Introduction
Giran is a medicine used to treat high blood pressure and heart disease. Lowering blood pressure helps to prevent future heart attack and stroke. This medicine is also effective in preserving kidney function in patients with diabetes.
Giran can be prescribed either alone or in combination with other medicines. It may be taken with or without food during the day or at night. However, try to take it at the same time each day to get the most benefit. It is important to continue taking it regularly even if you feel well or if your blood pressure is controlled. Most people with high blood pressure do not feel ill, but if you stop taking this medicine, your condition could get worse. This is a widely used medicine and is considered safe for long-term use.
Making some changes in your lifestyle will also help lower your blood pressure. These may include regular exercise, losing weight, smoking cessation, reducing alcohol intake, and reducing the amount of salt in your diet as advised by your doctor. This medicine is tolerated well by most patients and has few side effects. Dizziness, particularly after the first dose, is known to occur in some people. This may be associated with headache. Let your doctor know if these side effects bother you or do not go away. No weight gain has been seen with the regular use of this medicine.
Before taking this medicine, let your doctor know if you have any kidney or liver problems. Pregnant or breastfeeding mothers should also consult their doctor before taking it. Your doctor may check your kidney function, blood pressure and potassium levels in your blood at regular intervals while you are taking this medicine.
Uses of Giran
- Hypertension (high blood pressure)
- Heart failure
- Prevention of heart attack and stroke
Side effects of Giran
Common
- Dizziness
- Back pain
- Upper respiratory tract infection
- Sore throat
- Nasal congestion (stuffy nose)
How to use Giran
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Giran may be taken with or without food, but it is better to take it at a fixed time.
How Giran works
Giran is an angiotensin receptor blocker (ARB). It relaxes the blood vessel by blocking the action of a chemical that usually makes blood vessels tighter. This lowers the blood pressure, allowing the blood to flow more smoothly to different organs and the heart to pump more efficiently.
What if you forget to take Giran?
If you miss a dose of Giran, skip it and continue with your normal schedule. Do not double the dose.
Indication
Hypertension, Congestive heart failure
Administration
May be taken with or without food.
Adult Dose
Oral
Hypertension
Adult: Initially, 8 mg once daily adjusted according to response. Maintenance: 8 mg once daily. Max: 32 mg/day as single or in 2 divided doses. Patients w/ intravascular volume depletion: Initially, 4 mg once daily.
Heart failure
Adult: Initially, 4 mg once daily, may be doubled at intervals of not <2 wk. Max: 32 mg once daily.
Hepatic impairment: Mild to moderate: Initially, 4 mg once daily. Severe: Contraindicated.
Child Dose
Oral
Hypertension
Child: 1 to <6 yr Initially, 200 mcg/kg/day. May increase according to response to 50-400 mcg/kg/day.
>6 yr <50 kg: 4-8 mg/day, adjusted according to response to 2-16 mg/day;
>50 kg: 8-16 mg/day, adjusted according response to 4-32 mg/day.
All doses may be given as single or in 2 divided doses.
Renal Dose
Renal Impairment
No dose adjustment necessary for patients with mild renal impairment
Initiate thearpy at lower dose if moderate renal impairment
Contraindication
Hypersensitivity. Pregnancy (2nd and 3rd trimester) and lactation.
Mode of Action
Candesartan inhibits the binding of angiotensin II to AT1 receptors in many tissues (e.g. vascular smooth muscles, adrenal gland) which leads to vasoconstriction blockade and aldosterone release.
Precaution
Volume or sodium depletion, preexisting renal insufficiency; aortic or mitral valve stenosis, hypertrophic obstructive cardiomyopathy, renal artery stenosis, primary hyperaldosteronism. Patients with a history of angioedema, urticaria. Monitor serum potassium levels especially in elderly and renally impaired patients. Hypotension may occur during major surgery and anaesthesia due to suppression of the renin-angiotensin system.
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Lactation: Not known if excreted in breast milk; not recommended
Side Effect
Dizziness, headache, vertigo, back pain, upper resp tract infections, pharyngitis, rhinitis, hypotension, hyperkalaemia, increased serum creatinine.
Pregnancy Category Note
Pregnancy Category: D
Discontinue as soon as pregnancy detected; during the second and third trimesters of pregnancy, drugs that act directly on the renin-angiotensin have been associated with fetal injury that includes hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
Lactation: Not known if excreted in breast milk; not recommended
Interaction
NSAIDs may reduce antihypertensive effect and result in deterioration of renal function including possible acute renal failure. May increase serum lithium concentration. K-sparing diuretics, K supplements or salt substitutes containing K may increase risk of hyperkalaemia.
Potentially Fatal: Coadministration w/ aliskiren in diabetic patients may increase risk of renal impairment, hypotension and hyperkalaemia.