Candesartan — Blood Pressure Medication Guide | KiwiMeds
✅ Reviewed by a Registered Pharmacist NZ | Last updated: May 2026 | This information is for educational purposes only and does not replace advice from your doctor or pharmacist.
What is candesartan?
Candesartan is an angiotensin receptor blocker (ARB) used to treat high blood pressure (hypertension) and heart failure. It is often prescribed when ACE inhibitors (such as lisinopril or ramipril) cause a persistent dry cough. In NZ it is available generically and as the brand Atacand.
What is it used for? (NZ context)
Candesartan is used for hypertension, heart failure, and kidney protection in people with diabetes and high blood pressure. It is a commonly prescribed alternative to ACE inhibitors for patients who develop a cough on those medicines. It is funded by Pharmac.
How does it work?
Candesartan blocks angiotensin II receptors (AT1 receptors). Angiotensin II is a hormone that narrows blood vessels and raises blood pressure. By blocking its receptors, candesartan allows blood vessels to relax and widen, reducing blood pressure and the workload on the heart.
How to take it
Candesartan can be taken with or without food, once daily. Like all blood pressure medicines, it works best when taken consistently. Do not stop without talking to your doctor. Blood pressure medicines are usually lifelong in people with persistent hypertension.
Common side effects
- Dizziness — especially when standing up quickly (postural hypotension)
- Headache
- Fatigue
- Upper respiratory tract infections
Serious side effects to watch for
Candesartan can raise potassium levels (hyperkalaemia) — your doctor will monitor blood tests. In rare cases it can worsen kidney function. It must NOT be used during pregnancy — it can seriously harm the unborn baby. Stop immediately if you become pregnant.
Important drug interactions
Potassium supplements and potassium-sparing diuretics (spironolactone, amiloride) — risk of high potassium. ACE inhibitors — combining candesartan with an ACE inhibitor significantly increases the risk of kidney problems and is generally avoided. NSAIDs — may reduce the blood pressure lowering effect.
NZ-specific information
Pharmac funding: Candesartan 4mg, 8mg, and 16mg tablets are funded by Pharmac. Generic candesartan and the brand Atacand are both available. The 32mg dose may require Special Authority for heart failure.
Frequently asked questions
Why was I switched from lisinopril to candesartan?
ACE inhibitors like lisinopril cause a dry, persistent cough in about 10–15% of people. This is due to ACE inhibitor-related bradykinin accumulation. Candesartan (an ARB) has the same blood pressure and kidney-protecting benefits without causing cough.
Can candesartan affect my kidneys?
Candesartan can slightly reduce kidney filtration (eGFR) when first started — this is expected and usually stabilises. Your doctor will check kidney function and potassium levels with blood tests. It actually protects the kidneys long-term in people with diabetes.
Is candesartan safe during pregnancy?
No — candesartan and all ARBs are contraindicated during pregnancy. They can cause serious harm to the developing baby, including kidney problems. Use reliable contraception and stop immediately if you become pregnant.
💬 Talk to your pharmacist or doctor for personalised advice about candesartan.
Reviewed by a Registered Pharmacist NZ | BPharm, Pharmacy Council of New Zealand
References & Further Information
The following New Zealand and international resources were used to inform this page: