Candesartan
) is an
angiotensin II receptor antagonist used mainly for the treatment of
hypertension. The
prodrug candesartan cilexetil is marketed by
AstraZeneca and
Takeda Pharmaceuticals, commonly under the
trade names
Blopress,
Atacand,
Amias, and
Ratacand.
Indications
As with all angiotensin II receptor antagonists, candesartan is indicated for the treatment of
hypertension. Results from the CHARM study in the early
2000s demonstrated the
morbidity and
mortality reduction benefits of candesartan therapy in
congestive heart failure.
Thus, while
ACE inhibitors are still considered first-line therapy in heart failure, candesartan is an alternative in patients intolerant of ACE inhibitor therapy.
Combination with diuretic
Candesartan is also available in a combination formulation with a low dose
thiazide diuretic, invariably
hydrochlorothiazide, to achieve an additive antihypertensive effect. Candesartan/hydrochlorothiazide combination preparations are marketed under various trade names including
Atacand Plus,
Hytacand and
Ratacand Plus.
Candesartan is marketed as the
cyclohexyl 1-
hydroxyethyl carbonate (cilexetil)
ester, known as
candesartan cilexetil. Candesartan cilexetil is metabolised completely by
esterases in the
intestinal wall during absorption to the active candesartan moieity.
The use of a prodrug form increases the
bioavailability of candesartan. Despite this, absolute bioavailability is relatively poor at 15% (candesartan cilexetil tablets) to 40% (candesartan cilexetil solution).
*Over a period of four years, stage 1 hypertension developed in nearly two thirds of patients with untreated prehypertension (the placebo group). Treatment of prehypertension with candesartan appeared to be well tolerated and reduced the risk of incident hypertension during the study period. Thus, treatment of prehypertension appears to be feasible.[
1]
*
Atacand web site or
Atacand US, run by
AstraZeneca*
Candesartan
