The name of your medicine is Atacand. The active ingredient is candesartan cilexetil. This belongs to a group of medicines called angiotensin II receptor antagonists. It works by making your blood vessels relax and widen. This helps to lower your blood pressure. It also makes it easier for your heart to pump blood to all parts of your body.
This is medicine is used for:

•  treating high blood pressure (hypertension) in adult patients.
•  treating adult heart failure patients with reduced heart muscle function, in addition to Angiotensin Converting Enzyme (ACE) inhibitors or when ACE inhibitors cannot be used (ACE inhibitors are a group of medicines used to treat heart failure).

Do not take Atacand if you are pregnant, think you might be pregnant or considering becoming pregnant. You must tell your doctor if you think you are (or might become) pregnant. Atacand may cause serious harm or even death to your baby if used during pregnancy (see Pregnancy section).

Do not take Atacand

•  if you are allergic (hypersensitive) to candesartan cilexetil or any of the other ingredients of Atacand (see section 6).
•  if you are breast-feeding.
•  if you have severe liver disease or biliary obstruction (a problem with the drainage of the bile from the gall bladder).
•  If you are taking blood pressure medicine containing aliskiren and you have diabetes mellitus.
• If you are taking a blood pressure medicine containing aliskiren and you have kidney problems.

If you are not sure if any of these apply to you, talk to your doctor or pharmacist before taking Atacand.

Take special care with Atacand
Before you take, or whilst you are taking Atacand, tell your doctor.

•  if you have heart, liver or kidney problems, or are on dialysis.
•  if you have recently had a kidney transplant.
•  if you are vomiting, have recently had severe vomiting, or have diarrhoea.
•  if you have a disease of the adrenal gland called Conn’s syndrome (also called primary hyperaldosteronism).
•  if you have low blood pressure.
• if you have ever had a stroke.
• if you are taking any of the following medicines used to treat high blood pressure:

- an “ACE-inhibitor” (for example enalapril, lisinopril, ramipril), in particular if you have diabetes-related kidney problems.
- aliskiren

•  if you are taking an ACE-inhibitor together with a medicine which belongs to the class of medicines known as mineralocorticoid receptor antagonists (MRA). These medicines are for the treatment of heart failure (see “Other medicines and Atacand”).

Your doctor may want to see you more often and do some tests if you have any of these conditions.
If you are going to have an operation, tell your doctor or dentist that you are taking Atacand. This is because Atacand, when combined with some anaesthetics, may cause a drop in blood pressure.
Use in children
There is no experience with the use of Atacand in children (below the age of 18 years). Therefore Atacand should not be given to children.
Using other medicines
Please tell your doctor or pharmacist if you are using, or have recently used, any other medicines, including medicines obtained without a prescription.
Atacand can affect the way some other medicines work and some medicines can have an effect on Atacand. If you are using certain medicines, your doctor may need to do blood tests from time to time.
In particular, tell your doctor if you are using any of the following medicines:

•  Other medicines to help lower your blood pressure, including beta-blockers, diazoxide, aliskiren and ACE inhibitors such as enalapril, captopril, lisinopril or ramipril.
•  Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, diclofenac, celecoxib or etoricoxib (medicines to relieve pain and inflammation).
•  Acetylsalicylic acid (if you are taking more than 3 g each day) (medicine to relieve pain and inflammation).
•  Potassium supplements or salt substitutes containing potassium (medicines that increase the amount of potassium in your blood).
•  Heparin (a medicine for thinning the blood).
•  Water tablets (diuretics).
•  Lithium (a medicine for mental health problems).

Taking Atacand with food and drink (in particular alcohol)

•  You can take Atacand with or without food.
•  When you are prescribed Atacand, discuss with your doctor before drinking alcohol. Alcohol may make you feel faint or dizzy.

Pregnancy and breast-feeding
Pregnancy
You must not take Atacand if you are pregnant, might be pregnant, or are considering becoming pregnant. You must tell your doctor if you think you are (or might become) pregnant. Your doctor will ask you to stop taking Atacand before you become pregnant or as soon as you know you are pregnant and may recommend another medicine instead of Atacand. Atacand may cause serious harm or even death to your baby if used during pregnancy.
Breast-feeding
Tell your doctor if you are breast-feeding or about to start breast-feeding. Atacand must not be used by mothers who are breast-feeding.
Driving and using machines
Some people may feel tired or dizzy when taking Atacand. If this happens to you, do not drive or use any tools or machines.
Important information about some of the ingredients of Atacand
Atacand contains lactose which is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

Always take Atacand exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. It is important to keep taking Atacand every day.

You can take Atacand with or without food.
Swallow the tablet with a drink of water.
Try to take the tablet at the same time each day. This will help you to remember to take it.
High blood pressure:

•  The usual dose of Atacand is 8 mg once a day. Your doctor may increase this dose to 16 mg once a day and further up to 32 mg once a day depending on blood pressure response.
•  In some patients, such as those with liver problems, kidney problems or those who recently have lost body fluids, e.g., through vomiting or diarrhoea or by using water tablets, the doctor may prescribe a lower starting dose.
•  Some black patients may have a reduced response to this type of medicine, when given as the only treatment, and these patients may need a higher dose.

Heart failure:

•  The usual starting dose of Atacand is 4 mg once a day. Your doctor may increase your dose by doubling the dose at intervals of at least 2 weeks up to 32 mg once a day. Atacand can be taken together with other medicines for heart failure, and your doctor will decide which treatment is suitable for you.

If you take more Atacand than you should
If you take more Atacand than prescribed by your doctor, contact a doctor or pharmacist immediately for advice.

If you forget to take Atacand
Do not take a double dose to make up for a forgotten tablet. Just take the next dose as normal.
If you stop taking Atacand
If you stop taking Atacand, your blood pressure may increase again. Therefore do not stop taking Atacand without first talking to your doctor.
If you have any further questions on the use of this product, ask your doctor or pharmacist.

Like all medicines, Atacand can cause side effects, although not everybody gets them. It is important that you are aware of what these side effects may be.
Stop taking Atacand and seek medical help immediately if you have any of the following allergic reactions:

•  difficulties in breathing, with or without swelling of the face, lips, tongue and/or throat
•  swelling of the face, lips, tongue and/or throat, which may cause difficulties in swallowing
•  severe itching of the skin (with raised lumps)

Atacand may cause a reduction in number of white blood cells. Your resistance to infection may be decreased and you may notice tiredness, an infection or a fever. If this happens contact your doctor. Your doctor may occasionally do blood tests to check whether Atacand has had any effect on your blood (agranulocytosis).
Other possible side effects include:
Common (affects 1 to 10 users in 100)

•  Feeling dizzy/spinning sensation.
•  Headache.
•  Respiratory infection.
•  Low blood pressure. This may make you feel faint or dizzy.
•  Changes in blood test results:

- An increased amount of potassium in your blood, especially if you already have kidney problems or heart failure. If this is severe you may notice tiredness, weakness, irregular heart beat or pins and needles.

•  Effects on how your kidneys work, especially if you already have kidney problems or heart failure. In very rare cases, kidney failure may occur.

Very rare (affects less than 1 user in 10,000)

•  Swelling of the face, lips, tongue and/or throat.
•  A reduction in your red or white blood cells. You may notice tiredness, an infection or a fever.
•  Skin rash, lumpy rash (hives).
•  Itching.
•  Back pain, pain in joints and muscles.
•  Changes in how your liver is working, including inflammation of the liver (hepatitis). You may notice tiredness, yellowing of your skin and the whites of your eyes and flu like symptoms.
•  Nausea.
•  Changes in blood test results:

- A reduced amount of sodium in your blood. If this is severe then you may notice weakness, lack of energy, or muscle cramps.

•  Cough

If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

•  Keep out of the reach and sight of children.
• Do not use Atacand after the expiry date which is stated on the carton, blister pack or bottle. The expiry date refers to the last day of that month.
•  Keep the drug under 30ºC.
•  Keep the tablets in the original package.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.