Atacand (Candesartan) for Heart Disease

Atacand (candesartan cilexetil) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat certain adults with heart failure, a condition in which the heart cannot pump blood as well as it should.

How Atacand Works and How It’s Taken

Atacand is a type of medicine called an angiotensin 2 receptor blocker (ARB). It works by blocking the effects of angiotensin 2, a hormone that causes blood vessels to tighten. Blocking this hormone helps blood vessels relax and lowers blood pressure.

Doctors prescribe Atacand when adults have heart failure with reduced pumping ability. It helps lower the risk of death from heart-related causes and the need for hospital stays due to heart failure.

Atacand comes as a tablet taken by mouth. You can take it with or without food.

Typical Dosing for Heart Failure

The recommended starting dose of Atacand for adults with heart failure is 4 milligrams once daily.

The target dose is 32 milligrams once daily. Your doctor may double your dose about every two weeks, depending on how well you tolerate the medicine.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Atacand Side Effects

In clinical studies of Atacand for heart failure, the following side effects occurred in about 6 percent to 19 percent of people:

Hypotension (low blood pressure), which can cause dizziness or fainting
Hyperkalemia (high potassium levels)
Impaired renal function (abnormal kidney function), which can show up as worsening kidney function on blood tests

Serious Side Effects and Warnings

Atacand can cause serious side effects that may require immediate medical attention. These include:

Fetal harm — Atacand can injure or cause the death of a developing fetus if taken during pregnancy.
Kidney harm in infants — Atacand must not be given to children younger than 1 year for high blood pressure because it can affect the development of their kidneys.
Symptomatic hypotension — Severe low blood pressure can cause fainting or severe dizziness.
Impaired renal function — Kidney problems or worsening kidney function can be serious in some people.
Hyperkalemia — High potassium levels can cause dangerous heart rhythm problems.

Get medical help right away if you think you are having a serious reaction.

This drug has a boxed warning, the FDA's strongest safety warning, for some of the serious risks mentioned above. A boxed warning does not mean the drug is unsafe for everyone or that everyone faces the same level of risk.

If you experience serious side effects, you can report them to the FDA online or by calling 1-800-FDA-1088. You can also contact the drug's manufacturer.

What To Know Before Taking Atacand

Before taking Atacand, tell your doctor if you have any allergies to candesartan or other ingredients in Atacand.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Atacand can interact with other medicines and may cause serious side effects.

Be sure to tell your doctor if you take:

Lithium — This includes lithium carbonate (Lithobid) or lithium citrate, medicines used to treat certain mental health conditions. Taking these with Atacand may increase lithium levels in your blood and cause harmful effects.
Other blood pressure medicines — These include diuretics (water pills), ACE inhibitors, and aliskiren. Some combinations may increase the risk of low blood pressure, kidney problems, or high potassium.
Potassium supplements or salt substitutes containing potassium — These may increase potassium levels in your blood.
Potassium-sparing diuretics — These medicines can also raise potassium levels.
Nonsteroidal anti-inflammatory drugs (NSAIDs) — These medicines may reduce the blood pressure-lowering effect of Atacand and increase the risk of kidney problems.

Also tell your doctor if you:

Have heart problems
Have liver or kidney problems
Are currently experiencing vomiting or diarrhea
Are scheduled for surgery or anesthesia
Have any other medical conditions

Atacand can cause low blood pressure during major surgery or anesthesia.

Do not take Atacand if you:

Are allergic to candesartan or any of the ingredients in Atacand
Have diabetes and take aliskiren

Atacand is also FDA-approved to treat hypertension (high blood pressure) in adults and children ages 1 to younger than 17 years. Lowering high blood pressure helps reduce the risk of serious heart and blood vessel problems, mainly strokes and heart attacks.

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

If you are planning to become pregnant, talk with your doctor about other treatment options. Atacand can cause serious harm or death to a developing fetus. If you become pregnant while taking Atacand, tell your doctor right away.

Atacand should be stopped as soon as pregnancy is detected.

Breastfeeding is not recommended while taking Atacand because of the possible risk of serious side effects in breastfed infants.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Atacand for heart failure?

In two large clinical studies, Atacand helped lower the risk of death from heart-related causes or hospitalization for heart failure in adults whose hearts had reduced pumping ability.

CHARM-Alternative — Among adults who could not take an ACE inhibitor, a type of heart and blood pressure medicine, 334 people taking Atacand experienced death from heart-related causes or hospitalization for heart failure, compared with 406 people taking a placebo (an inactive treatment). This was a 23 percent reduction in risk over a median follow-up of 34 months.
CHARM-Added — Among adults already taking an ACE inhibitor, 483 people taking Atacand experienced death from heart-related causes or hospitalization for heart failure, compared with 538 people taking a placebo. This was a 15 percent reduction in risk over a median follow-up of 41 months.

Across both studies, Atacand reduced the risk of death from heart-related causes or hospitalization for heart failure by 18 percent.

Can Atacand be used with other medicines for heart failure?

Yes. In clinical studies, Atacand was used with other heart failure medicines, including water pills, beta-blockers, digoxin, and ACE inhibitors.

However, taking Atacand with other medicines that affect the body’s blood pressure control system can increase the risk of low blood pressure, high potassium levels, and kidney problems. Using Atacand with both an ACE inhibitor and a mineralocorticoid receptor antagonist (a medicine that blocks the effects of a hormone called aldosterone) is generally not recommended.

Your doctor should closely monitor your blood pressure, kidney function, and blood mineral levels if you take Atacand with other medicines that affect this system.

What tests or monitoring are needed with Atacand for heart disease?

Your doctor should check your blood pressure when increasing your Atacand dose and from time to time afterward.

Your doctor should also check your kidney function and potassium levels with regular blood tests. Atacand can cause worsening kidney function and high potassium levels, especially in people with severe heart failure, kidney problems, or those taking certain other medicines.