Candesartan cilexetil, Hydrochlorothiazide
Indications
Candesartan cilexetil, Hydrochlorothiazide is used for:
CANDESARTAN
May be used as a first line agent to treat uncomplicated hypertension, isolated systolic hypertension and left ventricular hypertrophy. May be used as a first line agent to delay progression of diabetic nephropathy. Candesartan may be also used as a second line agent in the treatment of congestive heart failure, systolic dysfunction, myocardial infarction and coronary artery disease in those intolerant of ace inhibitors
HYDROCHLOROTHIAZIDE
For the treatment of high blood pressure and management of edema
May be used as a first line agent to treat uncomplicated hypertension, isolated systolic hypertension and left ventricular hypertrophy. May be used as a first line agent to delay progression of diabetic nephropathy. Candesartan may be also used as a second line agent in the treatment of congestive heart failure, systolic dysfunction, myocardial infarction and coronary artery disease in those intolerant of ace inhibitors
HYDROCHLOROTHIAZIDE
For the treatment of high blood pressure and management of edema
Adult Dose
Child Dose
Renal Dose
Administration
Contra Indications
Precautions
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Candesartan cilexetil, Hydrochlorothiazide :
Mechanism of Action
CANDESARTAN
Candesartan selectively blocks the binding of angiotensin ii to at1 in many tissues including vascular smooth muscle and the adrenal glands. This inhibits the at1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin ii and results in an overall decrease in blood pressure. Candesartan is greater than 10,000 times more selective for at1 than at2. Inhibition of aldosterone secretion may increase sodium and water excretion while decreasing potassium excretion
HYDROCHLOROTHIAZIDE
Hydrochlorothiazide, a thiazide diuretic, inhibits water reabsorption in the nephron by inhibiting the sodium-chloride symporter (slc12a3) in the distal convoluted tubule, which is responsible for 5% of total sodium reabsorption. Normally, the sodium-chloride symporter transports sodium and chloride from the lumen into the epithelial cell lining the distal convoluted tubule. The energy for this is provided by a sodium gradient established by sodium-potassium atpases on the basolateral membrane. Once sodium has entered the cell, it is transported out into the basolateral interstitium via the sodium-potassium atpase, causing an increase in the osmolarity of the interstitium, thereby establishing an osmotic gradient for water reabsorption. By blocking the sodium-chloride symporter, hydrochlorothiazide effectively reduces the osmotic gradient and water reabsorption throughout the nephron
Candesartan selectively blocks the binding of angiotensin ii to at1 in many tissues including vascular smooth muscle and the adrenal glands. This inhibits the at1-mediated vasoconstrictive and aldosterone-secreting effects of angiotensin ii and results in an overall decrease in blood pressure. Candesartan is greater than 10,000 times more selective for at1 than at2. Inhibition of aldosterone secretion may increase sodium and water excretion while decreasing potassium excretion
HYDROCHLOROTHIAZIDE
Hydrochlorothiazide, a thiazide diuretic, inhibits water reabsorption in the nephron by inhibiting the sodium-chloride symporter (slc12a3) in the distal convoluted tubule, which is responsible for 5% of total sodium reabsorption. Normally, the sodium-chloride symporter transports sodium and chloride from the lumen into the epithelial cell lining the distal convoluted tubule. The energy for this is provided by a sodium gradient established by sodium-potassium atpases on the basolateral membrane. Once sodium has entered the cell, it is transported out into the basolateral interstitium via the sodium-potassium atpase, causing an increase in the osmolarity of the interstitium, thereby establishing an osmotic gradient for water reabsorption. By blocking the sodium-chloride symporter, hydrochlorothiazide effectively reduces the osmotic gradient and water reabsorption throughout the nephron