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Safety Concerns With Candesartan-Hydrochlorothiazide

Some Candesartan-Hydrochlorothiazide Warnings and Precautions

Patients taking this drug should keep the following warnings and precautions in mind:
  • Candesartan-hydrochlorothiazide may cause extremely low blood pressure in some people. Extremely low blood pressure is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are taking a diuretic, who are on dialysis, who have congestive heart failure, who have diarrhea or vomiting, or who have excessive sweating. This is why it is important to drink fluids regularly while taking candesartan-hydrochlorothiazide. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, contact your healthcare provider. If you have fainted, stop taking candesartan-hydrochlorothiazide until you have talked to your healthcare provider.
Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how candesartan-hydrochlorothiazide affects you.
  • Candesartan-hydrochlorothiazide is a pregnancy Category D medicine, meaning that the drug poses health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking candesartan-hydrochlorothiazide, contact your healthcare provider immediately (see Atacand HCT and Pregnancy for more information).
  • While taking candesartan-hydrochlorothiazide, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because in some people taking candesartan-hydrochlorothiazide, potassium in the blood can increase or decrease to dangerous levels.
  • Candesartan-hydrochlorothiazide may affect electrolytes in the blood (including sodium, potassium, magnesium, and chloride). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include a dry mouth, increased thirst, weakness, tiredness, restlessness, seizures, confusion, muscle pain or cramps, decrease in urine output, weak or irregular heartbeat, nausea, or vomiting.
  • This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. 
Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.
  • If you have moderate to severe liver disease, such as cirrhosis, your body may metabolize the candesartan-hydrochlorothiazide differently than intended. Therefore, your healthcare provider may recommend a lower starting dose of candesartan-hydrochlorothiazide and will monitor your situation more closely or may recommend a different blood pressure medicine.
  • Because of the hydrochlorothiazide, candesartan-hydrochlorothiazide is more likely than other drugs to cause allergic reactions. This is more common in people with a history of allergies or asthma. Make sure to discuss this risk with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
  • Because of the hydrochlorothiazide, candesartan-hydrochlorothiazide is more likely to worsen systemic lupus erythematosus or, in some cases, even cause the condition.
  • Because of the hydrochlorothiazide, candesartan-hydrochlorothiazide is also known to worsen gout.


  • Drugs that contain hydrochlorothiazide, including this medication, can sometimes cause a potentially dangerous eye reaction (a particularly dangerous type of glaucoma). This reaction usually occurs within days to weeks of starting the drug. Because this reaction can permanently damage vision, let your healthcare provider know right away if you develop vision changes and/or eye pain. The main treatment for this reaction is to stop taking this medication, although other treatment, including surgery, may sometimes be necessary. 


  • Candesartan-hydrochlorothiazide may cause high blood sugar (hyperglycemia) in diabetics or, in some cases, even cause diabetes in people without a history of the condition.
  • Candesartan-hydrochlorothiazide may increase levels of cholesterol and triglycerides in the blood.
  • If you are nursing, it is not known whether or not candesartan-hydrochlorothiazide passes through your breast milk. Therefore, if you are nursing, talk with your healthcare provider about whether you should stop taking candesartan-hydrochlorothiazide or stop breastfeeding.
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