Giran16mg
Type:Tablet
Generic Name:Candesartan Cilexetil
Manufacturer:Aristopharma Limited
Price:৳11.00
Indication
Hypertension, Congestive heart failure
Administration
May be taken with or without food.
Adult Dose
Oral Hypertension Adult: Initially, 8 mg once daily adjusted according to response. Maintenance: 8 mg once daily. Max: 32 mg/day as single or in 2 divided doses. Patients w/ intravascular volume depletion: Initially, 4 mg once daily. Heart failure Adult: Initially, 4 mg once daily, may be doubled at intervals of not <2 wk. Max: 32 mg once daily. Hepatic impairment: Mild to moderate: Initially, 4 mg once daily. Severe: Contraindicated.
Child Dose
Oral Hypertension Child: 1 to <6 yr Initially, 200 mcg/kg/day. May increase according to response to 50-400 mcg/kg/day. >6 yr <50 kg: 4-8 mg/day, adjusted according to response to 2-16 mg/day; >50 kg: 8-16 mg/day, adjusted according response to 4-32 mg/day. All doses may be given as single or in 2 divided doses.
Renal Dose
Renal Impairment No dose adjustment necessary for patients with mild renal impairment Initiate thearpy at lower dose if moderate renal impairment
Contraindication
Hypersensitivity. Pregnancy (2nd and 3rd trimester) and lactation.
Mode of Action
Candesartan inhibits the binding of angiotensin II to AT1 receptors in many tissues (e.g. vascular smooth muscles, adrenal gland) which leads to vasoconstriction blockade and aldosterone release.
Precaution
Volume or sodium depletion, preexisting renal insufficiency; aortic or mitral valve stenosis, hypertrophic obstructive cardiomyopathy, renal artery stenosis, primary hyperaldosteronism. Patients with a history of angioedema, urticaria. Monitor serum potassium levels especially in elderly and renally impaired patients. Hypotension may occur during major surgery and anaesthesia due to suppression of the renin-angiotensin system. Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death Lactation: Not known if excreted in breast milk; not recommended
Side Effect
Dizziness, headache, vertigo, back pain, upper resp tract infections, pharyngitis, rhinitis, hypotension, hyperkalaemia, increased serum creatinine.
Pregnancy Category Note
Pregnancy Category: D Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death Lactation: Not known if excreted in breast milk; not recommended
Interaction
NSAIDs may reduce antihypertensive effect and result in deterioration of renal function including possible acute renal failure. May increase serum lithium concentration. K-sparing diuretics, K supplements or salt substitutes containing K may increase risk of hyperkalaemia. Potentially Fatal: Coadministration w/ aliskiren in diabetic patients may increase risk of renal impairment, hypotension and hyperkalaemia.