Posology : מינונים

4.2 Posology and method of administration
Dosage
In Hypertension
The recommended dose of Atacand Plus is 1 tablet once daily.
Dose titration with the individual components (candesartan cilexetil and hydrochlorothiazide) is recommended. When clinically appropriate, a direct change from monotherapy to Atacand Plus can be considered. The dose of candesartan cilexetil should be titrated before switching to Atacand Plus. Atacand Plus can be administered in patients whose blood pressure is not optimally controlled with candesartan cilexetil or hydrochlorothiazide monotherapy.
Most of the antihypertensive effect is usually achieved within 4 weeks after starting treatment.

Method of administration:
Oral use.
Atacand Plus can be taken with or without food.
The bioavailability of candesartan is not affected by food.
There is no clinically significant interaction between hydrochlorothiazide and food.

Special populations
Elderly population
No dosage adjustment is needed in elderly patients.

Patients with reduced blood volume


1
Dose titration of candesartan cilexetil is recommended for patients with risk for hypotension, such as patients with possible volume loss (an initial dose of candesartan cilexetil 4 mg may be considered in these patients).

Patients with impaired renal function
Dose titration is recommended in patients with mild to moderate renal impairment (creatinine clearance 30-80 ml/min/1.73 m² Body Surface Area (BSA)).
Atacand Plus is contraindicated in patients with severe renal impairment (creatinine clearance < 30 ml/min/1.73 m² BSA) (see section 4.3).

Patients with reduced liver function
Dose titration of candesartan cilexetil is recommended in patients with mild to moderate hepatic impairment before treatment with Atacand Plus (the recommended starting dose of candesartan cilexetil is 2 mg in these patients). Atacand Plus is contraindicated in patients with severe hepatic impairment and/or cholestasis (see section 4.3).

Paediatric population
The safety and efficacy of Atacand Plus have not yet been established in children from birth to adolescents under the age of 18 years. No data is available.