Mode of Action

Candesartan cilexetil is a prodrug suitable for oral use. It is rapidly converted to the active substance, candesartan, by ester hydrolysis during absorption from the gastrointestinal tract. Candesartan is an angiotensin II receptor antagonist, selective for AT1 receptors, with tight binding to and slow dissociation from the receptor. It has no agonist activity.

In hypertension, candesartan causes a dose-dependent, long-lasting reduction in arterial blood pressure. The antihypertensive action is due to decreased systemic peripheral resistance, without reflex increase in heart rate. There is no indication of serious or exaggerated first dose hypotension or rebound effect after cessation of treatment.

When candesartan cilexetil is used together with hydrochlorothiazide, the reduction in blood pressure is additive. Concomitant administration of candesartan cilexetil with hydrochlorothiazide or amlodipine is well tolerated.

In heart failure, treatment with candesartan cilexetil reduces mortality, reduces hospitalisation due to heart failure, and improves symptoms in patients with left ventricular systolic dysfunction.

Adapted from Summary of Product Characteristics for Atacand (candesartan cilexetil)

Review period : 12 months
Last reviewed : June 2009