Candesartan and Hydrochlorothiazide (patient information)

IMPORTANT WARNING
Do not take candesartan and hydrochlorothiazide if you are pregnant. If you become pregnant while taking candesartan and hydrochlorothiazide, call your doctor immediately. Candesartan and hydrochlorothiazide may harm the fetus.

Why this medication is prescribed
The combination of candesartan and hydrochlorothiazide is used alone or with other medications to treat high blood pressure. Candesartan is in a class of medications called angiotensin II antagonists. It makes blood flow more smoothly by blocking the action of certain natural chemicals that tighten the blood vessels. Hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It works by causing the the kidneys to get rid of unneeded water and salt from the body into the urine.

How this medication should be used
The combination of candesartan and hydrochlorothiazide comes as a tablet to take by mouth. It is usually taken once or twice a day with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take candesartan and hydrochlorothiazide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Candesartan and hydrochlorothiazide controls high blood pressure but does not cure it. It may take up to 4 weeks before you feel the full benefit of candesartan and hydrochlorothiazide. Continue to take candesartan and hydrochlorothiazide even if you feel well. Do not stop taking candesartan and hydrochlorothiazide without talking to your doctor.

Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions
Before taking candesartan and hydrochlorothiazide:


 * tell your doctor and pharmacist if you are allergic to candesartan (Atacand), hydrochlorothiazide (HydroDIURIL, Microzide), sulfa drugs, or any other medications.
 * tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); cholestyramine (Questran); colestipol (Colestid); lithium (Eskalith, Lithobid); medications for diabetes; narcotic pain relievers; oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other medications for high blood pressure; phenobarbital (Barbita, Luminal, Solfoton), and potassium supplements (K-Dur, Klor-Con, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
 * tell your doctor if you are on dialysis and if you have or have ever had allergies, asthma, lupus (SLE), diabetes, heart failure, gout, or kidney or liver disease.
 * tell your doctor if you plan to become pregnant or are breast-feeding.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking candesartan and hydrochlorothiazine.
 * ask your doctor about the safe use of alcoholic beverages while you are taking candesartan and hydrochlorothiazide. Alcohol can make the side effects from candesartan and hydrochlorothiazide worse.
 * you should know that candesartan and hydrochlorothiazide may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking candesartan and hydrochlorothiazide. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
 * you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

Special dietary instructions
Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet or an exercise program, follow these directions carefully.

What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Minor side effects
Candesartan and hydrochlorothiazide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:


 * dizziness
 * back pain

Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:


 * lightheadedness
 * fainting
 * dry mouth
 * thirst
 * weakness
 * lack of energy
 * drowsiness
 * restlessness
 * confusion
 * seizures
 * muscle pain or cramps
 * infrequent urination
 * rapid or pounding heartbeat
 * upset stomach
 * vomiting

Candesartan and hydrochlorothiazide may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Other information
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to candesartan and hydrochlorothiazide.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Atacand HCT®