Candesartan chemical structure
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Atacand

Candesartan (kan-de-SAR-tan) belongs to the class of medicines called angiotensin II receptor antagonists. It is used to treat high blood pressure (hypertension) and is marketed under the brand name Atacand® (alternative name: Ratacand®) by AstraZeneca. more...

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High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.

Candesartan works by blocking the action of a substance in the body that causes blood vessels to tighten. As a result, candesartan relaxes blood vessels. This lowers blood pressure.

Side-effects

By decreasing aldosterone levels, candesartan and related drugs may cause hyperkalemia (high potassium levels in the blood). Supplements containing potassium, which are sometimes taken by patients with high blood pressure, are discouraged.

Some people taking candesartan report dizziness (occurs in 1 out of every 25 persons), blurry vision, lightheadedness, a sore throat or a runny nose. More serious side effects can be fainting, decreased sexual ability, jaundice, severe nausea, fatigue and chest pain.

Contraindications

It is contraindicated in pregnancy, especially in the last six months, preexistent hyperkalemia and a history of drug reactions to other AT II inhibitors.

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Water pills and night sweats
From Saturday Evening Post, 11/1/04 by Cory SerVaas

Dear Dr. SerVaas:

I take a water pill. Since starting on this pill, I have been having night sweats around my neck. The collar and front of my nightshirt sometimes gets so wet that I need to change shirts several times during the night.

The diuretic causes frequent urination. Does it also cause night sweats? The urinary frequency doesn't bother me, but I worry that the night sweats might be caused by something other than the diuretic I'm taking. If I know the sweats are probably caused by the medicine, I'll stop worrying about that one.

P.S.: The water pill I take is a combination pill called triamterene 37.5 mg and hydrochlorothiazide (HCTZ) 25 mg. The brand name is Maxzide-25.

Do any readers notice night sweats when they begin taking diuretics to help lower blood pressure?

Diuretics, or water pills, contain hydrochlorothiazide (HCTZ or HCT) alone or with other medicines. Hydrodiuril and Microzide are single-ingredient diuretics. Combination drugs include Aldoril, Atacand HCT, Avalide, Benicar HCT, Diovan HCT, Dyazide, Hyzaar, Lotensin HCT, Maxzide, Micardis HCT. Moduretic, Prinzide, Teveten HCT, Timolide, Uniretic, Vaseretic, Zestoretic and Ziac.

The combination pill you are taking (Maxzide) contains an ingredient to help you retain potassium, an important electrolyte needed for proper heart and muscle function. Water pills tend to flush potassium from the body along with sodium. To keep electrolytes in balance, healthcare professionals often advise those on diuretics to eat a banana every day to replenish potassium stores. Taking a daily multivitamin is a good idea, too.

We sent your question about diuretics and night sweats to Dr. Myron Weinberger, M.D., FACP. FACC, director of the Hypertension Research Center at the IU School of Medicine. Dr. Weinberger responds:

"I am unaware of any reports that night sweats are associated with Maxzide or either of its components. However, that does not eliminate the possibility of a rare occurrence. One way to evaluate whether a cause-and-effect relationship exists would be to discontinue Maxzide for a period of time to see if the symptoms disappear and then reinstitute the drug to see if they reappear. This poses a problem of risk of uncontrolled elevation of blood pressure if the drug is needed for blood pressure control. For that reason it should best be done under the advice and supervision of the patient's physician. He could also evaluate the night sweats if they persist after stopping Maxzide to determine if there Is another cause."

Night sweats can be a symptom of gastroesophageal reflux disease, obstructive sleep apnea, thyroid conditions, low blood sugar, and panic attacks. In menopausal women, several minutes of sweating can occur with hot flashes. Increased sweating has been noted in those taking Effexor or Zoloft for depression or anxiety.

COPYRIGHT 2004 Saturday Evening Post Society
COPYRIGHT 2004 Gale Group

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