Blopress Plus

Candesartan cilexetil 16 mg, hydrochlorothiazide 12.5 mg

HTN in patients not controlled on candesartan or hydrochlorothiazide monotherapy.

1 tab daily. Elderly ≥75 yr Initially 2 mg, <75 yr Initially 4 mg.

May be taken with or without food.

Hypersensitivity. Severe renal impairment (CrCl <30 mL/min/1.73 m²) or anuria; severe hepatic impairment &/or cholestasis; refractory hypokalemia & hypercalcemia; gout. Concomitant use of candesartan cilexetil/hydrochlorothiazide w/ aliskiren-containing medicines in patients w/ diabetes or moderate to severe renal impairment (GFR <60 mL/min/1.73 m²). Pregnancy & lactation.

Hypersensitive reactions to hydrochlorothiazide may occur in patients w/ or w/o history of allergy or bronchial asthma. Perform periodic determination of serum electrolytes to detect possible electrolyte imbalance; creatinine & uric acid levels. Cl replacement may be required in the treatment of metabolic alkalosis. Hyperuricaemia may occur or acute gout may be precipitated in certain patients receiving thiazide therapy. In diabetic patients, dosage adjustment of insulin or oral hypoglycaemia agents may be required. Discontinue thiazides prior to carrying out test for parathyroid function. Increase in cholesterol & triglyceride levels may be associated w/ thiazide diuretic therapy. Renal function may worsen in patients w/ renal artery stenosis. Increased risk of non-melanoma skin cancer w/ increasing cumulative dose of hydrochlorothiaze exposure. Limit exposure to sunlight & UV rays, adequate protection in case of exposure to minimize risk of skin cancer. May precipitate azotemia in patients w/ renal disease. Hypotension may occur during anaesth & surgery in patients treated w/ AIIA due blockade of the renin-angiotensin system. Patients suffering from haemodynamically relevant aortic or mitral valve stenosis or obstructive hypertrophic cardiomyopathy. Increased risk of hypotension, hyperkalaemia & renal function changes in the dual blockade of the renin-angiotensin-aldosterone-system (RAAS) by combining candesartan cliexetil/hydrochlorothiazide & aliskiren. Initiation of antihypertensice therapy may cause symptomatic hypotension in patients w/ intravascular vol- or Na-depletion eg, in patients treated vigorously w/ diuretics or on dialysis. Exacerbation or activation of SLE. Lithium should not be given w/ thiazides. Impaired hepatic function or progressive liver disease. Fetal & neonatal toxicity in babies born to women treated w/ candesartan cilexetil during pregnancy. Discontinue Blopress Plus immediately when pregnancy is detected. Nursing mothers. Risk of fetal or neonatal jaundice, thrombocytopenia & other AR that have occurred in adults. Ped patients.

URTI; back pain; flu-like symptoms; dizziness; headache.

Alcohol, barbiturate or narcotics, potentiation of orthostatic hypotension may occur. Dosage adjustment of antidiabetic drug may be required. Additive effect or potentiation w/ other antihypertensive drugs. Hydrochlorothiazide absorption is impaired in the presence of anionic exchange resins. Possible increased responsiveness to muscle relaxant w/ skeletal muscle relaxants, nondepolarizing agents. High risk of lithium toxicity w/ lithium. NSAIDs can reduce diuretic, natriuretic & antihypertensive effects of loop, K-sparing & thiazide diuretics.

Angiotensin II Antagonists / Diuretics

C09DA06 - candesartan and diuretics ; Belongs to the class of angiotensin II receptor blockers (ARBs) in combination with diuretics. Used in the treatment of cardiovascular disease.

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