[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/) › Candesartan

[Pharmacology](https://durgical.com/en/pharmacology/) · [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)

# Candesartan

An ARB given as the prodrug candesartan cilexetil. Used for high blood pressure and for heart failure.

Updated 2026-11-01

- Class: [Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)
- Receptor: Angiotensin II type 1 (AT1) receptor
- ATC code: C09CA06

◎**Angiotensin II type 1 (AT1) receptor**Candesartan

ⓘ The figure shows olmesartan, another ARB, in the same binding pocket of the human AT1 receptor; no structure with candesartan bound is available.

**Target in 3D:** Angiotensin II type 1 (AT1) receptor. PDB structure 4ZUD (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4ZUD) · Drag to rotate · pinch to zoom

## Mechanism of action

Candesartan cilexetil is hydrolysed in the gut wall during absorption to candesartan, which binds the AT1 receptor tightly and dissociates slowly. Angiotensin II can no longer constrict arterioles or release aldosterone, so blood pressure falls and sodium retention lessens, without raising bradykinin.

- Candesartan cilexetil is turned into candesartan during absorption
- Candesartan binds the AT1 receptor tightly
- Arterioles dilate, aldosterone falls and blood pressure drops

## Pharmacokinetics

**Absorption**
Prodrug converted during absorption; low bioavailability, not changed by food

**Elimination**
Urine and bile, mostly unchanged

**Half-life**
About 9 hours

## Indications

- High blood pressure, also in children [Arterial hypertension →](https://durgical.com/en/conditions/arterial-hypertension/)
- Heart failure with reduced ejection fraction [Heart failure →](https://durgical.com/en/conditions/heart-failure/)

## Adverse effects

### Common

- Dizziness and hypotension
- Hyperkalaemia
- Rise in creatinine
- Back pain

### Serious (rare, important)

- Acute kidney injury
- Marked hyperkalaemia in heart failure
- Fetal toxicity

## Contraindications

- Pregnancy
- Hypersensitivity to the drug
- Use with aliskiren in people with diabetes

## Key interactions

**Potassium-sparing diuretics, potassium supplements or salt substitutes**
Hyperkalaemia

**NSAIDs, including COX-2 inhibitors**
Weaker effect and risk of kidney injury

**Lithium**
Higher lithium levels and toxicity

## What is monitored

- Blood pressure
- Potassium and creatinine, closely in heart failure

## Administration and safety

- Given by mouth, with or without food
- Several «-sartan» names look alike: the name is checked on every order

## Nursing care

- Check blood pressure, potassium and creatinine when starting and after changes
- Watch for dizziness, especially in patients on diuretics
- Ask women of childbearing age about pregnancy plans
- Teach the patient to avoid potassium salt substitutes unless prescribed

## Pregnancy and breastfeeding

Contraindicated: drugs acting on the renin-angiotensin system can injure and kill the developing fetus; it is stopped as soon as pregnancy is detected.

## Memory aid

CANDEsartan is a CANDy wrapped in cilexetil: the gut unwraps it into the active drug.

## Test yourself

Think of the answer, then tap the question to see it.

## Is candesartan cilexetil active as given?

No. It is a prodrug hydrolysed to candesartan during absorption from the gut.

## Which lab values are followed closely when candesartan is used in heart failure?

Potassium and creatinine, because hyperkalaemia and worse kidney function are more frequent.

## Why is candesartan stopped when pregnancy is detected?

Drugs acting on the renin-angiotensin system can injure and kill the developing fetus.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/candesartan/)

## Related drugs

- [Valsartan](https://durgical.com/en/pharmacology/valsartan/)
- [Losartan](https://durgical.com/en/pharmacology/losartan/)
- [Telmisartan](https://durgical.com/en/pharmacology/telmisartan/)

## Related conditions

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Heart failure](https://durgical.com/en/conditions/heart-failure/)

[← Back to the class: Angiotensin II receptor blockers (ARBs)](https://durgical.com/en/pharmacology/classes/angiotensin-ii-receptor-blockers/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - CANDESARTAN CILEXETIL tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9da86c48-5911-4512-8c71-eca4a6418cf6) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C09CA06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/candesartan/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/candesartan/