Hydrochlorothiazide and candesartan is a combination medicine used to treat high blood pressure (hypertension).

Hydrochlorothiazide and candesartan may also be used for purposes not listed in this medication guide.

Do not use if you are pregnant. If you become pregnant, stop taking hydrochlorothiazide and candesartan and tell your doctor right away.

If you have diabetes, do not use hydrochlorothiazide and candesartan together with any medication that contains aliskiren (a blood pressure medicine).

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take hydrochlorothiazide and candesartan with or without food.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking this medication, which can lead to severely low blood pressure or a serious electrolyte imbalance.

Your blood pressure will need to be checked often. Your blood and urine may also be tested if you have been vomiting or are dehydrated.

If you need surgery or medical tests, tell the surgeon ahead of time that you are using hydrochlorothiazide and candesartan.

It may take up to 4 weeks for this medication to control your blood pressure. Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Hypertension:

Candesartan 16 to 32 mg-Hydrochlorothiazide 12.5 to 50 mg orally daily in 1 to 2 divided doses

Comments:
-The recommended starting dose of candesartan is 16 mg orally once a day when used as monotherapy in patients who are not volume depleted; doses larger than 32 mg do not appear to have a greater blood pressure lowering effect.
-A patient whose blood pressure remains uncontrolled on candesartan 32 mg can expect an incremental effect from candesartan 32 mg-hydrochlorothiazide 12.5 mg
-A patient whose blood pressure remains uncontrolled on hydrochlorothiazide 25 mg can expect an incremental effect from candesartan 16 mg-hydrochlorothiazide 12.5 mg; a patient whose blood pressure is controlled on hydrochlorothiazide 25 mg but is experiencing decreases in serum potassium can expect the same or incremental blood pressure effects from candesartan 16 mg-hydrochlorothiazide 12.5 mg and serum potassium may improve.
-Maximal antihypertensive effect can be expected within 4 weeks of treatment initiation.

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 (a blood pressure medicine).

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

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. Stop using the medicine and tell your doctor right away if you become pregnant. This medicine can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breastfeed while using this medicine.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include fast or slow heartbeat, feeling light-headed, or fainting.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Hydrochlorothiazide may increase your risk of skin cancer. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Your doctor may want you to have skin examinations on a regular basis.

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, unless your doctor has told you to.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, hydrochlorothiazide and candesartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

Also call your doctor at once if you have:

• eye pain, vision problems;

• a light-headed feeling, like you might pass out;

• little or no urinating;

• jaundice (yellowing of the skin or eyes);

• easy bruising, unusual bleeding; or

• signs of an electrolyte imbalance--increased thirst or urination, confusion, vomiting, constipation, muscle pain or weakness, leg cramps, bone pain, lack of energy, irregular heartbeats, tingly feeling.

Common side effects of hydrochlorothiazide and candesartan may include:

• dizziness;

• back pain; or

• cold or flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• lithium; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect hydrochlorothiazide and candesartan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.