Candesartan is a medicine widely used to treat high blood pressure and heart failure.

Candesartan helps to prevent future strokes, heart attacks and kidney problems. It also improves your survival if you’re taking it for heart failure.

This medicine is only available on prescription. It comes as tablets.

  • Candesartan lowers your blood pressure and makes it easier for your heart to pump blood around your body.
  • It’s often used as a second-choice treatment if you had to stop taking your first because it gave you a dry, irritating cough.
  • The main side effects of candesartan are dizziness, headache and
    cold or flu-like symptoms – but they’re usually mild and short-lived.
  • Drinking alcohol can increase the blood pressure-lowering effect of candesartan, which can make you feel dizzy or light-headed.
  • Candesartan is also called by the brand name Amias.

Candesartan can be taken by adults aged 18 and over.

It can also be taken by children aged 6 years and over, but only to treat high blood pressure.

Candesartan is meant for people who have tried taking blood pressure-lowering medicines called ACE inhibitors (such as ramipril and lisinopril) in the past, but had to stop taking them because of side effects such as a dry cough.

Candesartan isn’t suitable for some people.

To make sure candesartan is safe for you, tell your doctor if you:

  • have diarrhoea or vomiting (or if you’ve recently had it)
  • have been on a low salt diet
  • have recently had a kidney transplant
  • have had an allergic reaction to candesartan or any other medicines in the past
  • have severe liver disease or a problem with the drainage of the bile from your gall bladder (biliary obstruction)
  • have diabetes
  • have heart, liver or kidney problems
  • have low blood pressure
  • are trying to get pregnant, are already pregnant or you’re breastfeeding

It’s usual to take candesartan tablets once a day. You can take your
daily candesartan tablet at any time of day, but try to be consistent
and take it at the same time every day.

You can take candesartan tablets with or without food. Swallow the tablets whole with a drink of water.

How much will I take?

The dose of candesartan you take depends on why you need the medicine. Take it as instructed by your doctor.

As a general rule in adults, the dose to treat:

  • high blood pressure is 8mg to 32mg once a day
  • heart failure is 4mg to 32mg once a day

In people with liver or kidney problems, the dose may be lower.

As a general rule in children (aged 6 years and over), the dose to treat high blood pressure is:

  • for children weighing less than 50kg, the dose is 4mg to 8mg once a day
  • for children weighing 50kg and more, the dose is 4mg to 16mg once daily

Will my dose go up or down?

You will start on a low dose of candesartan. After a few weeks your
doctor will check your blood pressure and ask you if you’re getting any
side effects. You may also have blood tests to check how well your
kidneys are working and the amount of potassium in your blood. Your
doctor will then decide whether to change your dose of candesartan.

If candesartan doesn’t get your blood pressure down, your doctor may
want to increase the dose. If your blood pressure gets too low or you
get side effects, your doctor may want to lower your candesartan dose.

Like all medicines, candesartan can cause side effects although not everyone gets them. Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people.

Talk to your doctor or pharmacist if these side effects bother you or don’t go away:

  • feeling dizzy or having a spinning sensation (vertigo)
  • feeling sick
  • headache
  • vomiting or diarrhoea
  • pain in your joints or muscles

Serious side effects

It happens rarely, but some people have serious side effects after taking candesartan.

Tell a doctor straight away if you have:

  • yellow skin or eyes – this can be a sign of liver problems
  • pale skin, feeling tired, faint or dizzy, purple spots, any sign of bleeding, sore throat and fever – these can be signs of blood or bone marrow disorder
  • weakness, an irregular heartbeat, pins and needles and muscle cramps – these can be signs of changes in the sodium and potassium levels in your blood

Serious allergic reaction

In rare cases, candesartan may cause a serious allergic reaction.

What to do about:

  • feeling dizzy – if candesartan makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you don’t faint, then sit until you feel better. Don’t drive or use tools or machines if you feel dizzy, have muscle cramps or muscle pain, or if
    you just feel a bit shaky.
  • feeling sick – try taking your tablets with or after a meal or snack. It may also help if you don’t eat rich or spicy food.
  • headaches – make sure you rest and drink plenty of fluids. Don’t drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking candesartan. Talk to your doctor if they last longer than a week or are severe.
  • vomiting or diarrhoea – drink plenty of water to prevent dehydration. If you’re vomiting try small, frequent sips. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. If you get severe vomiting or diarrhoea from a stomach bug or illness, tell your doctor. You may need to stop taking candesartan for a while until you feel better.
  • pain in your joints or muscles – if you get unusual muscle pain, weakness or tiredness which isn’t from exercise or hard work, talk to your doctor. You may need a blood test to check what might be causing it.

Candesartan is not normally recommended in pregnancy or when breastfeeding. However, your doctor may prescribe it for you if
they think the benefits of the medicine outweigh the risks.

If you’re trying to get pregnant or you’re already pregnant, talk to your doctor about the benefits and possible harms of taking candesartan. These will depend on how many weeks pregnant you are and the reason you need to take it. There may be other treatments that are safer for you.

Candesartan and breastfeeding

Small amounts of candesartan may get into breast milk. This can cause low blood pressure in the baby. Talk to your doctor, as other medicines might be better while you are breastfeeding.

Some medicines interfere with the way candesartan works.

Tell your doctor if you’re taking:

  • other medicines to help lower your blood pressure, including aliskiren, enalapril, captopril, lisinopril or ramipril
  • painkillers such as ibuprofen, naproxen, diclofenac, celecoxib or etoricoxib
  • aspirin (if you’re taking more than 3g a day)
  • potassium supplements or salt substitutes containing potassium
  • heparin (a medicine for thinning the blood)
  • water tablets (diuretics)
  • lithium (a medicine for mental health problems)
  • spironolactone (a medicine to treat heart failure)

Mixing candesartan with herbal remedies or supplements

There’s very little information about taking herbal remedies and supplements with candesartan.

For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with candesartan.

How does candesartan work?