Tablet.
Round, white, biconvex tablets, scored on one side, engraved with mark 4.
The score line is only to facilitate breaking for ease of swallowing and not to divide into equal doses.
Treatment of hypertension in children and adolescents aged 6 to <18 years.
Treatment of adult patients with heart failure and impaired left ventricle systolic function (left ventricular ejection fraction ≤ 40%) when ACE-inhibitors are not tolerated or as add-on therapy to ACE-inhibitors in patients with symptomatic heart failure, despite optimal therapy, when mineralocorticoid receptor antagonists are not tolerated (see sections 4.2, 4.4, 4.5 and 5.1).
… cipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 and 5.1).
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impair
Storage and shelf life
§6.3 — Shelf life
2 years
§6.4 — Special precautions for storage
Do not store above 30°C.
Interchangeable — 2
These products do not disagree on any concept in their labels.
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesar …
… vity to the active substance or to any of the excipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 …
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in …
… cipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 and 5.1).
… cipients listed in section 6.1.
Second and third trimester of pregnancy (see sections 4.4 and 4.6).
Severe hepatic impairment and/or cholestasis.
Children aged below 1 year (see section 5.3).
The concomitant use of Candesartan cilexetil with aliskiren-containing products is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) (see sections 4.5 and 5.1).
… atients with very severe or end-stage renal impairment (Clcreatinine < 15 ml/min).
In these patients Candesartan cilexetil should be carefully titrated with thorough monitoring of blood pressure.
Evaluation of patients with heart failure should include periodic assessments of renal function, especially in elderly patients 75 years or older, and patients with impaired renal function. During dose titration of Candesartan cilexetil, monitoring of serum creatinine and potassium is recommended. Clinical trials in heart failure did not include patients with serum creatinine >265 μmol/L (>3 mg/dl).
Concomitant therapy with an ACE inhibitor in heart failure
The risk of adverse reactions, especially hypotension, hyperkalaemia and decreased renal function (including acute renal failure), may …
… with angiotensin II antagonists due to blockade of the renin-angiotensin system. Very rarely, hypotension may be severe such that it may warrant the use of intravenous fluids and/or vasopressors.
Aortic and mitral valve stenosis (obstructive hypertrophic cardiomyopathy)
As with other vasodilators, special caution is indicated in patients suffering from haemodynamically relevant aortic or mitral valve stenosis, or obstructive hypertrophic cardiomyopathy.
Primary …
… rtery to a solitary kidney.
Kidney transplantation
There is no experience regarding the administration of Candesartan cilexetil in patients with a recent kidney transplantation.
Hypotension
Hypotension may occur during treatment with Candesartan cilexetil in heart failure patients. It may also occur in hypertensive patients with intravascular volume depletion such as those receiving high dose diuretics. Caution should be observed when initiating therapy and correction of hypovolemia should be attempted.
Anaesthesia and surgery
Hypotension may occur during anaesthesia and surgery in patients treated with angiotensin II antagonists due to blockade of the renin-angiotensin system. Very rarely, hyp …
… atients with very severe or end-stage renal impairment (Clcreatinine < 15 ml/min).
In these patients Candesartan cilexetil should be carefully titrated with thorough monitoring of blood pressure.
Evaluation of patients with heart failure should include periodic assessments of renal function, especially in elderly patients 75 years or older, and patients with impaired renal function. During dose titration of Candesartan cilexetil, monitoring of serum creatinine and potassium is recommended. Clinical trials in heart failure did not include patients with serum creatinine >265 μmol/L (>3 mg/dl).
Concomitant therapy with an ACE inhibitor in heart failure
The risk of adverse reactions, especially hypotension, hyperkalaemia and decreased renal function (including acute renal failure), may …
Renal impairment
As with other agents inhibiting the renin-angiotensin-aldosterone system, changes in renal function may be anticipated in susceptible patients treated with Candesartan cilexetil. When Candesartan cilexetil is used in hypertensive patients with renal impairment, periodic monitoring of serum potassium and creatinine levels is recommended. There is limited experience in patients with very severe or end-stage renal impairment (Clcreatinine < 15 ml/min).
In these patients Candesartan cilexetil should be carefully titrated with thorough monitoring of blood pressure.
Evaluation of patients with heart failure should include periodic assessments of r …
… regnancy should be evaluated on a regular basis. Appropriate information should be given and/or action taken to prevent the risk of exposure during pregnancy (see sections 4.3 and 4.6).
Lactose
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially "sodium-free".
… regnancy should be evaluated on a regular basis. Appropriate information should be given and/or action taken to prevent the risk of exposure during pregnancy (see sections 4.3 and 4.6).
Lactose
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially "sodium-free".
… t close monitoring of renal function, electrolytes and blood pressure.
ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.
Haemodialysis
During dialysis the blood pressure may be particularly sensitive to AT1-receptor blockade as a result of reduced plasma volume and activation of the renin-angiotensin-aldosterone system. Therefore …
… e and potassium is recommended. Clinical trials in heart failure did not include patients with serum creatinine >265 μmol/L (>3 mg/dl).
Concomitant therapy with an ACE inhibitor in heart failure
The risk of adverse reactions, especially hypotension, hyperkalaemia and decreased renal function (including acute renal failure), may increase when Candesartan cilexetil is used in combination with an ACE-inhibitor. Triple combination of an ACE-inhibitor, a mineralocorticoid receptor antagonist and candesartan is also not recommended. Use of these combinations should be under specialist supervision and subject to frequent close monitoring of renal function, electrolytes and blood pressure.
ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy.
Haemodialysis
During dialysis the blood pressure may be particularly …
… bility of pregnancy should be evaluated on a regular basis. Appropriate information should be given and/or action taken to prevent the risk of exposure during pregnancy (see sections 4.3 and 4.6).
Lactose
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Sodium
This medicine contains less …
… ns 4.3 and 4.6).
Lactose
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially "sodium-free".
… me and activation of the renin-angiotensin-aldosterone system. Therefore Candesartan cilexetil should be carefully titrated with thorough monitoring of blood pressure in patients on haemodialysis.
Renal artery stenosis
Medicinal products that affect the renin-angiotensin-aldosterone system, including angiotensin II receptor antagonists (AIIRAs), may increase blood urea and serum creatinine in patients with bilate …
… ment, periodic monitoring of serum potassium and creatinine levels is recommended. There is limited experience in patients with very severe or end-stage renal impairment (Clcreatinine < 15 ml/min).
In these patients Candesartan cilexetil should be carefully titrated with thorough monitoring of blood pressure.
Evaluation of patients with heart failure should include periodic assessments of renal function, especially in elderly patients 75 years or older, and patients with impaired renal function. During …
… a potassium-sparing diuretic (e.g. spironolactone) and Candesartan cilexetilis not recommended and should be considered only after careful evaluation of the potential benefits and risks.
General
In patients whose vascular tone and renal function depend predominantly on the activity of the renin-angiotensin-aldosterone system (e.g. patients with severe congestive heart failure or underlying renal disease, including renal artery stenosis), treatment with other medicinal products that affect this system has been associated with acute hypotension, azotaemia, oliguria or, rarely, acute renal failure. The possibility of similar effects cannot be excluded with AIIRAs. As with any antihypertensive agent, excessive blood pressure decrease in patients with ischaemic cardiopathy or ischaemic cerebrovascular disease could result in a myocardial infarction or stroke.
The antihypertensive effect of candesartan may be enhanced by other medicinal products with blood pressure lowering properties, whether prescribed as an antihypertensive or prescribed for other ind …
… rimester of pregnancy, ultrasound check of renal function and skull is recommended.
Infants whose mothers have taken AIIRAs should be closely observed for hypotension (see sections 4.3 and 4.4).
Breastfeeding
Because no information is available regarding the use of Candesartan cilexetil during breastfeeding, Candesartan cilexetil is not recommended and alternative treatments with better established safe …