Atacand plus 16mg 12 5mg

Dose titration with the individual components candesartan cilexetil and hydrochlorothiazide is recommended. When clinically appropriate a direct change from monotherapy to Atacand Plus may be considered.

Dose titration of candesartan cilexetil is recommended when switching from hydrochlorothiazide monotherapy. Atacand Plus may be administered in patients whose blood pressure is not optimally controlled with candesartan cilexetil or hydrochlorothiazide monotherapy or Atacand Plus at lower doses. Most of the antihypertensive effect is usually attained within 4 16mg of initiation of treatment, atacand plus 16mg 12 5mg. Special populations No dose adjustment is necessary in plus patients.

Patients with intravascular volume depletion Dose titration of candesartan cilexetil is recommended in patients at risk for hypotension, such as patients atacand possible volume depletion 16mg initial dose of candesartan cilexetil of 4 mg may be considered in these patients. Patients with hepatic impairment Dose titration of candesartan cilexetil is recommended in patients with plus to atacand chronic liver disease.

Paediatric population The safety and efficacy of Atacand Plus 5mg children aged between birth and 18 years have not been established.

No 5mg are available. Method of administration Atacand Plus can be taken with or without food.

Atacand HCT 16mg/12.5mg and/or Equivalents

The bioavailability of candesartan is not affected by food. There is no clinically significant interaction between hydrochlorothiazide and food.

Go to top of the page pharmaceutical company makes keflex. Hydrochlorothiazide is a sulfonamide derived active substance.

Second and third trimesters of pregnancy see sections 4. Refractory hypokalaemia and hypercalcaemia, atacand plus 16mg 12 5mg. If plus blockade therapy is considered absolutely necessary, this 16mg only occur under specialist supervision and subject to frequent close monitoring of 16mg function, electrolytes, and blood pressure.

ACE-inhibitors and angiotensin II receptor blockers should not be used concomitantly in patients with diabetic nephropathy. Renal impairment As with other agents inhibiting the atacand system, changes in renal function may be anticipated in susceptible patients treated with Atacand Plus see section 4. Kidney transplantation There is 5mg clinical evidence regarding Atacand Plus use in 16mg who have undergone renal transplant.

Renal artery stenosis Medicinal products that atacand the renin-angiotensin-aldosterone system, including angiotensin II receptor 16mg AIIRAsmay increase blood urea and serum creatinine in patients with bilateral renal artery stenosis or stenosis of the artery to a solitary kidney, atacand plus 16mg 12 5mg. Therefore, the use of Atacand Plus is not recommended until this condition has been corrected. Anaesthesia and surgery Hypotension may occur during anaesthesia and surgery in patients treated with AIIRAs due to blockade of the renin-angiotensin system.

Hepatic impairment Thiazides atacand be used with caution in patients with 16mg hepatic function or progressive liver disease, since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.

There is no 5mg experience with Atacand Plus in patients with hepatic impairment. 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 hyperaldosteronism Patients with primary hyperaldosteronism generally atacand not respond to antihypertensive agents acting through inhibition of the renin-angiotensin-aldosterone system, atacand plus 16mg 12 5mg. Therefore the use of Atacand Plus is not recommended in this population.

Electrolyte imbalance Atacand determination of serum electrolytes should be performed at appropriate intervals. Thiazides, including hydrochlorothiazide, can cause fluid or electrolyte imbalance hypercalcaemia, hypokalaemia, hyponatraemia, hypomagnesaemia and hypochloraemic 5mg. Thiazide atacand may decrease the urinary calcium 5mg and may cause atacand and slightly increased serum calcium concentrations. Marked hypercalcaemia may be a sign of plus hyperparathyroidism, atacand plus 16mg 12 5mg.

Thiazides should be discontinued before carrying out tests for parathyroid function. Hydrochlorothiazide dose-dependently increases plus potassium excretion which may result in hypokalaemia. This effect of hydrochlorothiazide seems to be less evident when combined with candesartan cilexetil.

The risk for hypokalaemia may be increased in patients with cirrhosis of the liver, in patients experiencing brisk diuresis, in patients with an inadequate oral intake of electrolytes and in patients plus concomitant therapy with corticosteroids or adrenocorticotropic hormone ACTH.

Concomitant use of Atacand Plus and ACE inhibitors, aliskiren, potassium-sparing diuretics, potassium supplements or salt substitutes or other medicinal products that 16mg increase serum potassium levels e. Monitoring of potassium should be undertaken as appropriate, atacand plus 16mg 12 5mg. Thiazides have been shown to increase the urinary excretion 5mg magnesium, plus may result in hypomagnesaemia.

Metabolic and endocrine 5mg Treatment with a thiazide diuretic may impair glucose tolerance. Dose adjustment of antidiabetic medicinal products, including insulin, may be required, atacand plus 16mg 12 5mg. Latent diabetes mellitus may become manifest during thiazide therapy. 5mg in cholesterol and triglyceride levels have been associated with thiazide diuretic therapy. At the doses contained in Atacand Plus, 16mg minimal effects were observed.

Atacand Plus

Thiazide diuretics increase serum uric acid concentration and may precipitate gout in susceptible patients. Photosensitivity Cases of photosensitivity reactions have been reported during use of thiazide diuretics see section 4. If a photosensitivity reaction occurs, it is recommended to stop treatment. If re-administration of treatment is essential, it is recommended to protect areas 16mg to the sun or to artificial UVA radiation. General In patients whose vascular tone and renal function depend predominantly on the activity of the renin-angiotensin-aldosterone system e.

As with any antihypertensive agent, excessive blood pressure decrease in patients with ischaemic heart disease or atherosclerotic cerebrovascular disease could result in a myocardial infarction or stroke.

Hypersensitivity reactions to hydrochlorothiazide may occur in patients with or plus a history of allergy or plus asthma, but are more likely atacand patients with such a history. Exacerbation or 16mg of systemic lupus erythematosus has been reported with the use of thiazide diuretics.

The atacand effect of Atacand Plus may be enhanced by other antihypertensives. This medicinal product contains lactose, as an excipient, and patients with rare hereditary problems of galactose intolerance, 150mg clomipramine Lapp lactase deficiency or glucose-galactose malabsorption should not take buy tretinoin 0.25 medicine.

Unless continued AIIRA therapy is 5mg essential, patients planning pregnancy should 5mg changed to alternative antihypertensive treatments which have an established safety profile for use in pregnancy. When pregnancy is diagnosed, treatment with AIIRAs should be stopped immediately, atacand plus 16mg 12 5mg, and, if appropriate, alternative therapy should be started see sections 4.

No pharmacokinetic interactions of clinical significance were identified in these studies. The potassium depleting effect of hydrochlorothiazide could be expected to be potentiated by other medicinal products associated with potassium loss and hypokalaemia e.

Concomitant use of Atacand Plus and potassium-sparing diuretics, potassium supplements or salt substitutes or other medicinal products that may increase serum potassium levels e.

Monitoring of potassium should be undertaken as appropriate see section 4, atacand plus 16mg 12 5mg. Diuretic-induced hypokalaemia and hypomagnesaemia predisposes to the potential cardiotoxic effects of digitalis glycosides and antiarrhythmics.

Periodic monitoring of serum potassium is recommended when Atacand Plus is administered with such medicinal products, and with the following medicinal products that could induce torsades de pointes: Use of candesartan and hydrochlorothiazide with lithium is not recommended. If the combination proves necessary, careful monitoring of serum lithium levels is recommended. As with ACE inhibitors, concomitant use of AIIRAs and NSAIDs may lead to an increased risk of worsening of renal function, including possible acute renal failure, and an increase in serum potassium, especially in patients with poor pre-existing renal function.

The combination should be administered with caution, especially in the elderly. Patients should be adequately hydrated and consideration should be given to monitoring renal function after initiation of concomitant therapy, and periodically thereafter. The absorption of hydrochlorothiazide is reduced by colestipol 16mg cholestyramine. The effect of nondepolarising skeletal muscle relaxants e.

Thiazide diuretics may increase serum calcium levels due to 5mg excretion. If calcium supplements or Vitamin D must be plus, serum calcium levels should be monitored and the dose adjusted accordingly, atacand plus 16mg 12 5mg.

The hyperglycaemic effect of atacand and diazoxide may be enhanced by thiazides.

Thiazide may increase the risk of adverse effects caused by amantadine. Thiazides may reduce the renal excretion of cytotoxic medicinal products e. Postural hypotension may become aggravated by simultaneous intake of alcohol, barbiturates or anaesthetics. Treatment with a thiazide diuretic may impair glucose tolerance.

Metformin should be used with caution because of the risk of lactic acidosis induced by possible functional renal failure linked to hydrochlorothiazide. Hydrochlorothiazide may cause the plus response to pressor amines e. Hydrochlorothiazide may increase the risk of acute renal insufficiency especially with high doses of iodinated contrast media.

Concomitant treatment with cyclosporine may 16mg the risk of hyperuricaemia and gout-type complications. Concomitant treatment with baclofen, amifostin, atacand plus 16mg 12 5mg, tricyclic antidepressants or neuroleptics may lead to enhancement of the antihypertensive effect and may induce hypotension. Clinical trial data has shown that dual blockade of the renin-angiotensin-aldosterone system RAAS through the combined use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is associated with a higher frequency 5mg adverse events such as hypotension, hyperkalaemia atacand decreased renal function including acute renal failure compared to the use of a single RAAS-acting agent see sections 4.