This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains 2 medications: candesartan and hydrochlorothiazide. Candesartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so blood can flow more easily. Hydrochlorothiazide is a "water pill" (diuretic). It increases the amount of urine you make, especially when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.

These medications are used together when 1 drug alone is not controlling your blood pressure. Your doctor may direct you to start taking the individual medications first, and then switch you over to this combination product if this is the best dose combination for you.

Read the Patient Information Leaflet if available from your pharmacist before you start taking candesartan/hydrochlorothiazide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually once daily. It is best to avoid taking this medication within 4 hours of your bedtime to avoid having to get up to urinate. Consult your doctor or pharmacist if you have questions about your dosing schedule.

The dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. It may take up to 4 weeks before you get the full benefit of this drug.

If you also take certain drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 4 hours before or at least 4 to 6 hours after these medications.

Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

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

You should not use this medicine if you are unable to urinate, or if you are allergic to sulfa drugs.

If you have diabetes, do not use Atacand HCT together with any medication that contains aliskiren (such as Tekturna or Tekamlo).00

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 Atacand HCT together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

You may also need to avoid taking Atacand HCT with aliskiren if you have kidney disease.

To make sure Atacand HCT is safe for you, 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. If you become pregnant, stop taking this medicine and tell your doctor right away. Atacand HCT can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

Hydrochlorothiazide can pass into breast milk and may cause side effects in the nursing baby. You should not breast-feed while using this medicine.

Dizziness and lightheadedness may occur as your body adjusts to the medication. If either of these effects persists or worsens, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This product may cause a loss of too much body water (dehydration) and salt/minerals. Tell your doctor right away if you have any symptoms of dehydration or mineral loss, including: extreme thirst, very dry mouth, muscle cramps/weakness, fast/slow/irregular heartbeat, confusion.

Tell your doctor right away if you have any serious side effects, including: fainting, signs of kidney problems (such as change in the amount of urine), toe/joint pain, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat), decrease in vision, eye pain.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• decreased urine
• if you are on a special diet, like a low salt diet
• immune system problems, like lupus
• kidney disease
• liver disease
• an unusual or allergic reaction to candesartan, hydrochlorothiazide, sulfa drugs, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. If it upsets your stomach, take it with food. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

• barbiturates like phenobarbital
• corticosteroids. like prednisone
• diabetic medicines
• diuretics like triamterene, spironolactone, or amiloride
• lithium
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• potassium salts or potassium supplements
• prescription pain medicines
• skeletal muscle relaxants like tubocurarine
• some cholesterol lowering medicines like cholestyramine or colestipol