General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hypotensive effects magnified by natriuretic agents or sodium depletion. Can cause hyperkalemia, metabolic acidosis. Acute renal dysfunction with bilateral or transplant renal artery stenosis, low renal perfusion pressure.
Half-Life (Normalesrd) Hours
9-13/7.3-12
Plasma Protein Binding %
99
Volume Of Distribution L/Kg
0.13
Dose For Normal Renal Function
16-32 mg q24h
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: No dose adjustment,[A]
Supplement For Dialysis [Recommendation Level]: Pd
PD: No dose adjustment,[A]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50,titrate, [D]
References
de Zeeuw D, Remuzzi G, Kirch W. Pharmacokinetics of candesartan cilexetil in patients with renal or hepatic impairment. J Hum Hypertens. 1997; 11 Suppl 2: S37-42.[PMID: 9331004] / Ottosson P, Attman PO, Agren AC, Samuelsson O. Candesartan cilexetil in haemodialysis patients. Clin Drug Investig. 2003; 23: 545-50. [PMID: 17535067] / Pfister M, Frey FJ, Uehlinger DE. Pharmacokinetics, haemodynamics and safety of candesartan cilexetil in hypertensivepatients undergoing haemodialysis [Abstract]. J Hum Hypertens. 1999; 13(Suppl 3): 21. [PMID unavailable] / Pfister M, Schaedeli F, Frey FJ, Uehlinger DE. Pharmacokinetics and haemodynamics of candesartan cilexetil in hypertensive patients on regular haemodialysis. Br J Clin Pharmacol. 1999; 47: 645-51. [PMID: 10383542]
Toxicity Notes
Rapidly and completely bioactivated by ester hydrolysis during absorption from the gastrointestinal tract.