Candesar

Candesar is an antihypertensive drug.

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Indications Candesara

It is used to reduce elevated blood pressure, and also in cases of CHF and left ventricular systolic dysfunction.

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Release form

The release is made in tablets, in the amount of 10 pieces inside a blister pack. In a box - 1 such blister.

Pharmacodynamics

The active element of the drug is a selective antagonist of the angiotensin-2 element. The mechanism of its medicinal action is based on the suppression of RAAS activity.

Candesar is usually tolerated without complications. It does not affect metabolic processes.

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Pharmacokinetics

Absorption and distribution processes.

After administration of the drug, the component of candesartan cilexetil is converted into the active element candesartan. Its bioavailability index when using oral solution of candesartan cilexetil is approximately 40%. The level of relative bioavailability of the tablet form of the drug compared to the solution is approximately 34%, and its variability is extremely low. The level of calculated bioavailability of the drug in tablet form is 14%.

Peak serum levels of the drug are observed 3-4 hours after administration. Candesartan serum levels increase linearly with increasing dosages in the therapeutic range.

There is no dependence of the pharmacokinetic parameters of candesartan on the patient's gender.

The AUC values of the drug in the serum after co-administration with food do not change significantly.

Candesartan is highly bound to plasma protein (above 99%). The distribution volume of the substance is 0.1 l/kg.

The bioavailability values of Candesar are not changed when taken with food.

Metabolic processes and excretion.

Excretion of unchanged candesartan occurs with bile and urine. Only a small part of the substance undergoes metabolism in the liver (CYP2C9 component). The existing information taken from interaction tests does not show that the drug affects elements of CYP2C9, as well as CYP3A4. In vitro tests have shown that the drug does not interact in vivo with drugs whose metabolic processes depend on hemoprotein P450 isoenzymes - CYP1A1 and CYP2A6, as well as CYP2C9 with CYP2C19 and CYP2D6, as well as CYP2E and CYP3A4. The terminal half-life of the substance is approximately 9 hours. With repeated use of the drug, accumulation of the drug component is not observed.

The total clearance of the drug is approximately 0.37 ml/minute/kg; renal clearance is approximately 19 ml/minute/kg. The clearance of the substance inside the kidneys is carried out by glomerular filtration and active tubular secretion.

When the 14C-labeled component cilexetil candesartan is consumed, approximately 26% of the dose is excreted in the urine as the element candesartan, and another 7% as an inactive metabolite. Another 56% of candesartan is excreted in the faeces (as an inactive metabolite – 10%).

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Dosing and administration

The selection of the Candesar portion sizes is carried out for each patient individually. The recommended initial dosage is 4-8 g per day.

Use Candesara during pregnancy

It is not recommended to use angiotensin-2 reuptake inhibitors (candesartan is one of them) in the first trimester. The drug is contraindicated for use in the second and third trimesters.

Since there is no information regarding the use of the drug during breastfeeding, it is not recommended to prescribe it during this period. It is necessary to use alternative drugs, the safety of which when taken by lactating women has been established more reliably (this is especially true for breastfeeding premature and newborn babies).

Contraindications

It is contraindicated to prescribe the medication to people with hypersensitivity to its elements and severe kidney disease.

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Side effects Candesara

The use of the drug may provoke the occurrence of side effects: headaches, pain in the back, arthralgia, diarrhea, myalgia, dizziness, dyspeptic symptoms and loss of strength.

Overdose

As a result of intoxication, the patient experiences dizziness, tachycardia, and a strong decrease in blood pressure. Symptomatic procedures are used to eliminate the disorders. Hemodialysis will be ineffective.

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Interactions with other drugs

Clinical drug interaction tests have been conducted using drugs such as warfarin with glibenclamide, hydrochlorothiazide with nifedipine and digoxin, and oral contraception (such as ethinyl estradiol with levonorgestrel) and enalapril. No clinically significant therapeutic effects have been observed.

Combined use with potassium-sparing diuretics, potassium-containing salt substitutes, and also potassium supplements or other drugs (such as heparin) may lead to an increase in potassium values. With such combinations of drugs, potassium values should be closely monitored.

When combined with ACE inhibitors and lithium drugs, a reverse increase in serum lithium values, as well as its toxicity, was observed. Such an effect can develop when using ARA-II. Therefore, the combination of Candesar with lithium is prohibited. If such a combination is necessary, lithium values in the blood serum should be carefully monitored during therapy.

The use of the drug together with NSAIDs (such as selective COX-2 inhibitors) and non-selective NSAIDs, as well as aspirin (in doses >3 g/day) its antihypertensive effect may be reduced.

As with ACE inhibitors, the combination of the drug with NSAIDs may increase the likelihood of weakening of renal function (acute renal failure may develop, and serum potassium may increase, especially in people with pre-existing poor renal function). This combination should be used with caution, especially in the elderly. Patients should consume sufficient fluid, and renal function should be monitored after initiation of combination therapy and periodically thereafter.

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Storage conditions

Candesar should be kept in a dry place, out of reach of children. Temperature indicators should not exceed 25°C.

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Shelf life

Candesar can be used for 2 years from the date of manufacture of the drug.

Application for children

The efficacy and safety of the drug in people under 18 years of age have not been established. For this reason, it cannot be prescribed to this category of patients.

Analogues

The drug's analogues include such medications as Atacand and Cantab with Advant, Kasark, Candecor and Khizart.

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Reviews

Candesar receives a lot of positive feedback regarding its therapeutic effectiveness.