Atacand (candesartan cilexetil) is an angiotensin II receptor agonist used to treat high blood pressure and heart failure. A prodrug, it is itself inert but is converted to the active drug candesartan during the digestive process.

The medication works by dilating blood vessels, which makes it easier for the heart to circulate blood, which in turn provides a number of benefits:

• Lowers blood pressure
• Reduces the heart's workload
• Reduces incidence of heart attack
• Reduces incidence of stroke
• Spares the kidneys from high blood pressure damage
• Reduces overall mortality from above causes

Atacand is often used on its own, but it's also not unusual for other medications, such as diuretics, to be taken along with it to further enhance effects.

How Atacand Improves Cardiovascular Health

Atacand's benefit can start with prehypertension; the medication, particularly when used along with lifestyle changes, can slow or prevent prehypertension from progressing into hypertension. In treating patients with prehypertension the incidence of developing hypertension was reduced by almost 66% in studies.

In hypertension Atacand works by helping blood vessels stay dilated, allowing for easy blood flow. As an ACE II inhibitor it can be used with ACE I inhibitors to better control high blood pressure and further reduce resulting organ damage or mortality from stroke or heart attack.

Since hypertension can also cause damage to fine structures within the kidneys, the medication helps reduce damage to kidney as well. In fact it is often prescribed for its kidney sparing properties in diabetes. It may also help prevent the development of diabetic nephropathy.

The medication is also often used in treatment of heart failure, where it reduces cardiac load and helps to reduce heart attacks. Studies have demonstrated reduced mortality when the medication was used to treat congestive heart failure.

Treatment Overview

Atacand is usually taken once or twice a day with or without food. Ideally the medication should be taken at the same time every day to keep levels of the drug consistent in the body.

Dosage can vary considerably and will need to be individualized according the condition being treated, its severity, other medical conditions present, other medications being taken, age, weight, and so forth. Response to treatment is also variable and dosage adjustments may be required several times before the ideal dose is determined.

In otherwise healthy adults treating hypertension, a rough guideline is:

• If not taking other medications, start with 16 mg taken once or twice per day.
• Results should be evaluated after two weeks of treatment.
• If needed dose may be increased up to 32 mg, taken once or twice per day.
• If effects are not sufficient at 32 mg per day, adding another anti-hypertension medication is likely to be more effective than further increasing dosage of Atacand.

And in heart failure:

• Start with 4 mg taken once per day.
• After 2 weeks results should be evaluated and dosage doubled if no serious side effects are present.
• Dosage may be doubled every two weeks up to 32 mg per day, provided no adverse effects develop.

In both cases treatment is typically long term, often for the remainder of life. If treatment does end it should not do so abruptly; gradually tapering down dosage over several weeks is recommended.

Precautions & Side Effects

Most patients experience only mild side effects, and these are typically transient---they stop occurring over time as the body adjusts to treatment. Most common are:

• Sneezing, runny or stuffy nose
• Cough
• Headache
• Sore back
• Dizziness
• Joint pain
• Lack of energy

Weakness, tiredness, dizziness and other signs of low blood pressure may be experienced at the start of treatment or following dosage adjustments. These should stop as the body adjusts to its new lower blood pressure.

Some patients develop weakened or erratic heartbeats while taking blood pressure medications; this should be brought to the attention of a doctor.

Atacand should not be used during pregnancy or if trying to conceive; it is known to be harmful to unborn babies. Effects on nursing infants are not known.

Rarely some patients have an allergic reaction to Atacand; warning signs include difficulty breathing, swelling of the face or throat, and hives. These symptoms warrant emergency medical attention.