Candesartan cïleksetïl
When ATH:
C09CA06
Characteristic.
White or almost white powder. Practically insoluble in water, poorly soluble in methanol. Molecular weight 610,67.
Pharmacological action.
Antigipertenzivnoe.
Application.
Arterial hypertension; heart failure and systolic dysfunction of the left ventricle (as adjunctive therapy to ACE inhibitors or intolerance to ACE inhibitors).
Contraindications.
Hypersensitivity, pregnancy, lactation.
Restrictions apply.
Serious liver and kidney, childhood (efficacy and safety of use in children have not been established).
Pregnancy and breast-feeding.
Contraindicated in pregnancy. If pregnancy occurs during treatment, reception immediately cease.
Category actions result in FDA - C (I trimester). (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)
Category actions result in FDA -D (II and III trimesters).
At the time of treatment should stop breastfeeding (unknown, PM gets there in breast milk).
Side effects.
From the nervous system and sensory organs: headache, dizziness.
Cardio-vascular system and blood (hematopoiesis, hemostasis): крайне редко — лейкопения, neutropenia, agranulocytosis, thrombocytopenia.
From the respiratory system: cough, upper respiratory tract infection, pharyngitis, rhinitis.
From the digestive tract: nausea.
On the part of the musculoskeletal system: backache, arthralgia, myalgia.
Allergic reactions: angioedema, hives, itch.
Other: increased ALT, hyperuricemia, gout, flushing.
Cooperation.
Potassium-sparing diuretics and potassium supplements increase the risk of hyperkalemia.
Overdose.
Symptoms: severe hypotension.
Treatment: symptomatic; constant monitoring of vital functions. Hemodialysis nyeeffyektivyen.
Dosing and Administration.
Inside, regardless of the meal, with hypertension: 8–16 мг 1 once a day. Dose selected individually. In severe kidney failure (клиренс креатинина меньше 30 mL/min/1.73 m2) treatment is initiated with low doses (4 mg).
The recommended starting dose for heart failure is 4 mg 1 once a day. Increasing the dose to 32 mg / day or until maximum tolerated dose is done by doubling it at intervals of not less than 2 Sun.
Precautions.
Caution should be used in patients with severe renal insufficiency, patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney (possible increase in urea and plasma creatinine, therefore requires regular monitoring of these indicators), patients with stenosis of the aortic and mitral valves, after kidney transplantation history, patients with cerebrovascular disease and ischemic heart disease, patients with marked decrease in the bcc (conditioned, eg, receiving high doses of diuretics, because of the risk of hypotension), when hyperkalemia, patients with hypertrophic cardiomyopathy, with end-stage renal failure (creatinine clearance <15 ml / min) and severe hepatic impairment and / or cholestasis (clinical experience is limited). Not recommended in patients with primary hyperaldosteronism (resistance to therapy).
