Look inside the book: Nursing 2025-2026 Drug Handbook

candesartan cilexetil

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(dysuria, frequency, urgency, pelvic or back pain, hematuria, fever, nausea, vomiting). Alert: Advise patient to seek immediate medical attention for signs and symptoms of AKI (decreased urine output, swelling in legs or feet). Warn patient not to stop drug without first discussing with prescriber. • Warn patient of possible risks to fetus and infant during pregnancy and breastfeeding. Instruct patient who is breastfeeding to dis continue drug or discontinue breastfeeding. • Caution patient to avoid dehydration, which can cause hypotension. Promote adequate fluid intake, and instruct patient to report signs and symptoms of hypotension (postu ral dizziness, weakness, syncope). • Advise patient to use care during first few weeks of therapy because of increased risk of falls. • Instruct patient on general diabetes care, in cluding importance of diet and exercise and monitoring of blood glucose and HbA 1c lev els; signs and symptoms and management of hypoglycemia and hyperglycemia; and assess ment for diabetes complications. • Advise patient to seek medical advice promptly during periods of stress (such as fever, trauma, infection, or surgery) because medication requirements may change. • Teach about proper drug administration and handling. Atacand Therapeutic class: Antihypertensives Pharmacologic class: ARBs AVAILABLE FORMS Tablets: 4 mg, 8 mg, 16 mg, 32 mg INDICATIONS & DOSAGES Adjust-a-dose (for all indications): If patient, especially patient with impaired kidney func tion, is taking a diuretic, administer under close medical supervision and consider a lower starting dose. ➤ HTN (used alone or with other antihy pertensives) Adults: Initially, 16 mg PO once daily when used alone in patients who aren’t volume depleted; usual dosage range, 8 to 32 mg PO candesartan cilexetil kan-de-SAR-tan

daily as a single dose or in two divided doses. Adjust dosage about every 2 weeks, as toler ated, to target effect. Adjust-a-dose: In patients with Child-Pugh class B liver impairment, initially give 8 mg PO once daily. ➤ Pediatric HTN (used alone or with other antihypertensives) Alert: Don’t use in children with GFR less than 30 mL/minute/1.73 m 2 . Children ages 6 to younger than 17: Initially for patients weighing more than 50 kg, 8 to 16 mg PO once daily. May adjust dosage to between 4 and 32 mg PO as single dose or di vided doses as indicated. Initially for patients weighing less than 50 kg, 4 to 8 mg PO once daily. May adjust dosage to between 2 and 16 mg PO as single dose or divided doses as needed. Children ages 1 to younger than 6: Initially, 0.2 mg/kg PO once daily. Dosage range, 0.05 to 0.4 mg/kg/day PO as single dose or divided doses. ➤ HF with reduced ejection fraction (NYHA Class II to IV) Adults: Initially, 4 mg PO once daily. Double dose about every 2 weeks as tolerated to tar get dose of 32 mg once daily. ADMINISTRATION PO • Give drug without regard for food. • Pharmacist may make tablets into suspen sion for patients unable to swallow pills. • Shake suspension well before each use. • Suspension may be stored unopened at room temperature for 100 days. • Use suspension within 30 days of opening bottle. ACTION Inhibits vasoconstrictive action of angiotensin II by blocking angiotensin II receptor on the surface of vascular smooth muscle and other tissue cells. Route Onset Peak Duration PO Unknown 3–4 hr 24 hr Half-life: 9 hours. ADVERSE REACTIONS CNS: dizziness, headache. CV: hypotension. EENT: pharyngitis, rhinitis. GU: kidney func tion abnormality. Metabolic: hyperkalemia.

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