Candesartan Teva-Ratio 32 mg Tablets

Introduction

Leaflet: Information for the user

Candesartan Teva-ratio 32 mg tablets EFG

candesartan cilexetil

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet, you may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack and other information

1. What is Candesartan Teva-ratio and what is it used for
2. What you need to know before you take Candesartan Teva-ratio
3. How to take Candesartan Teva-ratio
4. Possible side effects
5. Storage of Candesartan Teva-ratio

1. Contents of the pack and further information

1. What is Candesartan Teva-ratio and what is it used for

Your medicine is called Candesartan Teva-ratio. The active substance is candesartan cilexetil. This belongs to a group of medicines known as angiotensin II receptor antagonists. It works by making your blood vessels relax and dilate. This helps to lower your blood pressure. It also makes it easier for your heart to pump blood to all parts of your body.

This medicine is used for:

• treatment of high blood pressure (hypertension) in adult patients and in children and adolescents aged 6 to less than 18 years.
• treatment of adult patients with heart failure with reduced muscular function of the heart when it is not possible to use angiotensin-converting enzyme inhibitors (ACE inhibitors), or added to ACE inhibitors when symptoms persist despite treatment and it is not possible to use mineralocorticoid receptor antagonists (MRAs). (ACE inhibitors and MRAs are medicines used to treat heart failure).

2. What you need to know before you take Candesartan Teva-ratio

Do not take Candesartan Teva-ratio

• if you are allergic to candesartan cilexetil or any of the other ingredients of this medicine (listed in section 6).
• if you are more than 3 months pregnant (it is better to avoid this medicine in the beginning of pregnancy – see section 2: Pregnancy and breast-feeding).
• if you have severe liver disease or biliary obstruction (a problem with the release of bile from the gallbladder).
• if the patient is a child under 1 year of age.
• if you have diabetes or kidney impairment and are being treated with a blood pressure lowering medicine containing aliskiren.

If you are not sure if any of these apply to you, talk to your doctor or pharmacist before taking this medicine.

Warnings and precautions

Talk to your doctor or pharmacist before taking Candesartan Teva-ratio:

• if you have heart, liver or kidney problems, or are on dialysis
• if you have recently had a kidney transplant.
• if you have vomiting, have recently had severe vomiting or have diarrhea.
• if you have a disease of the adrenal gland called Conn's syndrome (also known as primary hyperaldosteronism).
• if you have low blood pressure.
• if you have ever had a stroke.
• tell your doctor if you are pregnant (or think you might be) or are planning to become pregnant. Your doctor will normally advise you to stop taking Candesartan Teva-ratio before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Candesartan Teva-ratio. Candesartan Teva-ratio is not recommended in early pregnancy and must not be taken if you are more than 3 months pregnant, as it may seriously harm your baby if used after the third month of pregnancy.
• if you are taking any of the following medicines used to treat high blood pressure:
• • an angiotensin-converting enzyme inhibitor (ACE inhibitor) (e.g. enalapril, lisinopril, ramipril), particularly if you have kidney problems associated with diabetes.
  • aliskiren
• if you are taking an ACE inhibitor together with a medicine belonging to the class of medicines known as mineralocorticoid receptor antagonists (MRAs) for the treatment of heart failure (see “Taking Candesartan Teva-ratio with other medicines”).

Your doctor may check your kidney function, blood pressure and levels of electrolytes (e.g. potassium) in your blood at regular intervals.

See also the information under the heading “Do not take Candesartan Teva-ratio”.

If you are in one of these situations, your doctor may want to see you more often and do some tests.

Talk to your doctor if you get any of the following symptoms: abdominal pain, nausea, vomiting or diarrhea after taking Candesartan Teva-ratio. Your doctor will decide whether you should continue to take this medicine. Do not stop taking this medicine without talking to your doctor.

If you are going to have surgery, tell your doctor or dentist that you are taking candesartan. This is because this medicine, in combination with some anesthetics, may cause a drop in blood pressure.

Children and adolescents

Candesartan has been studied in children. For more information, talk to your doctor. Candesartan should not be given to children under 1 year of age due to the potential risk to the developing kidneys.

Taking Candesartan Teva-ratio with other medicines

Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines, including those obtained without a prescription.

Candesartan may affect the way some medicines work and some medicines may affect the way candesartan works. If you are taking certain medicines, your doctor may need to do blood tests from time to time.

In particular, tell your doctor if you are taking any of the following medicines:

• Other medicines to lower your blood pressure, including beta-blockers, diazoxide and ACE inhibitors such as enalapril, captopril, lisinopril or ramipril.
• Non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen, naproxen, diclofenac, celecoxib or etoricoxib (medicines to relieve pain and inflammation).
• Aspirin (if you are taking more than 3 g every day) (a medicine to relieve pain and inflammation).
• Potassium supplements or salt substitutes containing potassium (medicines that increase the amount of potassium in your blood).
• Heparin (a medicine to increase the fluidity of your blood).
• Cotrimoxazole (an antibiotic) also known as trimethoprim/sulfamethoxazole.
• Diuretics (medicines to increase urine production).
• Lithium (a medicine for mental health problems).

Your doctor may need to change your dose and/or take other precautions:

• if you are taking an ACE inhibitor or aliskiren (see also the information under the headings “Do not take Candesartan Teva-ratio” and “Warnings and precautions”).
• if you are being treated with an ACE inhibitor together with other specific medicines for the treatment of your heart failure, known as mineralocorticoid receptor antagonists (MRAs) (e.g. spironolactone, eplerenone).

Taking Candesartan Teva-ratio with food, drinks and alcohol

• You can take this medicine with or without food.
• When you are prescribed candesartan, talk to your doctor before taking alcohol. Alcohol may make you feel dizzy or faint.

Pregnancy and breast-feeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Pregnancy

You should tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking candesartan before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of candesartan. Candesartan is not recommended in early pregnancy and must not be taken when more than 3 months pregnant, as it may seriously harm your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Candesartan is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you want to breast-feed, especially if your baby is a newborn or was born prematurely.

Driving and using machines

Some patients may feel tired or dizzy when taking this medicine. If this happens to you, do not drive or use tools or machines.

Candesartan Teva-ratio contains lactose

This medicine contains lactosewhich is a type of sugar. If your doctor has told you that you have an intolerance to some sugars, contact them before taking this medicine.

3. How to take Candesartan Teva-ratio

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

It is important that you take this medicine every day.

You can take candesartan with or without food.

Swallow the tablet with a little water.

Try to take the tablet at the same time each day. This will help you to remember to take it.

High blood pressure:

• The recommended dose of candesartan is 8 mg once a day. Your doctor may increase this dose to 16 mg once a day and then to 32 mg once a day depending on your response to blood pressure.
• In some patients, such as those with liver or kidney problems, or those who have recently lost body fluids (e.g. through vomiting, diarrhea, or because they are taking diuretics), your doctor may prescribe a lower initial dose.
• Some black patients may have a reduced response to this type of medicine, when they are given as the only treatment, and these patients may need a higher dose.

Heart failure:

• The recommended initial dose of candesartan is 4 mg once a day. Your doctor may increase this dose by doubling the dose at intervals of at least 2 weeks up to 32 mg once a day. Candesartan can be taken with other medicines for heart failure, and your doctor will decide what treatment is suitable for you.

Use in children and adolescents with high blood pressure

Children aged 6 to less than 18 years:

The recommended initial dose is 4 mg once a day.

For patients who weigh less than 50 kg: in some patients whose blood pressure is not adequately controlled, your doctor may decide that the dose should be increased to a maximum of 8 mg once a day.

For patients who weigh 50 kg or more: in some patients whose blood pressure is not adequately controlled, your doctor may decide that the dose should be increased to 8 mg once a day and then to 16 mg once a day.

The tablet can be divided into two equal doses.

If you take more Candesartan Teva-ratio than you should

If you have taken more candesartan than prescribed by your doctor, contact your doctor or pharmacist immediately.

In case of overdose or accidental ingestion, contact your doctor or pharmacist immediately or call the Toxicological Information Service, telephone 91 562 04 20, indicating the medicine and the amount taken.

If you forget to take Candesartan Teva-ratio

Do not take a double dose to make up for a forgotten dose. Just take the next dose as normal.

If you stop taking Candesartan Teva-ratio

If you stop taking candesartan, your blood pressure may increase again. Therefore, do not stop taking this medicine without talking to your doctor.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

It is important that you know what these side effects may be.

Stop taking Candesartan Teva-ratio and seek medical help immediately if you have any of the following allergic reactions:

• difficulty breathing, with or without swelling of the face, lips, tongue and/or throat,
• swelling of the face, lips, tongue and/or throat which may cause difficulty in swallowing,
• severe itching of the skin (with rash)

This medicine may cause a reduction in the number of white blood cells. Your resistance to infection may be decreased and you may notice tiredness, infection or fever. If this happens, contact your doctor. Your doctor may occasionally do blood tests to check whether candesartan has had an effect on your blood (agranulocytosis).

Other possible side effects include

Common (may affect up to 1 in 10 people)

• Dizziness.
• Headache.
• Respiratory infections.
• Low blood pressure. This may cause dizziness or fainting.
• Changes in blood test results:

• An increase in the levels of potassium in your blood, especially if you already have kidney problems or heart failure. If this is severe, you may feel tired, weak, have irregular heartbeats or numbness.

• Effects on your kidney function, especially if you already have kidney problems. In rare cases, kidney failure may occur.

Very rare (may affect up to 1 in 10,000 people)

• Swelling of the face, lips, tongue and/or throat.
• A decrease in the number of red or white blood cells. You may notice tiredness, infection or fever.
• Rash, itching.
• Itching.
• Cough.
• Back pain, pain in the joints and muscles.
• Changes in your liver function, including inflammation of the liver (hepatitis). You may feel tired, have yellowing of the skin and the whites of the eyes and flu-like symptoms.
• Intestinal angioedema: swelling in the intestine that presents with symptoms such as abdominal pain, nausea, vomiting and diarrhea.
• Nausea.
• Changes in your blood test results:

• A decrease in the levels of sodium in your blood. If this is severe, you may feel weak, lack energy or have muscle cramps.

Frequency not known (cannot be estimated from the available data)

• Diarrhea

Additional side effects in children and adolescents

In children treated for high blood pressure, side effects appear to be similar to those seen in adults, but occur more frequently. Sore throat is a very common side effect in children but not reported in adults, and runny nose, fever and increased heart rate are common in children but not reported in adults.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Spanish Medicines Monitoring System for Human Use: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Candesartan Teva-ratio

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton after EXP. The expiry date is the last day of the month shown.

This medicine does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Package Contents and Additional Information

Composition of Candesartán Teva-ratio

The active ingredient is candesartan cilexetil.

Each Candesartán Teva-ratio 32 mg tablet contains 32 mg of candesartan cilexetil.

The other components (excipients) are pregelatinized corn starch, povidone K-30, calcium carmellose, microcrystalline cellulose (E460), lactose monohydrate, magnesium stearate, poloxamer 188, and red iron oxide (E172).

Appearance of the Product and Package Contents

Pink, capsule-shaped tablets, 12.2 mm in length and 5.4 mm in thickness,

scored on one side. One side is engraved with the number "32". The other side of the tablet is engraved with "C/C". The tablet can be divided into equal doses.

Blister OPA/Aluminum/PVC-PVC/PVAC/Aluminum/OPA:

Packages: 7, 14, 15, 20, 28, 30, 50, 50 x 1 single-dose blister pack (hospital package), 56, 60, 84, 90, 98, 100, 250, and 300 tablets.

Only some package sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Teva Pharma, S.L.U.

C/ Anabel Segura 11, Edificio Albatros B

28108 Alcobendas, Madrid

Manufacturer:

Teva Pharmaceutical Works Private Limited Company

Pallagi út 13, 4042 Debrecen

Hungary

or

Teva Operations Poland Sp.z.o.o

80 Mogilska Str. (Cracow) - 31-546

Poland

or

Pharmachemie B.V.

Swenswg 5, 2031 GA Haarlem

Netherlands

or

PLIVA Hrvatska D.O.O.

Prilaz baruna Filipovica 25, 10000 Zagreb

Croatia

or

Teva Pharma S.L.U.

C/ C, n 4 Polígono Industrial Malpica (Zaragoza) - 50016 - Spain

or

Merckle GmbH

Ludwig-Merckle Strasse 3, (Blaubeuren) – D- 89143

Germany

This medicinal product is registered in the EEA Member States under the following names:

Spain: Candesartán Teva-ratio 32 mg tablets EFG

Date of the last revision of this leaflet:January 2025

Detailed and updated information on this medicinal product is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/.

You can access detailed and updated information about this medicinal product by scanning the QR code included in the packaging with your mobile phone (smartphone). You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/75342/P_75342.html