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Generic Name: candesartan and hydrochlorothiazide (kan de SAR tan and hye droe clor oh THYE ah zide)
Brand Names: Atacand HCT

What is candesartan and hydrochlorothiazide?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Candesartan is in a group of drugs called angiotensin II receptor antagonists. Candesartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.

The combination of candesartan and hydrochlorothiazide is used to treat high blood pressure (hypertension).

Candesartan and hydrochlorothiazide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about candesartan and hydrochlorothiazide?

Do not use this medication without telling your doctor if you are pregnant. Candesartan and hydrochlorothiazide may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Candesartan and hydrochlorothiazide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of candesartan and hydrochlorothiazide.

What should I discuss with my healthcare provider before taking candesartan and hydrochlorothiazide?

Do not use this medication if you are allergic to candesartan or hydrochlorothiazide (Carozide, Diaqua, Ezide HCTZ, HydroDiuril, Microzide, and others), or if you:

• are unable to urinate; or

• are allergic to sulfa drugs.

Before using candesartan and hydrochlorothiazide, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;
• liver disease;

• congestive heart failure;

• low or high levels of potassium in your blood;

• asthma or allergies;

• high cholesterol or triglyceride levels;

• gout;

• lupus; or

• diabetes.

If you have any of these conditions, you may not be able to use candesartan and hydrochlorothiazide, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category D. This medication can cause harm to an unborn baby. Candesartan and hydrochlorothiazide may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. Do not use candesartan and hydrochlorothiazide without your doctor's consent if you are pregnant. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. It is not known whether candesartan and hydrochlorothiazide passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take candesartan and hydrochlorothiazide?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take this medication with a full glass (8 ounces) of water.

To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled visits to your doctor.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medication, which can lead to severely low blood pressure or a serious electrolyte imbalance.

Hydrochlorothiazide can interfere with the results of a thyroid test. Tell any doctor who treats you that you are using this medication.

It may take up to 4 weeks for this medication to control your blood pressure. Keep using this medication even if you feel fine. High blood pressure often has no symptoms.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using candesartan and hydrochlorothiazide. You may need to stop using the medicine for a short time.

Store candesartan and hydrochlorothiazide at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Symptoms of a candesartan and hydrochlorothiazide overdose may include fast or slow heartbeat, feeling light-headed, or fainting.

What should I avoid while taking candesartan and hydrochlorothiazide?

Candesartan and hydrochlorothiazide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of candesartan and hydrochlorothiazide.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Do not use potassium supplements or salt substitutes while you are taking candesartan and hydrochlorothiazide, unless your doctor has told you to.

Candesartan and hydrochlorothiazide side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• chest pain, feeling short of breath, even with mild exertion;

• fever;

• swelling, rapid weight gain;

• urinating more or less than usual, or not at all;

• jaundice (yellowing of the skin or eyes); or

• dry mouth, increased thirst, drowsiness, restless feeling, confusion, nausea, vomiting, increased urination, muscle pain or weakness, fast heart rate, feeling light-headed, fainting, or seizure (convulsions).

Continue using the medication and talk with your doctor if you have any of these less serious side effects:

• stomach pain;

• back pain;

• dizziness, drowziness;

• headache;

• runny or stuffy nose, sore throat; or

• dry cough.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect candesartan and hydrochlorothiazide?

Before taking candesartan and hydrochlorothiazide, tell your doctor if you are using any of the following drugs:

• any other blood pressure medications;

• steroids (prednisone and others);

• lithium (Eskalith, Lithobid);

• cholestyramine (Prevalite, Questran) or colestipol (Colestid);

• insulin or diabetes medicine you take by mouth;

• a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);

• any other diuretics, such as amiloride (Midamor), bumetanide (Bumex), chlorthalidone (Hygroton, Thalitone), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril), indapamide (Lozol), metolazone (Mykrox, Zarxolyn), spironolactone (Aldactone), triamterene (Dyrenium, Maxzide, Dyazide), torsemide (Demadex), and others;

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others;

• a muscle relaxer such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), metaxalone (Skelaxin), or methocarbamol (Robaxin), orphenadrine (Norflex), or tizanidine (Zanaflex); or

• a narcotic medication such as hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin), oxymorphone (Numorphan), or propoxyphene (Darvon, Darvocet).

If you are using any of these drugs, you may not be able to use candesartan and hydrochlorothiazide, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect candesartan and hydrochlorothiazide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about candesartan and hydrochlorothiazide written for health professionals that you may read.

What does my medication look like?

Candesartan and hydrochlorothiazide is available with a prescription under the brand name Atacand. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Atacand HCT 16-12.5 (16 mg of candesartan and 12.5 mg of hydrochlorothiazide)--peach, oval tablets

• Atacand HCT 32-12.5 (32 mg of candesartan and 12.5 mg of hydrochlorothiazide)--yellow, oval tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.04. Revision Date: 11/1/06 2:52:25 PM.