Blopress tablets 2 mg – patient leaflet, side effects, dosage

1. What Blopress is and what it is used for

The name of your medicine is Blopress. The active ingredient is candesartan cilexetil. This belongs to a group of medicines called angiotensin II receptor antagonists. It works by making your blood vessels relax and widen. 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:

• treating high blood pressure (hypertension) in adult patients and in children and adolescents aged 6 to under 18 years.

• treating adult heart failure patients with reduced heart muscle function when Angiotensin Converting Enzyme (ACE) inhibitors cannot be used or in addition to ACE inhibitors when symptoms persist despite treatment and mineralocortocoid receptor antagonists (MRA) cannot be used (ACE inhibitors and MRAs are medicines used to treat heart failure).

2. What you need to know before you take Blopress

Do not take Blopress

• 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 also better to avoid Blopress in early pregnancy – see pregnancy section).
• if you have severe liver disease or biliary obstruction (a problem with the drainage of the bile from the gall bladder).
• if the patient is a child under 1 year of age.
• if you have diabetes or impaired kidney function and you are 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 Blopress.

Warnings and precautions

Talk to your doctor before taking Blopress.

• if you have heart, liver or kidney problems, or are on dialysis.
• if you have recently had a kidney transplant.
• if you are vomiting, have recently had severe vomiting, or have diarrhoea.
• if you have a disease of the adrenal gland called Conn’s syndrome (also called primary hyperaldosteronism).
• if you have low blood pressure.
• if you have ever had a stroke.
• you must tell your doctor if you think you are (or might become) pregnant. Blopress is not recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage (see pregnancy section).

• if you are taking any of the following medicines used to treat high blood pressure:

  • an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes related kidney problems.
  • aliskiren
• if you are taking an ACE-inhibitor together with a medicine which belongs to the class of medicines known as mineralocorticoid receptors antagonists (MRA). These medicines are for the treatment of heart failure (see “Other medicines and Blopress”).

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

See also information under the heading “Do not take Blopress”.

Your doctor may want to see you more often and do some tests if you have any of these conditions.

If you are going to have an operation, tell your doctor or dentist that you are taking Blopress. This is because Blopress, when combined with some anaesthetics, may cause a drop in blood pressure.

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

Other medicines and Blopress

Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines.

Blopress can affect the way some other medicines work and some medicines can have an effect on Blopress. If you are using certain medicines, your doctor may need to do blood tests from time to time.

In particular, tell your doctor if you are using any of the following medicines as your doctor may need to change your dose and/or take other precautions:

• Other medicines to help lower your blood pressure, including beta-blockers, diazoxide and ACE inhibitors such as enalapril, captopril, lisinopril or ramipril.
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, diclofenac, celecoxib or etoricoxib (medicines to relieve pain and inflammation).
• Acetylsalicylic acid (if you are taking more than 3 g each day) (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 for thinning the blood).
• Water tablets (diuretics).
• Lithium (a medicine for mental health problems).
• If you are taking an ACE-inhibitor or aliskiren (see also information under the headings “Do not take Blopress” and “Warnings and precautions”)
• If you are being treated with an ACE-inhibitor together with certain other medicines to treat your heart failure, which are known as mineralocorticoid receptors antagonists (MRA) (for example spironolactone, eplerenone).”

Blopress with food and drink and alcohol

• You can take Blopress with or without food.
• When you are prescribed Blopress, discuss with your doctor before drinking alcohol. Alcohol may make you feel faint or dizzy.

Pregnancy and breast-feeding

Pregnancy

You must tell your doctor if you think you are (or might become) pregnant. Your doctor will normally advise you to stop taking Blopress before you become pregnant or as soon as you know you are pregnant and will advise you to take another medicine instead of Blopress. Blopress is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to 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. Blopress is not recommended for mothers who are breast-feeding, and your doctor may choose another treatment for you if you wish to breast-feed, especially if your baby is newborn, or was born prematurely.

Driving and using machines

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

Blopress contains lactose. Lactose is a type of sugar. If you have been told by your doctor that have an intolerance to some sugars, contact your doctor before taking this medicine.

3. How to take Blopress

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. It is important to keep taking Blopress every day. You can take Blopress with or without food.

Swallow the tablet with a drink of water.

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

Blopress 4mg, 8mg, 16mg and 32mg tablets: The tablet can be divided into equal doses.

High blood pressure:

• The recommended dose of Blopress is 8 mg once a day. Your doctor may increase this dose to 16 mg once a day and further up to 32 mg once a day depending on blood pressure response.
• In some patients, such as those with liver problems, kidney problems or those who recently have lost body fluids, e.g., through vomiting or diarrhoea or by using water tablets, the doctor may prescribe a lower starting dose.
• Some black patients may have a reduced response to this type of medicine, when given as the only treatment, and these patients may need a higher dose.

Use in children and adolescents with high blood pressure:

Children 6 to under 18 years of age:

The recommended starting dose is 4 mg once daily.

For patients weighing less than 50 kg: In some patients whose blood pressure is not adequately controlled, your doctor may decide the dose needs to be increased to a maximum of 8 mg once daily.

For patients weighing 50 kg or more: In some patients whose blood pressure is not adequately controlled, your doctor may decide the dose needs to be increased to 8 mg once daily and to 16 mg once daily.

Heart failure in adults:

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

If you take more Blopress than you should

If you take more Blopress than prescribed by your doctor, contact a doctor or pharmacist immediately for advice.

If you forget to take Blopress

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

If you stop taking Blopress

If you stop taking Blopress, your blood pressure may increase again. Therefore do not stop taking Blopress without first talking to your doctor.

If you have any further questions on the use of this medicine, 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 are aware of what these side effects may be.

Stop taking Blopress and seek medical help immediately if you have any of the following allergic reactions:

• difficulties in 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 difficulties in swallowing
• severe itching of the skin (with raised lumps)

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

Other possible side effects include:

Common (affects 1 to 10 users in 100)

• Feeling dizzy/spinning sensation.
• Headache.
• Respiratory infection.
• Low blood pressure. This may make you feel faint or dizzy.

• Changes in blood test results:

  • An increased amount of potassium in your blood, especially if you already have kidney problems or heart failure. If this is severe you may notice tiredness, weakness, irregular heart beat or pins and needles.
• Effects on how your kidneys work, especially if you already have kidney problems or heart failure. In very rare cases, kidney failure may occur.

Very rare (affects less than 1 user in 10,000)

• Swelling of the face, lips, tongue and/or throat.
• A reduction in your red or white blood cells. You may notice tiredness, an infection or a fever.
• Skin rash, lumpy rash (hives).
• Itching.
• Back pain, pain in joints and muscles.
• Changes in how your liver is working, including inflammation of the liver (hepatitis). You may notice tiredness, yellowing of your skin and the whites of your eyes and flu like symptoms.
• Cough.
• Nausea.

• Changes in blood test results:

  • A reduced amount of sodium in your blood. If this is severe then you may notice weakness, lack of energy, or muscle cramps.

Not known (frequency cannot be estimated from the available data)

• Diarrhoea

In children treated for high blood pressure, side effects appear to be similar to those seen in adults, but they happen more often. 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. This includes any side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store Blopress

• 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 label and blister foil after (EXP). The expiry date refers to the last day of that month.
• Do not store above 30ºC.

Do not throw away any medicine via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6. Contents of the pack and other information

What Blopress contains

• The active substance is candesartan cilexetil. Each tablet contains 2 mg, 4 mg, 8 mg, 16 mg or 32 mg of candesartan cilexetil.
• The other ingredients are carmellose calcium, hydroxypropylcellulose, lactose monohydrate, magnesium stearate, maize starch and macrogol. The 8 mg, 16 mg and 32 mg tablets also contain red iron oxide (E172).

What Blopress looks like and contents of the pack

• 2 mg tablets are white, round tablets.
• 4 mg tablets are white, round tablets with a score line on each side.
• 8 mg tablets are pale pink, round tablets with a score line on each side.
• 16 mg tablets are light pink, round tablets with one convex side embossed “16” and one flat side with a score line.
• 32 mg tablets are light pink, round tablets with convex faces, debossed “32” on one side and with a score line on the other.

Blopress is available in Polypropylene or PVC/PVDC/Alu blister packs.

Blopress 2 mg tablets come in a blister pack containing 7,14 and 28 tablets.

Blopress 4 mg, 8 mg and 16 mg tablets come in blister packs containing 7, 14, 20, 28, 30, 50, 56, 84, 90, 91, 98, 98x1 (single dose unit) 100, 140, 280 or 300 tablets.

Blopress 32 mg tablets come in blister packs of 7, 10, 14, 20, 28, 30, 50, 56, 84, 90, 91, 98, 100, 140, 280 or 300 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

The Marketing Authorisations for Blopress are held by Takeda Pharma A/S, Dybendal Alle 10, 2630 Taastrup, Denmark.

Your tablets are manufactured by Delpharm Novara S.r.l, Via Crosa 86, 28065 Cerano (No), Italy.

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

This leaflet was last revised in August 2018

Other sources of information

Detailed information on this medicine is available on the MHRA web site.