache
• An increased level of potassium recorded in blood tests 
• Low blood pressure 
• Nausea or vomiting
• Changes to kidney function
• Increased risk of infection

Uncommon side effects may include: 

• Skin swelling or rash
• Muscle aches or pains
• Other skin reactions
• Reduced platelet count

Rare side effects may include: 

• Joint pain
• Abnormal liver function
• Abnormalities of the blood including agranulocytosis, leucopenia and neutropenia)
• Hepatitis (inflammation of the liver)
• Hyponatraemia (low levels of sodium salt in the blood)

Serious side effects are rare, however, if you experience any of the following then seek medical attention: 

• Rash, swelling of the face, lips or tongue, wheezing or difficulty breathing – this may indicate an allergic reaction
• Yellowing of the skin or whites of the eyes – this can indicate a liver problem
• Purple spots on the skin or unexpected bruising or bleeding – this may indicate a blood disorder
• Weakness, an irregular heartbeat or palpitations, pins and needles or muscle cramps – these can be signs of changes in the salt levels in your blood

Contraindications

Candesartan is not suitable for you if you are:

• Allergic to any of the ingredients in this medication
• Pregnant

Before taking candesartan, tell your doctor if you:

• Have diabetes
• Are under 18 or over 65
• Are prone to vomiting or diarrhoea 
• Have kidney problems including renal artery stenosis
• Have had a kidney transplant
• Have heart problems, including heart failure or valvular heart disease 
• Have liver disease
• Have any operations scheduled
• Are trying to get pregnant 
• Are breastfeeding
• Are of black African or African-Caribbean descent
• Have a history of angioedema (rapid and severe swelling of the skin)
• Have primary aldosteronism
• Have been on a low-salt diet
• Have ever had low blood pressure

Drug interactions

It’s a good idea to disclose any other medicines that you are taking, or plan to take, before beginning a new prescription. This includes any herbal medicines or remedies. The following medicines could interact with candesartan: 

• Additional medication to treat high blood pressure
• Certain types of painkillers e.g. ibuprofen
• Aspirin in doses higher than 3mg per day 
• Potassium supplements 
• Heparin
• Diuretics 
• Spironolactone
• Lithium

How to cope with candesartan side effects?

Taking candesartan may make you feel dizzy. If this happens, sit or lie down until it passes and avoid driving until you feel stable. If you feel sick or nauseous, taking your medication with food may help to settle your stomach, and drink plenty of water if you are experiencing headaches.

Will candesartan affect my contraception?

Candesartan won’t interfere with your contraception. However, if you have high blood pressure then the combined oral contraceptive pill is likely to be unsuitable for you as it can also increase your blood pressure and place you at increased risk of experiencing a blood clot. Alert your doctor if this applies to you and they will be able to suggest a more suitable method of contraception.

Will candesartan affect my fertility?

Your fertility won’t be affected by candesartan but it should not be taken if you are pregnant. So you should let your doctor know if you are planning to start a family and they can prescribe you the appropriate medication.

Lifestyle changes to make when taking candesartan

Lifestyle factors such as your diet, how active you are and how much you smoke or drink alcohol all have an impact on your blood pressure. If your blood pressure is high you should be reducing your salt intake, eating plenty of fresh fruit and vegetables, cutting down on fatty foods and avoiding tobacco smoke. These changes will also help to reduce your blood pressure.

Candesartan vs other angiotensin receptor blockers

There are several different types of angiotensin receptor blockers. They work in similar ways but some are broken down inside the body in different ways. Which type of ARB you’ll be prescribed will depend on your condition, the severity of your symptoms and other factors such as your age.

Alternatives to candesartan

There are other types of medicine used to treat high blood pressure or heart failure. ACE inhibitors work in a similar way to angiotensin receptor blockers like candesartan. A calcium channel blocker, diuretic or beta-blocker are other medication options to lower blood pressure.

Natural treatments for high blood pressure

There are steps you can take towards a healthier lifestyle that will positively impact your blood pressure. These include eating a healthy, low salt and low fat diet, maintaining a healthy weight, cutting back on caffeine and alcohol and exercising regularly.

Can candesartan help anxiety?

Candesartan treats high blood pressure and heart failure but there is no evidence to suggest it can be helpful in treating a mental health condition like anxiety. If you’re worried you have anxiety, speak to your doctor who can suggest management strategies, including medication.

Is candesartan a beta blocker?

Candesartan is a type of medicine called an angiotensin receptor blocker (ARB) which is different from a beta-blocker. 

Will candesartan protect me from Alzheimer’s disease?

There are studies that have found that candesartan may increase your protection against developing Alzheimer’s disease. This isn’t a definite link but it is a potential benefit of taking candesartan.

Will Candesartan change my sex life?

Candesartan has not been shown to affect sexual function.

Can I take candesartan before surgery?

You will usually need to stop taking candesartan 24 hours before having surgery. You should always inform your doctor that you are taking candesartan if you are scheduled for a procedure so that they can advise you correctly on what you can and cannot take.

Can I take candesartan for migraines?

Candesartan can be taken to prevent migraines and may be effective for migraine sufferers who have tried other medications such as propranolol without success. Only take medication for the indication for which it was prescribed. 

Can I stop taking candesartan after my blood pressure is reduced?

If you stop taking candesartan then your blood pressure might rise again. Always take it as prescribed by your doctor, even if you feel better.

Is long term use of candesartan safe?

Yes, candesartan is designed for long term use and is more effective when taken over a long period of time.

Do I need to take candesartan forever?

It is likely that you will need to take candesartan long term in order to regulate your blood pressure. This ensures that your blood pressure stays at a reasonable level and protects you from suffering a heart attack or stroke.