This combination is used for the treatment of hypertension and congestive heart failure.

Candesartan Cilexetil and Hydrochlorothiazide together provide a dual mechanism by combining an angiotensin II receptor blocker with a diuretic.

Candesartan Cilexetil is an ester prodrug that is converted in the body to its active form, candesartan, during absorption from the gastrointestinal tract. It works by selectively blocking angiotensin II from binding to AT1 receptors, thereby preventing vasoconstriction and reducing aldosterone secretion in various tissues such as vascular smooth muscle and adrenal glands.

Hydrochlorothiazide is a thiazide diuretic that acts on the renal tubules to enhance sodium excretion. This leads to a reduction in plasma volume and a subsequent increase in renin activity and aldosterone secretion, causing potassium loss and reduced serum potassium levels. The presence of candesartan helps counteract this potassium loss associated with hydrochlorothiazide.

The usual dose is one tablet once daily.

No clinically significant drug interactions have been observed with candesartan cilexetil when used with medications such as glyburide, nifedipine, digoxin, warfarin, hydrochlorothiazide, or oral contraceptives. However, the use of alcohol, barbiturates, or narcotics may enhance the risk of orthostatic hypotension. Antidiabetic medications, including insulin and oral agents, may require dose adjustments. Concomitant use with other antihypertensive drugs may produce an additive blood pressure-lowering effect. Skeletal muscle relaxants like tubocurarine may show increased sensitivity. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing, and thiazide diuretics.

This combination is contraindicated in patients with known hypersensitivity to any of its components. Due to the hydrochlorothiazide component, it is also contraindicated in patients with anuria or hypersensitivity to sulfonamide-derived drugs.

Adverse effects are generally mild and transient, with an overall incidence comparable to placebo. Reported side effects include headache, upper respiratory tract infection, back pain, and influenza-like symptoms.

Use of this combination during pregnancy and lactation is not recommended.

No discontinuation due to significant changes in serum potassium levels has been reported. Overall, this combination has not shown any clinically meaningful effect on serum potassium levels.

Use in pediatric patients: Safety and effectiveness have not been established in children.

Combined antihypertensive preparations