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ARB·Cardiovascular - Antihypertensives
Hypertension, Heart Failure, Diabetic nephropathy
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Max Dose
32 mg/day
Half-life
9 h
Dry Cough
SAFE
Caution: Hyperkalemia
HIGH RISK
Avoid / Cautions
Bilateral renal artery stenosis, severe hepatic impairment/cholestasis. Pregnancy Category D. Causes fetal renal failure/death.
Overview
Angiotensin II Receptor Blocker (ARB). The direct alternative to ACE inhibitors. Provides identical cardiovascular and renal protection without causing the bradykinin-mediated dry cough.
Clinical Focus
Carries the exact same risk of hyperkalemia, renal failure (Triple Whammy), and fetal toxicity as ACE inhibitors.
Bottom Line
Candesartan is the ideal ACE inhibitor substitute (no cough) with unique migraine prophylaxis evidence, but carries identical renal and pregnancy risks to ACEis.
Brand Names
Atacand
Oral Routes
Tablets (4, 8, 16, 32 mg).
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Hypertension, Heart Failure, Diabetic nephropathy.
Clinical Place
First-line substitute for patients who develop an ACE-inhibitor cough. Identical efficacy in heart failure.
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