ATACAND HCT Rx
Generic Name and Formulations:
Candesartan cilexetil, hydrochlorothiazide; 16mg/12.5mg, 32mg/12.5mg, 32mg/25mg; scored tabs.
Indications for ATACAND HCT:
Not for initial therapy. May be substituted for titrated components. BP not controlled on HCTZ 25mg once daily, or controlled but serum potassium decreased: one Atacand HCT 16/12.5mg tab once daily. BP not controlled on candesartan 32mg per day: initially one Atacand HCT 32/12.5mg tab once daily; may increase to 32/25mg once daily. Moderate-to-severe hepatic impairment or CrCl ≤30mL/min: not recommended.
Anuria. Sulfonamide allergy. Concomitant aliskiren in patients with diabetes.
Fetal toxicity may develop; discontinue if pregnancy is detected. Correct hypovolemia before starting, or monitor closely. Hepatic or renal impairment. Renal artery stenosis. CHF. Asthma. Diabetes. SLE. Gout. Surgery. Acute myopia. Secondary angle-closure glaucoma. Hypercalcemia: avoid. Monitor renal function and electrolytes periodically. Elderly. Neonates. Pregnancy (Cat.D); monitor. Nursing mothers: not recommended.
See Contraindications. Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Digitalis, lithium toxicity (monitor). Adjust antidiabetic, antigout medications. Hyperkalemia with K+ supplements, K+ sparing diuretics, K+ containing salt substitutes. Hypokalemia with corticosteroids, ACTH. Orthostatic hypotension potentiated by alcohol, CNS depressants. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors; monitor. Potentiates other antihypertensives. May potentiate nondepolarizing muscle relaxants, diazoxide, cyclophosphamide, methotrexate. Concomitant cyclosporine may increase risk of hyperuricemia. Separate dosing by ≥4hrs before or 4–6hrs after cholestyramine or colestipol resins. May antagonize noradrenaline. May interfere with parathyroid tests.
Angiotensin II receptor blocker (ARB) + thiazide diuretic.
Upper RTI, back pain, dizziness, flu-like symptoms; hypotension, renal dysfunction, electrolyte and metabolic disturbances, rhabdomyolysis (rare).