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Uses

What is candesartan/hydrochlorothiazide used for?

Candesartan/hydrochlorothiazide is commonly used to lower high blood pressure (hypertension).

Candesartan/hydrochlorothiazide may also be used for other conditions as determined by your healthcare provider.

How does candesartan/hydrochlorothiazide work (mechanism of action)?

Candesartan blocks receptors in your body that normally bind to a hormone called angiotensin II. When angiotensin II binds to these receptors, it causes your blood vessels to constrict. Blocking these receptors helps your blood vessels relax so that blood can move through them more easily. 

Hydrochlorothiazide works by increasing how much you pee. It does this by helping the kidneys remove electrolytes, such as sodium (salt), and water from the body.  It also appears to allow blood to flow more freely (less resistance to flow).

These effects can help lower blood pressure, and may reduce your risk for heart attack and stroke. 

How is candesartan/hydrochlorothiazide supplied (dosage forms)?

Brands and other names

  • Atacand HCT

Dosage forms and strengths

  • 16 mg/12.5 mg oral tablets
  • 32 mg/12.5 mg oral tablets
  • 32 mg/25 mg oral tablets

How should I store candesartan/hydrochlorothiazide?

Candesartan/hydrochlorothiazide should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place, in a tightly closed container.

Side Effects

What are the most common side effects of candesartan/hydrochlorothiazide?

The most common side effects of candesartan/hydrochlorothiazide are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Headache
  • Dizziness
  • Low blood pressure (see below)
  • Kidney problems
  • Electrolyte changes and increased blood sugar (see below)
  • An increase in how much you pee

There may be other side effects of candesartan/hydrochlorothiazide that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of candesartan/hydrochlorothiazide?

While less common, the most serious side effects of candesartan/hydrochlorothiazide are described below, along with what to do if they happen.

Decreased Blood Pressure (Hypotension). Candesartan/hydrochlorothiazide may cause low blood pressure, especially in people with low levels of fluids or salt. This can happen especially in people taking a medicine that causes you to pee more often (diuretic). If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Kidney Damage. Kidney damage can happen when taking candesartan/hydrochlorothiazide. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures 

Electrolyte Changes and Increased Blood Sugar. Candesartan/hydrochlorothiazide may increase your blood sugar (glucose) levels and cause changes to the levels of certain minerals in your body, called electrolytes. For example, it may cause low or high potassium levels (hypokalemia or hyperkalemia), low sodium levels (hyponatremia), low magnesium levels (hypomagnesemia), high calcium levels (hypercalcemia), or low chloride levels (hypochloremia), or high glucose levels (hyperglycemia). These changes can be serious. Your healthcare provider will do bloodwork to check your glucose and electrolyte levels, especially if you take certain other medicines. Keep your appointments to have your blood checked. Call your healthcare provider if you have any of the following symptoms.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation
  • Nausea, vomiting, or loss of appetite
  • Dizziness
  • Restlessness or irritability
  • Difficulty breathing
  • Confusion or decreased alertness
  • Abnormal heart rhythm
  • Slow heartbeat or feeling of skipped heartbeats
  • Seizures

Short-Sightedness and Glaucoma. Candesartan/hydrochlorothiazide may make it harder to see faraway objects (short-sightedness). It also may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. These issues may be more likely with taking candesartan/hydrochlorothiazide if you have a sulfa or penicillin allergy. Tell your healthcare provider right away if you have any of the following symptoms.

  • Trouble seeing faraway objects
  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Severe Allergic Reactions. Candesartan/hydrochlorothiazide may cause allergic reactions, which can be serious. Stop taking candesartan/hydrochlorothiazide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use candesartan/hydrochlorothiazide?

Allergies to Ingredients. People who are allergic to any of the following should not take candesartan/hydrochlorothiazide.

  • Atacand HCT
  • Candesartan
  • Hydrochlorothiazide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific candesartan/hydrochlorothiazide products they stock.

Sulfa Allergy. Some people who have a sulfa allergy may also be allergic to candesartan/hydrochlorothiazide. A sulfa allergy is a rash or more serious reaction to sulfa, or sulfonamide, medicines. Sulfa medicines include sulfamethoxazole, sulfadiazine silver, or sulfasalazine. Tell your healthcare provider if you have any allergies to medicines. Your healthcare provider can help you decide if it is safe for you to take candesartan/hydrochlorothiazide.

Drug Interactions. Candesartan/hydrochlorothiazide should not be taken while you are using certain other medicines and if you have diabetes. Before taking candesartan/hydrochlorothiazide, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.  See the Interactions section for more details.

No Urine Production. Do not take candesartan/hydrochlorothiazide if you are making very little to no pee. This condition is also called anuria.

What should I know about candesartan/hydrochlorothiazide before using it?

Do not take candesartan/hydrochlorothiazide unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share candesartan/hydrochlorothiazide with other people, even if they have the same condition as you. It may harm them.

Keep candesartan/hydrochlorothiazide out of the reach of children.

Candesartan/hydrochlorothiazide can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how candesartan/hydrochlorothiazide affects you.

What should I tell my healthcare provider before using candesartan/hydrochlorothiazide?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if candesartan/hydrochlorothiazide is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems 
  • Kidney problems
  • Liver problems
  • Eye problems
  • Electrolyte imbalance, such as high or low levels of sodium or potassium
  • Persistent or severe diarrhea or vomiting, which can lead to dehydration
  • Abnormal heart rhythm (arrhythmias)
  • Diabetes
  • Gout
  • Prostate problems
  • A reduced need to pee

Systemic Lupus Erythematosus. Candesartan/hydrochlorothiazide may activate or worsen systemic lupus erythematosus. Tell your healthcare provider if you develop or have worsening rash, joint pain, fever, or unusual tiredness.

Pregnancy. Candesartan/hydrochlorothiazide can cause death or serious harm to an unborn baby if taken during pregnancy. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, stop taking candesartan/hydrochlorothiazide right away and contact your healthcare provider.

Breastfeeding. At least one component of candesartan/hydrochlorothiazide passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop candesartan/hydrochlorothiazide.

Interactions

Does candesartan/hydrochlorothiazide interact with foods or drinks?

There are no known interactions between candesartan/hydrochlorothiazide and foods or drinks. However, since candesartan/hydrochlorothiazide affects electrolytes, it is important to discuss your intake of electrolytes, including sodium and potassium, with your healthcare provider.

It is unknown if drinking alcohol will affect candesartan/hydrochlorothiazide. The risk of dizziness may be increased if you drink alcohol while taking candesartan/hydrochlorothiazide. It is best to limit the amount of alcohol you drink.

Does candesartan/hydrochlorothiazide interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking candesartan/hydrochlorothiazide.

  • Aliskiren (Tekturna), which is a medicine for high blood pressure 
  • A supplement or salt-substitute containing potassium
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
  • Lithium, which is a medicine for certain mental health conditions
  • An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
  • Cholestyramine or colestipol, which are sometimes used to lower cholesterol
  • A corticosteroid, such as prednisone, methylprednisolone, or dexamethasone, which is a medicine for certain inflammatory conditions
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
  • Cyclophosphamide (Cytoxan and others), which is a medicine commonly used for certain types of cancer
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine to suppress your immune system
  • Any muscle relaxant
  • Any medicine for diabetes
  • Any medicine for high blood pressure 

This may not be a complete list of medicines that can interact with candesartan/hydrochlorothiazide. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much candesartan/hydrochlorothiazide?

If you or someone else has used too much candesartan/hydrochlorothiazide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of candesartan/hydrochlorothiazide?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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