Atacand HCT

Name: Atacand HCT

Atacand HCT Overview

Atacand HCT is a prescription medication used to treat high blood pressure. It is a single product containing 2 medications: candesartan and hydrochlorothiazide. Candesartan is in a class of medications called angiotensin II receptor antagonists. It works by blocking the action of certain natural substances that tighten the blood vessels, allowing the blood to flow more smoothly and the heart to pump more efficiently. Hydrochlorothiazide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

This medication comes in tablet form and is taken once or twice daily, with or without food.

Common side effects of Atacand HCT include nausea, a condition of excess uric acid in the blood (hyperuricemia), and upper respiratory tract infection.  

Atacand HCT can also cause dizziness.  Do not drive or operate heavy machinery until you know how Atacand HCT affects you.

Atacand HCT Interactions

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.  Especially tell your doctor if you take:

  • other medicines for high blood pressure or a heart problem
  • water pills (diuretics)
  • potassium supplements. Your doctor may check the amount of potassium in your blood periodically. 
  • a salt substitute. Your doctor may check the amount of potassium in your blood periodically. 
  • antidiabetic medicines including insulin
  • narcotic pain medicines
  • sleeping pills
  • lithium, a medicine used in some types of depression (Eskalith, Lithobid, Lithium Carbonate, Lithium Citrate)
  • aspirin or other medicines called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), like ibuprofen or naproxen 
  • digoxin or other digitalis glycosides (a heart medicine)
  • muscle relaxants (medicines used during operations)
  • certain cancer medicines, like cyclophosphamide or methotrexate 
  • certain antibiotics (rifamycin group), a drug used to protect against transplant rejection (cyclosporin) or an antiretroviral drug used to treat HIV/AIDS infection (ritonavir). These drugs may increase the effect of Atacand HCT.

This is not a complete list of Atacand HCT drug interactions. Ask your doctor or pharmacist for more information.

 

Atacand HCT Precautions

Serious side effects have been reported with Atacand HCT including the following:

  • harm to an unborn baby causing injury and even death.
  • low blood pressure (hypotension). Low blood pressure is most likely to happen if you:
    • take water pills
    • are on a low salt diet
    • get dialysis treatments
    • have heart problems
    • get sick with vomiting or diarrhea
    • drink alcohol
  • allergic reactions. People with and without allergy problems or asthma who take Atacand HCT may get allergic reactions.
  • worsening of lupus. Hydrochlorothiazide, one of the medicines in Atacand HCT, may cause lupus to become active or worse.
  • fluid and electrolyte (salt) problems. Tell your doctor about any of the following signs and symptoms of fluid and electrolyte problems:
    • dry mouth
    • thirst
    • lack of energy (lethargy)
    • weakness
    • drowsiness
    • restlessness
    • confusion
    • seizures
    • muscle pain or cramps
    • muscle fatigue
    • very low urine output
    • fast heartbeat
    • nausea and vomiting
  • kidney problems. Kidney problems may become worse in people that already have kidney disease. Some people will have changes on blood tests for kidney function and may need a lower dose of Atacand HCT. Call your doctor if you get swelling in your feet, ankles, or hands, or unexplained weight gain. If you have heart failure, your doctor should check your kidney function before prescribing Atacand HCT.
  • skin rash. Call your doctor right away if you have an unusual skin rash.
  • eye problems. One of the medicines in Atacand HCT can cause eye problems that may lead to vision loss. Symptoms of eye problems can happen within hours to weeks of starting Atacand HCT. Tell your doctor right away if you have:
    • decrease in vision
    • eye pain

Do not take Atacand HCT if you:

  • are allergic to Atacand HCT or to any of its ingredients, or medicines that contain sulfonamides
  • make less urine due to kidney problems
  • are a diabetic patient taking aliskiren

Inform MD

Before taking Atacand HCT, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

  • are pregnant or plan to become pregnant
  • are breastfeeding
  • have liver problems
  • have kidney problems
  • have or had gallstones
  • have lupus
  • have high levels of uric acid in the blood
  • have ever had a reaction called angioedema to another blood presure medication. Angioedema causes swelling of the face, lips, tongue, throat, and may cause difficulty breathing

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Atacand HCT Usage

Take Atacand HCT exactly as prescribed.

Atacand HCT comes in tablet form and is taken once or twice daily, with or without food.  

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Atacand HCT at the same time.

What should I with my healthcare provider before taking Atacand HCT (hydrochlorothiazide and candesartan)?

You should not use this medicine if you are allergic to candesartan or hydrochlorothiazide, or if:

  • you are unable to urinate; or

  • you are allergic to sulfa drugs.

If you have diabetes, do not use hydrochlorothiazide and candesartan together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

You may also need to avoid taking hydrochlorothiazide and candesartan with aliskiren if you have kidney disease.

To make sure hydrochlorothiazide and candesartan is safe for you, tell your doctor if you have ever had:

  • liver disease;

  • congestive heart failure;

  • glaucoma;

  • low or high levels of potassium in your blood;

  • asthma or allergies;

  • high cholesterol or triglyceride levels;

  • gout;

  • lupus;

  • diabetes; or

  • an allergy to penicillin.

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Hydrochlorothiazide and candesartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

Hydrochlorothiazide can pass into breast milk and may cause side effects in the nursing baby. You should not breast-feed while using this medicine.

What should I avoid while taking Atacand HCT (hydrochlorothiazide and candesartan)?

If you also take cholestyramine or colestipol, avoid taking these medications within 4 hours before or 4 hours after you take hydrochlorothiazide and candesartan.

Drinking alcohol can further lower your blood pressure and may cause side effects.

Do not use potassium supplements or salt substitutes while you are taking hydrochlorothiazide and candesartan, unless your doctor has told you to.

Precautions While Using Atacand HCT

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Dizziness, lightheadedness, or fainting may occur after the first dose, especially if you have been taking a diuretic (water pill). Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you dizzy or not alert. If you feel dizzy, lie down so you do not faint. Then sit for a few moments before standing to prevent the dizziness from returning.

Check with your doctor right away if you experience confusion, dizziness, muscle pain, weakness, or a fast heartbeat. Drink more fluids when you exercise or if the weather is hot. Heavy sweating or diarrhea and vomiting can cause dehydration (loss of too much water) or electrolyte imbalances (loss of sodium in the body). Check with your doctor if you become sick with severe nausea, vomiting, or diarrhea.

Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment. Your doctor may want an eye doctor to check your eyes.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

Avoid alcoholic beverages while you are using this medicine. Alcohol may make the low blood pressure effect worse and/or increase the possibility of dizziness or fainting.

This medicine may affect blood sugar levels. Diabetic patients may notice a change in the results of your blood or urine sugar tests. Talk to your doctor if you have any questions.

Do not take other medicines unless they have been discussed with your doctor. This especially includes potassium supplements or salt substitutes that contain potassium, since they may change your blood potassium levels, or over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they may tend to increase your blood pressure.

What are some things I need to know or do while I take Atacand HCT?

  • Tell all of your health care providers that you take Atacand HCT. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this medicine affects you.
  • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
  • If you have high blood sugar (diabetes), Atacand HCT may sometimes raise blood sugar. Talk with your doctor about how to keep your blood sugar under control.
  • Have your blood pressure checked often. Talk with your doctor.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • This medicine may affect how much of some other drugs are in your body. If you are taking other drugs, talk with your doctor. You may need to have your blood work checked more closely while taking this medicine with your other drugs.
  • This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take Atacand HCT.
  • If you are taking a salt substitute that has potassium, potassium-sparing diuretics, or potassium, talk with your doctor.
  • If you are on a low-salt or salt-free diet, talk with your doctor.
  • Talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, ibuprofen or like products, and some natural products or aids.
  • Talk with your doctor before you drink alcohol or use other drugs and natural products that slow your actions.
  • Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
  • Tell your doctor if you have too much sweat, fluid loss, throwing up, or loose stools. This may lead to low blood pressure.
  • If you take cholestyramine or colestipol, talk with your pharmacist about how to take them with this medicine.
  • Watch for gout attacks.
  • If you have lupus, Atacand HCT can make your lupus active or get worse. Tell your doctor right away if you get any new or worse signs.
  • It may take 1 month to see the full effect.

How is this medicine (Atacand HCT) best taken?

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • Take with or without food.
  • Take Atacand HCT at the same time of day.
  • Keep taking this medicine as you have been told by your doctor or other health care provider, even if you feel well.
  • To gain the most benefit, do not miss doses.
  • This medicine may cause you to pass urine more often. To keep from having sleep problems, try to take before 6 pm.
  • Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.

What do I do if I miss a dose?

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out Atacand HCT?

  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

Overdosage

Candesartan Cilexetil-Hydrochlorothiazide

No lethality was observed in acute toxicity studies in mice, rats and dogs given single oral doses of up to 2000 mg/kg of candesartan cilexetil or in rats given single oral doses of up to 2000 mg/kg of candesartan cilexetil in combination with 1000 mg/kg of hydrochlorothiazide. In mice given single oral doses of the primary metabolite, candesartan, the minimum lethal dose was greater than 1000 mg/kg but less than 2000 mg/kg.

Limited data are available in regard to overdosage with candesartan cilexetil in humans. The most likely manifestations of overdosage with candesartan cilexetil would be hypotension, dizziness, and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be initiated. For hydrochlorothiazide, the most common signs and symptoms observed are those caused by electrolyte depletion (hypokalemia, hypochloremia, hyponatremia) and dehydration resulting from excessive diuresis. If digitalis has also been administered, hypokalemia may accentuate cardiac arrhythmias.

Candesartan cannot be removed by hemodialysis. The degree to which hydrochlorothiazide is removed by hemodialysis has not been established.

Treatment

To obtain up-to-date information about the treatment of overdose, consult your Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians’ Desk Reference (PDR). In managing overdose, consider the possibilities of multiple-drug overdoses, drug-drug interactions, and altered pharmacokinetics in your patient.

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