Candesartan

Candesartan is an angiotensin II receptor blocker (ARB) used to treat hypertension and heart failure in adults. It is administered as candesartan cilexetil, a prodrug that is rapidly converted to the active candesartan after absorption. Candesartan selectively and competitively blocks the AT1 receptor, reducing angiotensin II–mediated vasoconstriction, aldosterone release, and sympathetic nervous system activation. This leads to lower systemic vascular resistance and blood pressure.

Indications commonly include management of essential hypertension and treatment of heart failure to improve symptoms and outcomes in adults. It has been studied for reducing cardiovascular events in patients with heart disease and is used as part of a broader treatment strategy that may include other antihypertensive or heart failure therapies.

Administration and dosing are typically once daily, with or without food. Dosing varies by indication and patient response, generally ranging from low milligram doses up to higher daily amounts, with gradual titration to achieve target blood pressure or clinical benefit while monitoring for side effects.

Contraindications include pregnancy due to risk to the fetus. Candesartan should be used with caution in patients with bilateral renal artery stenosis or significant renal impairment, and in those with a history of angioedema. It should not be combined with certain other renin–angiotensin system inhibitors unless specifically advised. Common adverse effects include dizziness, hypotension, hyperkalemia, and potential deterioration of renal function; angioedema is rare but important to monitor.

Candesartan is available in generic form and under brand names such as Atacand. As with all RAAS inhibitors, monitoring of blood pressure, kidney function, and electrolyte levels is recommended during treatment.