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Danazol

Danazolby Ros Wood Danazol has been used to treat women with endometriosis since the 1970s 1. It was the most monly used drug in the early 1980s, but its use declined markedly after the introduction of the GnRH agonists in the late 1980s and early 1990s. Danazol is a synthetic androgen 1. Androgens are hormones produced by the male testes. They are responsible for the functioning of the male reproductive system and the development of the male characteristics, such as facial hair and a deep voice. The ovaries also produce small amounts of androgens. Danazol is an effective treatment for endometriosis, and has the same effectiveness as the other hormonal treatments. However, it has many androgenic (male-like) side effects, including weight gain, increased body hair and acne. Its unpleasant side effects and its tendency to adversely affect blood lipid (cholesterol) levels mean it is not usually the first choice of treatment for endometriosis 1. How it works Like all the other hormonal treatments, danazol does not cure endometriosis permanently. Rather, it suppresses its growth and development temporarily, so the disease may recur following treatment. Danazol has a multitude of effects on the body. Some of these effects bine to produce high levels of androgen and low levels of oestrogen in the body.

This hormonal environment stops menstruation and suppresses the growth of endometrial implants, causing them to degenerate 1,2. Most women will stop ovulating and menstruating by the second month of treatment, though this may depend on the dosage used. The symptoms of endometriosis usually begin to diminish by the end of the second month. Most women will resume ovulating and menstruating within 46 weeks of stopping treatment 2. The usual length of treatment is 36 months, but it may be extended to 9 months in some circumstances. The remended dosages vary.

North American gynaecologists tend to remend dosages of 800 milligrams per day, whereas European and Australian gynaecologists tend to remend dosages of 600 milligrams per day 3. Some gynaecologists believe it is better to base the dosage on the minimum needed to stop menstruation. In this case, they may suggest that you start with 400 milligrams per day, and, if necessary, increase the dose until your periods stop 3. Alternatively, they may suggest that you start with 600 milligrams a day, and reduce the dosage to 400 milligrams a day or even 200 milligrams a day 2. You should start your course of danazol on the first day of your period to decrease the risk of taking the drug while you are pregnant. If there is any possibility that you may be pregnant, you should have a pregnancy test before starting treatment 4. Although it is unlikely that you will conceive while on danazol, care should be taken to avoid pregnancy. It is remended that you use barrier contraception (condom or diaphragm or both) throughout treatment 4. You should not take danazol if you have 5: liver disease high blood pressure heart failure poor kidney functionDanazol is a synthetic steroid derived from ethisterone. It is a white to pale yellow crystalline powder, practically insoluble or insoluble in water, and sparingly soluble in alcohol. Chemically, Danazol is 17 - Pregna-2,4-dien-20-yno 2,3- d - isoxazol-17-ol. The molecular formula is C 22 H 27 NO 2 . It has a molecular weight of 337.46 and the following structural formula: Danazol capsules for oral administration contain 200160mg Danazol.

Inactive Ingredients: Corn Starch, Lactose, Magnesium Stearate, Talc, DampC Yellow 10, DampC Red 28, FDampC Red 40, Gelatin, Silicon Dioxide, Sodium Lauryl Sulfate, Titanium Dioxide. CLINICAL PHARMACOLOGY Danazol suppresses the pituitary-ovarian axis. This suppression is probably a bination of depressed hypothalamic-pituitary response to lowered estrogen production, the alteration of sex steroid metabolism, and interaction of Danazol with sex hormone receptors. The only other demonstrable hormonal effect is weak androgenic activity. Danazol depresses the output of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Recent evidence suggests a direct inhibitory effect at gonadal sites and a binding of Danazol to receptors of gonadal steroids at target organs. In addition, Danazol has been shown to significantly decrease IgG, IgM and IgA levels, as well as phospholipid and IgG isotope autoantibodies in patients with endometriosis and associated elevations of autoantibodies, suggesting this could be another mechanism by which it facilitates regression of the disease. Bioavailability studies indicate that blood levels do not increase proportionally with increases in the administered dose. When the dose of Danazol is doubled the increase in plasma levels is only about 35 to 40. Separate single dosing of 100 mg and 200 mg capsules of Danazol to female volunteers showed that both the extent of availability and the maximum plasma concentration increased by three-to-four fold, respectively, following a meal ( 30 grams of fat), when pared to the fasted state.

Further, food also delayed mean time to peak concentration of Danazol by about 30 minutes. In the treatment of endometriosis, Danazol alters the normal and ectopic endometrial tissue so that it bees inactive and atrophic. plete resolution of endometrial lesions occurs in the majority of cases. Changes in vaginal cytology and cervical mucus reflect the suppressive effect of Danazol on the pituitary-ovarian axis. In the treatment of fibrocystic breast disease, Danazol usually produces partial to plete disappearance of nodularity and plete relief of pain and tenderness. Changes in the menstrual pattern may occur.

Generally, the pituitary-suppressive action of Danazol is reversible. Ovulation and cyclic bleeding usually return within 60 to 90 days when therapy with Danazol is discontinued. In the treatment of hereditary angioedema, Danazol at effective doses prevents attacks of the disease characterized by episodic edema of the abdominal viscera, extremities, face, and airway which may be disabling and, if the airway is involved, fatal. In addition, Danazol corrects partially or pletely the primary biochemical abnormality of hereditary angioedema by increasing the levels of the deficient C1 esterase inhibitor (C1EI). As a result of this action the serum levels of the C4 ponent of the plement system are also increased. INDICATIONS AND USAGE Endometriosis. Danazol is indicated for the treatment of endometriosis amenable to hormonal management.

Fibrocystic Breast Disease. Most cases of symptomatic fibrocystic breast disease may be treated by simple measures (e. g. padded brassieres and analgesics). In infrequent patients, symptoms of pain and tenderness may be severe enough to warrant treatment by suppression of ovarian function. Danazol is usually effective in decreasing nodularity, pain, and tenderness. It should be stressed to the patient that this treatment is not innocuous in that it involves considerable alterations of hormone levels and that recurrence of symptoms is very mon after cessation of therapy. Hereditary Angioedema. Danazol is indicated for the prevention of attacks of angioedema of all types (cutaneous, abdominal, laryngeal) in males and females. Danazol should not be administered to patients with:What Is Danazol Danazol is a man-made form of a steroid.

Danazol affects the ovaries and pituitary gland and prevents the release of certain hormones in the body. Danazol is used to treat endometriosis and fibrocystic breast disease. Danazol is also used to prevent attacks of angioedema in people with an inherited form of this disorder (hereditary angioedema). Danazol may also be used for purposes not listed in this medication guide. You should not use this medication if you are allergic to danazol, or if you have porphyria, a history of stroke or blood clot, or severe problems with your heart, liver, or kidney. You also should not take danazol if you are pregnant or breast-feeding, if you have breast or uterine cancer, or if you have abnormal vaginal bleeding that has not been checked by a doctor.

Danazol can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide).

Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctor39s advice. It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment. Call your doctor at once if you have a serious side effect such as sudden numbness or weakness, problems with vision or speech, chest pain, sudden cough, or wheezing, swelling, rapid weight gain, feeling short of breath, ringing in your ears, dizziness, nausea, pain behind your eyes, stomach pain and loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes). You should not use this medication if you are allergic to danazol, or if you have: severe heart disease, a history of stroke or blood clot severe kidney disease severe liver disease a hormone-related cancer such as breast or uterine cancer porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system) abnormal vaginal bleeding that has not been checked by a doctor or if you are pregnant or breast-feeding.

To make sure you can safely take danazol, tell your doctor if you have any of these other conditions: heart disease, high blood pressure, coronary artery disease, congestive heart failure high cholesterol or triglycerides a history of breast cancer diabetes hypoparathyroidism, or low levels of calcium in your blood a seizure disorder kidney or liver disease or migraine headaches. FDA pregnancy category X. This medication can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use danazol if you are pregnant. Stop taking danazol and tell your doctor right away if you bee pregnant during treatment.

You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Danazol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using danazol. Taking danazol to treat endometriosis may increase your risk of ovarian cancer. Talk with your doctor about your individual risk.

Danazol Side Effects Get emergency medical help if you have any of these signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat. In rare cases, danazol can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine. Call your doctor at once if you have a serious side effect such as: sudden numbness or weakness (especially on one side of the body), confusion, problems with speech or balance severe headache, ringing in your ears, dizziness, nausea, vomiting, vision problems, pain behind your eyes chest pain, sudden cough, wheezing, rapid breathing, coughing up blood pain, swelling, warmth, or redness in one or both legs swelling or rapid weight gain, especially in your face and midsection bloody, black, or tarry stools cough up blood or vomit that looks like coffee grounds or upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include: acne or other skin problems, increased sweating increased hair growth or hair loss breast changes decreased amount of semen released during sex hoarse or deepened voice, sore throat flushing (warmth, redness, or tingly feeling) changes in your menstrual periods unusual vaginal bleeding or spotting vaginal dryness, disfort, or itching. This is not a plete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.Danazol Description Danazol USP is a synthetic steroid derived from ethisterone. It is a white to pale yellow crystalline powder, practically insoluble or insoluble in water, and sparingly soluble in alcohol. Chemically, Danazol USP is 17alpha-Pregna-2,4-dien-20-yno 2,3- d - isoxazol-17-ol, which has the following structural formula: Slideshow: Parkinsons Disease: A Healthcare Professionals Guide C 22 H 27 NO 2 M. W. 337.46 Danazol capsules USP for oral administration, contain 50 mg, 100 mg or 200 mg of Danazol USP. In addition, each capsule contains the following inactive ingredients: black iron oxide, DampC yellow no. 10, DampC yellow no. 10 aluminum lake, FDampC blue no. 1 aluminum lake, FDampC blue no. 2 aluminum lake, FDampC red no. 40 aluminum lake, gelatin, lactose monohydrate, magnesium stearate, pharmaceutical glaze, propylene glycol, sodium starch glycolate, stearic acid and titanium dioxide The 50 mg and 100 mg capsule shells also contain FDampC yellow no. 6. The 200 mg capsule shell also contains FDampC red no. 40 and DampC red no. 28. Danazol - Clinical Pharmacology Danazol suppresses the pituitary-ovarian axis.

This suppression is probably a bination of depressed hypothalamic-pituitary response to lowered estrogen production, the alteration of sex steroid metabolism, and interaction of Danazol with sex hormone receptors. The only other demonstrable hormonal effect is weak androgenic activity. Danazol depresses the output of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Recent evidence suggests a direct inhibitory effect at gonadal sites and a binding of Danazol to receptors of gonadal steroids at target organs. In addition, Danazol has been shown to significantly decrease IgG, IgM and IgA levels, as well as phospholipid and IgG isotope autoantibodies in patients with endometriosis and associated elevations of autoantibodies, suggesting this could be another mechanism by which it facilitates regression of the disease. In the treatment of endometriosis, Danazol alters the normal and ectopic endometrial tissue so that it bees inactive and atrophic. plete resolution of endometrial lesions occurs in the majority of cases. Changes in vaginal cytology and cervical mucus reflect the suppressive effect of Danazol on the pituitary-ovarian axis.

In the treatment of fibrocystic breast disease, Danazol usually produces partial to plete disappearance of nodularity and plete relief of pain and tenderness. Changes in the menstrual pattern may occur. Generally, the pituitary-suppressive action of Danazol is reversible. Ovulation and cyclic bleeding usually return within 60 to 90 days when therapy with Danazol is discontinued. In the treatment of hereditary angioedema, Danazol at effective doses prevents attacks of the disease characterized by episodic edema of the abdominal viscera, extremities, face, and airway which may be disabling and, if the airway is involved, fatal.

In addition, Danazol corrects partially or pletely the primary biochemical abnormality of hereditary angioedema by increasing the levels of the deficient C1 esterase inhibitor (C1EI). As a result of this action the serum levels of the C4 ponent of the plement system are also increased. Pharmacokinetics Absorption: After oral administration of a 400 mg dose to healthy male volunteers, peak plasma concentrations of Danazol are reached between 2 and 8 hours, with a median T max value of 4 hours. Steady state conditions are observed following 6 days of twice daily dosing of Danazol. The pharmacokinetic parameters for Danazol after administering a 400 mg oral dose to healthy males are summarized in the following table:/media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-patientcare. jpg / Quality Care Find out why Mayo Clinic is the right place for your health care. Make an appointment. /media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-docsdepts. jpg / Meet the Staff Find a directory of doctors and departments at all Mayo Clinic campuses.

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jpg / Professional Services Explore Mayo Clinics many resources and see jobs available for medical professionals. Get updates. /media/kcms/gbs/research/images/2014/04/29/12/35/globalnav-you-are-blue. jpg / Give to Mayo Clinic Help set a new world standard in care for people everywhere. Give now. On this page Start taking danazol on the first day of your period unless you have been told otherwise.

You can take the capsules either before or after meals. About danazol Available as Danazol works by altering the levels of some of your bodys hormones. It is used to treat a number of different conditions. Endometriosis is a condition where tissue that normally lines the inside of your womb (uterus) is found elsewhere in your body, often in the pelvic area or abdomen.

It can cause painful periods and persistent pain in the pelvic area, as well as other symptoms. By altering the levels of your hormones, danazol will help to relieve these symptoms. Danazol is also prescribed to ease severe pain and tenderness associated with breast cyst disease (where other treatments have proved unhelpful). Breast cysts are small lumps which are found in the breast, but which are not cancerous. In addition to the two conditions above, danazol is also prescribed by specialist doctors for people with a condition known as hereditary angio-oedema (although it is not licensed for this condition).

If you have been prescribed it for this reason, please speak with your doctor if you have any questions about your treatment. Related discussionsDanazol 50 mg-BAR What are the possible side effects of danazol (Danocrine) Get emergency medical help if you have any of these signs of an allergic reaction . hives difficult breathing swelling of your face, lips, tongue, or throat. In rare cases, danazol can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever. unusual tiredness, and dark colored urine. Call your doctor at once if you have a serious side effect such as: sudden numbness or weakness (especially on one side of the body), confusion, problems with speech or balance severe headache. ringing in your ears, dizziness.

nausea, vomiting, vision problems, pain behind your eyes chest pain. sudden cough. wheezing, rapid breathing, coughing up blood pain, swelling, warmth, or redness in one or both legs swelling or rapid weight gain, especially in your face and midsection bloody, black, or tarry stools cough up blood or vomit that looks like coffee grounds or upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Less serious side effects may include: acne or other skin problems, increased sweating increased hair growth or hair loss breast changes decreased amount of semen released during sex hoarse or deepened voice, sore throat flushing (warmth, redness, or tingly feeling) changes in your menstrual periods unusual vaginal bleeding or spotting vaginal dryness, disfort, or itching.

This is not a plete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What is the most important information I should know about danazol (Danocrine) You should not use this medication if you are allergic to danazol, or if you have porphyria, a history of stroke or blood clot, or severe problems with your heart, liver, or kidney.

You also should not take danazol if you are pregnant or breast-feeding, if you have breast or uterine cancer, or if you have abnormal vaginal bleeding that has not been checked by a doctor. Danazol can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol.

Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctors advice. It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment. Call your doctor at once if you have a serious side effect such as sudden numbness or weakness, problems with vision or speech, chest pain, sudden cough, or wheezing, swelling, rapid weight gain, feeling short of breath, ringing in your ears, dizziness, nausea, pain behind your eyes, stomach pain and loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes).Endometriosis Mild: 200-400 mg/day PO divided BID Moderate-to-severe: 800 mg/day PO divided BID Titrate downward to dose sufficient to maintain amenorrhea Fibrocystic Breast Disease 100-400 mg/day PO divided BID Frequency Not Defined Increased blood pressure Thromboembolism Depression Black Box Warnings Pregnancy amp Lactation Pregnancy Category: X Lactation: enters breast milk/contraindicated Pregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable.

Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.

Danazol Reviews Discussions danazol. Finally got the danazol. The pharmacy had to order it, which took a few extra days, so I just now took my first pill. Ill let u all know if anything. More danazol.

Thanks for the link. The more I read on it, the more it worries me that Ill turn into a deep voiced hairy beast. But I just feel like Im not going. More danazol. Its supposed to slow the estrogen down so it starves the endo growths and possibly shrinks them. But there are some ugly side effects. voice deepeni. More danazol.

I have not heard of it. What is it What does it do More Danazol If you are TTC, you cannot try for 6 months following Danazol. Natural progesterone is the only treatment that worked for me without the side effect. MoreDanazol Side Effects Last Updated: May 18, 2010 By Carole Anne Tomlinson Carole Anne Tomlinson Carole Anne Tomlinson is a registered nurse with experience in rehabilitation, nutrition, chemical dependency, diabetes and health problems related to the elderly. Tomlinson holds a Bachelor of Arts in criminal justice and is presently working on her masters degree in nursing. Her screenplays have been viewed by Merchant Ivory, Angela Lansbury and Steven Kings associates. The synthetic steroid generically named danazol may be prescribed for a variety of uses, the Mayo Clinic reports, that generally relate to sexual development and ailments. For example, danazol may be prescribed to reduce the pain of endometriosis, a scarring disease of the uterus, as well as to help overe fertility problems caused by this disease. The medicine also may help fight fibrocystic breast disease, premature development of girls and gyneastia, a condition in men in which their breasts develop more than normal. Breast and Weight Side Effects In women, danazol may induce problems that potentially are serious mon side effects relating to their breasts and weight.

The medication may reduce the size of womens breasts. Danazol also may induce the unintended gaining of weight. These side effects, the Mayo Clinic states, require medical attention as soon as possible. Menstrual Problems Danazol also can work to decrease the disfort of menstrual pain, but it also may induce a mon serious side effect in women that affects their menstruation. The use of the medicine may cause a disruption in cycles for the woman, meaning she may experience an irregularity of her periods, the Mayo Clinic reports. This, too, classifies as a serious medical problem requiring professional help./media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-patientcare.

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You also should not take danazol if you are pregnant or breast-feeding, if you have breast or uterine cancer, or if you have abnormal vaginal bleeding that has not been checked by a doctor. Danazol can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide).

Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctors advice. It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment. Call your doctor at once if you have a serious side effect such as sudden numbness or weakness, problems with vision or speech, chest pain, sudden cough, or wheezing, swelling, rapid weight gain, feeling short of breath, ringing in your ears, dizziness, nausea, pain behind your eyes, stomach pain and loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes). What is danazol Danazol is a man-made form of a steroid.

Danazol affects the ovaries and pituitary gland and prevents the release of certain hormones in the body. Danazol is used to treat endometriosis and fibrocystic breast disease. Danazol is also used to prevent attacks of angioedema in people with an inherited form of this disorder (hereditary angioedema). Danazol may also be used for purposes not listed in this medication guide. What should I discuss with my healthcare provider before taking danazol You should not use this medication if you are allergic to danazol, or if you have: severe heart disease, a history of stroke or blood clot severe kidney disease severe liver disease a hormone-related cancer such as breast or uterine cancer porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system) abnormal vaginal bleeding that has not been checked by a doctor or if you are pregnant or breast-feeding. To make sure you can safely take danazol, tell your doctor if you have any of these other conditions: heart disease, high blood pressure, coronary artery disease, congestive heart failure high cholesterol or triglycerides a history of breast cancer diabetes hypoparathyroidism, or low levels of calcium in your blood a seizure disorder kidney or liver disease or migraine headaches. FDA pregnancy category X. This medication can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use danazol if you are pregnant.

Stop taking danazol and tell your doctor right away if you bee pregnant during treatment. You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Danazol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using danazol.

Taking danazol to treat endometriosis may increase your risk of ovarian cancer. Talk with your doctor about your individual risk. How should I take danazol Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than remended. Follow the directions on your prescription label. Women who take danazol to treat endometriosis or fibrocystic breast disease should start the medication during a menstrual period. Danazol is usually given for 6 to 9 months to treat fibrocystic breast disease or endometriosis. To prevent attacks of hereditary angioedema, you may need to use the medication long-term. Follow your doctors instructions.

Your doctor may occasionally change your dose to make sure you get the best results. Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctors advice. Use danazol regularly to get the most benefit.

Try not to miss any doses. Get your prescription refilled before you run out of medicine pletely. While using danazol, you may need blood tests at your doctors office. Visit your doctor regularly. It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment.

What happens if I miss a doseDanazol News ADVERSE REACTIONS The following events have been reported in association with the use of danazol: Androgen like effects include weight gain, acne and seborrhea. Mild hirsutism, edema, hair loss, voice change, which may take the form of hoarseness, sore throat or of instability or deepening of pitch, may occur and may persist after cessation of therapy. Hypertrophy of the clitoris is rare. Other possible endocrine effects are menstrual disturbances including spotting, alteration of the timing of the cycle and amenorrhea. Although cyclical bleeding and ovulation usually return within 60 to 90 days after discontinuation of therapy with danazol, persistent amenorrhea has occasionally been reported. Flushing, sweating, vaginal dryness and irritation and reduction in breast size, may reflect lowering of estrogen. Nervousness and emotional lability have been reported.

In the male a modest reduction in spermatogenesis may be evident during treatment. Abnormalities in semen volume, viscosity, sperm count, and motility may occur in patients receiving long-term therapy. Hepatic dysfunction, as evidenced by reversible elevated serum enzymes and/or jaundice, has been reported in patients receiving a daily dosage of danazol of 400 mg or more. It is remended that patients receiving danazol be monitored for hepatic dysfunction by laboratory tests and clinical observation. Serious hepatic toxicity including cholestatic jaundice, peliosis hepatis, and hepatic adenoma have been reported (see WARNINGS and PRECAUTIONS ). Abnormalities in laboratory tests may occur during therapy with danazol including CPK, glucose tolerance, glucagon, thyroid binding globulin, sex hormone binding globulin, other plasma proteins, lipids and lipoproteins.

The following reactions have been reported, a causal relationship to the administration of danazol has neither been confirmed nor refuted allergic: urticaria, pruritus and rarely, nasal congestion CNS effects: headache, nervousness and emotional lability, dizziness and fainting, depression, fatigue, sleep disorders, tremor, paresthesias, weakness, visual disturbances, and rarely, benign intracranial hypertension, anxiety, changes in appetite, chills, and rarely convulsions, Guillain-Barre syndrome gastrointestinal: gastroenteritis, nausea, vomiting, constipation, and rarely, pancreatitis and splenic peliosis musculoskeletal: muscle cramps or spasms, or pains, joint pain, joint lockup, joint swelling, pain in back, neck, or extremities, and rarely, carpal tunnel syndrome which may be secondary to fluid retention genitourinary: hematuria, prolonged posttherapy amenorrhea hematologic: an increase in red cell and platelet count. Reversible erythrocytosis, leukocytosis or polycythemia may be provoked. Eosinophilia, leukopenia and thrombocytopenia have also been noted. Skin: rashes (maculopapular, vesicular, papular, purpuric, petechial), and rarely, sun sensitivity, Stevens-Johnson syndrome and erythema multiforme other: increased insulin requirements in diabetic patients, change in libido, myocardial infarction, palpitation, tachycardia, elevation in blood pressure, interstitial pneumonitis, and rarely, cataracts, bleeding gums, fever, pelvic pain, nipple discharge. Malignant liver tumors have been reported in rare instances, after long-term use. REPORTS OF SUSPECTED DANAZOL SIDE EFFECTS / ADVERSE REACTIONS Possible Danazol side effects / adverse reactions in 72 year old female Reported by a health professional (non-physician/pharmacist) from Ireland on 2011-11-04 Other drugs received by patient: Perindopril Erbumine Levothyroxine Sodium Possible Danazol side effects / adverse reactions in 47 year old female Reported by a physician from Switzerland on 2011-11-29 Patient: 47 year old female Reactions: Hepatocellular Injury Other drugs received by patient: Tramadol Hydrochloride ALL Other Therapeutic Products Calcimagon Fosamax Livial Possible Danazol side effects / adverse reactions in 91 year old maleDanazol 50 mg-BAR What is the most important information I should know about danazol You should not use this medication if you are allergic to danazol, or if you have porphyria, a history of stroke or blood clot, or severe problems with your heart, liver, or kidney. You also should not take danazol if you are pregnant or breast-feeding, if you have breast or uterine cancer, or if you have abnormal vaginal bleeding that has not been checked by a doctor. Danazol can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use if you are pregnant. You may need to have a negative pregnancy test before starting this treatment.

Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctors advice. It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment. Call your doctor at once if you have a serious side effect such as sudden numbness or weakness, problems with vision or speech, chest pain, sudden cough, or wheezing, swelling, rapid weight gain, feeling short of breath, ringing in your ears, dizziness, nausea, pain behind your eyes, stomach pain and loss of appetite, dark urine, or jaundice (yellowing of the skin or eyes). What is danazol Danazol is a man-made form of a steroid.

Danazol affects the ovaries and pituitary gland and prevents the release of certain hormones in the body. Danazol is used to treat endometriosis and fibrocystic breast disease. Danazol is also used to prevent attacks of angioedema in people with an inherited form of this disorder (hereditary angioedema). Danazol may also be used for purposes not listed in this medication guide. What should I discuss with my healthcare provider before taking danazol You should not use this medication if you are allergic to danazol, or if you have: severe heart disease, a history of stroke or blood clot severe kidney disease severe liver disease a hormone-related cancer such as breast or uterine cancer porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system) abnormal vaginal bleeding that has not been checked by a doctor or if you are pregnant or breast-feeding. To make sure you can safely take danazol, tell your doctor if you have any of these other conditions: heart disease, high blood pressure, coronary artery disease, congestive heart failure high cholesterol or triglycerides a history of breast cancer diabetes hypoparathyroidism, or low levels of calcium in your blood a seizure disorder kidney or liver disease or migraine headaches. FDA pregnancy category X. This medication can harm an unborn baby or cause vaginal birth defects in a newborn female infant. Do not use danazol if you are pregnant. Stop taking danazol and tell your doctor right away if you bee pregnant during treatment.

You may need to have a negative pregnancy test before starting this treatment. Use a barrier form of birth control (such as a condom or diaphragm with spermicide). Hormonal contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment with danazol. Danazol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using danazol. Taking danazol to treat endometriosis may increase your risk of ovarian cancer. Talk with your doctor about your individual risk. How should I take danazol Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than remended.

Follow the directions on your prescription label. Women who take danazol to treat endometriosis or fibrocystic breast disease should start the medication during a menstrual period. Danazol is usually given for 6 to 9 months to treat fibrocystic breast disease or endometriosis. To prevent attacks of hereditary angioedema, you may need to use the medication long-term. Follow your doctors instructions. Your doctor may occasionally change your dose to make sure you get the best results.

Your medication needs may change if you bee ill, have a fever or infection, or if you have surgery or a medical emergency. Tell your doctor about any such situation that affects you. Do not change your medication dose or schedule without your doctors advice. Use danazol regularly to get the most benefit. Try not to miss any doses. Get your prescription refilled before you run out of medicine pletely. While using danazol, you may need blood tests at your doctors office. Visit your doctor regularly. It may take several weeks before your symptoms improve.

Keep using the medication as directed and tell your doctor if your symptoms do not improve or if they get worse during treatment. This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using danazol. What happens if I miss a doseBOSTON, MA -- November 5, 2007 -- Patients receiving the standard treatment of pegylated interferon alfa 2a plus ribavirin for chronic hepatitis C virus (HCV) may bee thrombocytopenic, but are able to achieve increased platelet counts through danazol therapy, according to research presented here at the 58th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD). This is the first report of using a novel alternative treatment for thrombocytopenia in this difficult patient population, noted lead author, Guillermo Cabrera-Alvarez, MD, Gastroenterology and Liver Department, Internal Medicine Division, Regional General Hospital - Family Medicine Unit 1, Mexican Social Security Institute, Cuernavaca, Morelos, Mexico.

Dr. Cabrera-Alvarez and colleagues conducted an open-label clinical trial of 41 danazol-naive patients with chronic HCV (90 with cirrhosis of the liver), who had developed thrombocytopenia as a result of treatment with pegylated interferon alga 2a plus ribavirin. The treatment group (n 26, 20 female) received danazol at 300-600 mg/day until the end of the HCV therapy. Fifteen control subjects (9 females) were matched for baseline platelet count, presence of cirrhosis, age, sex, and HCV genotype, but were not considered thrombocytopenic. The mean baseline platelet count for treated patients was 75,300 177 11,502, which was increased at the end of the study to 123,900 177 30,411 (P .0063) in the 23 patients available for evaluation (20 females).

Of those 23 danazol-treated patients, 4 were considered non-responders, 7 were mild responders, and 12 were considered to have had a good response. Efficacy was evaluated as the capacity to increase platelet counts until the end of the treatment period. In the control group (non-thrombocytopenic), the mean platelet count went from 238,953.3 177 141,962.9 at baseline to 174,200 177 91,643 at end of treatment (P .9246). Only two danazol-treated patients developed reversible cholestasis, noted Dr. Cabrera-Alvarez. No other patients presented with side effects. We believe that maybe the mechanism of action involves impairment of macrophage-mediated clearance of antibody-coated platelets via decreased Fc receptor expression, as in autoimmune thrombocytopenia, said Dr. Cabrera-Alvarez. Danazol has been used successfully to treat patients with autoimmune thrombocytopenia. Danazol is a derivative of the synthetic steroid ethisterone, a modified testoterone. This drug decreases the follicle-stimulating hormone and luteinizing hormone.

Liver function must be monitored on a periodic basis in patients receiving long-term therapy with danazol, as it is metabolised by the liver. Presentation title: Danazol Increases the Platelets Count in Thrombo-Cytopenic Patients with Chronic Hepatitis C and Liver Cirrhosis Treated With Peg-Interferon Alfa 2a and Ribavirin. Abstract 260 Danazol Increases the Platelets Count in Thrombo-Cytopenic Patients with Chronic Hepatitis C and Liver Cirrhosis Treated With Peg-Interferon Alfa 2a and Ribavirin. G. Cabrera-Alvarez1 L. Canedo-Dorantes2 J. Reyes-Esparza3 L. Rodriguez-Fragoso3 N. Mendez-Sanchez5 A. Burguete4 V. Madrid-Marina4 1. Gastroenterology, IMSS, Cuernavaca, Morelos, Mexico. 2. Faculty of Medicine, Postgraduate Division, Universidad Autnoma del Estado de Morelos, Cuernavaca, Morelos, Morelos, Mexico. 3. Faculty of Pharmacology, Universidad Autnoma del Estado de Morelos, Cuernavaca, Morelos, Morelos, Mexico.

4. Chronic Infections and Cancer Division, Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Morelos, Mexico. 5. Liver Unit, Medica Sur Clinic Foundation, Mexico city, Mxico, Mexico. Background and Aim: Chronic hepatitis C (HCV) infection has been associated with the development of several extrahepatic alterations, including thrombocytopenia. Currently it remains unresolved. Danazol, an attenuated androgen has been succesfully used in patients with autoimmune thrombocytopenia. The aim of the present study was to investigate the effects of Danazol treatment for thrombocytopenia associated to peginterferon alfa-2a and ribavirin therapy in naive HCV patients. Methods: A prospective study carried out in patients with chronic hepatitis C or liver cirrhosis patients who were under antiviral therapy. The protocol was approved by the Review Board/Ethics mittee of the Hospital.

The inclusion criteria including both gender, age (20 to 70 yr), without co-infection with hepatitis B virus or human immunodeficiency virus (HIV-1/2), thrombocytopenia during peginterferon alfa-2a and ribavirin therapy was defined when the count was 8806 90,000 platelets/mL in the last month. Danazol 300-600 mg/day was administered until the end of therapy. We considere as a control patients those on antiviral therapy who did not receive adjuvant danazol due to only mild thrombocytopenia on antiviral therapy, matched for baseline platelet count, presence of cirrhosis, age, sex and HCV genotype. Efficacy was evaluated as the capacity to increase in platelet counts until the end of the treatment period.

Results: A total of 41 patients with HCV-associated thrombocytopenia with PEG IFN/ribavirin treatment were studied: 26 patients (20 females, 6 males), mean age of 54.57177 8.40 yr who received danazol and 15 controls (9 females, 6 males), mean age of 55.8 177 13 yr. Ninety percent of 41 patients had cirrhosis and the HCV genotypes were similar between groups. The platelet count increases in the Danazol group from baseline (75300 177 11502) after treatment (123,900 177 30411 p0.0063). Whereas in the control group the mean count range from (238953.3 177 141962.9 to 174200177 91643, p0.9246) respectively. No association between genotypes and thrombocytopenia was observed (P0.05). Danazol safety was assessed by the absence of collateral negative effects, except colestasis reversible in two patients.

Conclusions: Adjuvant use of Danazol is associated with increased platelets counts in patients on antiviral therapy with interferon and rivabirin for HCV infection and cirrhosis. This is new therapeutic option to treat thrombocytopenia and maximize the sustained virologic responseDiscussion on Testosterone Replacement Therapy Something New: Danazol When speaking with Chip on today I learned about Danazol. thought Id share and hope Chip doesnt mind. if you do, sorry Chip Danazol, is a replacement for oxandrolone amp stanozolol Suggested dose protocol: Take one 25mg capsule twice per day for 30 days then once per day thereafter to maintain. For extreme cases of sexual dysfunction (God help you. )- take 3 25mg capsule per day for 90 days then 25mg per day thereafter to maintain. Danazol is also an quotanti-estrogenquot which can assist in blocking testosterones conversion to estradiol. Any of you guys heard of it Sounds interesting to me.

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Candesartancandesartan Candesartan is used to treat high blood pressure (hypertension ). Lowering high blood pressure helps prevent strokes, heart attacks. and kidney problems. Candesartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so blood can flow more easily. This medication is also used to treat heart failure . This medication is not remended for use in children younger than 1 year due to increased risk of side effects. OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. This drug may also be used to help protect the kidneys from damage due to diabetes .

How to use candesartan Read the Patient Information Leaflet if available from your pharmacist before you start taking candesartan and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight . Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. For the treatment of high blood pressure, it may take up to 6 weeks before you get the full benefit of this drug.

Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase). Side Effects Dizziness. tiredness, or lightheadedness may occur as your body adjusts to the medication. Runny nose or sore throat may also occur. If any of these effects persists or worsens, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: fainting. symptoms of a high potassium blood level (such as muscle weakness. slow/irregular heartbeat ).

Although candesartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking candesartan. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a plete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at fda. gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. Precautions Before taking candesartan, tell your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems.

Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, high blood levels of potassium in the blood (hyperkalemia), loss of too much body water and/or minerals (dehydration ). This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Too much sweating. diarrhea. or vomiting may cause you to feel lightheaded. Report prolonged diarrhea or vomiting to your doctor. This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Older adults may be more sensitive to the side effects of this drug, especially dizziness, increases in potassium level, and unusual change in the amount of urine (kidney problems). This medication is not remended for use during pregnancy. It may harm an unborn baby. Consult your doctor for more details. (See also Warning section.) It is unknown if this drug passes into breast milk. Consult your doctor before breast - feeding.

Interactions See also Precautions section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.

Do not start, stop, or change the dosage of any medicines without your doctors approval. Check the labels on all your medicines (such as cough-and-cold products, diet aids, or NSAIDs such as ibuprofen, naproxen) because they may contain ingredients that could increase your blood pressure or worsen your heart failure. Ask your pharmacist for more details. If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222.

Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast heartbeat, severe dizziness, fainting. Do not share this medication with others. Laboratory and/or medical tests (such as kidney function, potassium levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. Lifestyle changes that may help this medication work better include stress reduction programs, exercise, and dietary changes. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Have your blood pressure checked regularly while taking this medication.

Learn how to monitor your own blood pressure at home, and share the results with your doctor. Missed Dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal pany. Information last revised December 2015. Copyright(c) 2015 First Databank, Inc. Medicines treatments centre CANDESARTAN WARNINGS Candesartan should be used with caution in:patients with kidney disease or who have had a kidney transplant, patients with liver or heart disease. with renal artery stenosis, those with abnormally low blood pressure. patients who are about to have anaesthetics and surgery (including dental surgery), obstructive hypertrophic cardiomyopathy.

primary hyperaldosteronism, hyperkalaemia. severe congestive heart failure. It should not be used in:women who are more than 3 months pregnant (it is also better to avoid candesartan in early pregnancy ), patients who are allergic to candesartan or to any of the ingredients in the medicine severe liver disease or biliary obstruction (a problem with the drainage of the bile from the gall bladder ). CANDESARTAN USES Candesartan is used to lower blood pressure by relaxing your blood vessels, making it easier for your heart to pump your blood around your body. It is an angiotensin II receptor antagonist, sometimes known as an angiotensin receptor blocker (ARB). In general this drug is used to treat high blood pressure (hypertension). It is also used to treat heart failure when bined with a specific type of medicines called angiotensin-converting-enzyme inhibitors (ACE inhibitors ) or when ACE inhibitors are considered not suitable Benefits of being on this drug can include lowering of blood pressure and treating heart failure Listed below are the typical uses of Candesartan. Treatment of high blood pressure in adult patients Treatment of heart failure with reduced heart muscle function in addition to an angiotensin converting enzyme (ACE) inhibitor or when ACE inhibitors cannot be used, in adult patients. On occasion your doctor may prescribe this medicine to treat a condition not on the above list. HOW TO USE/TAKE How often do I take itTake this medication orally usually once a day, with or without food.

Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day - unless specifically told otherwise by your doctor. It may take up to 4 weeks before the full benefit of this drug takes effect. Certain medical conditions may require different dosage instructions as directed by your doctor. What doseDosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines. Do I need to avoid anythingWhen driving vehicles or operating machines it should be taken into account that dizziness or weariness may occur during treatment.

Consult your doctor or pharmacist for more details. When can I stopIt is important to continue taking this medication even if you feel well, unless your doctor tells you to stop. CANDESARTAN SIDE EFFECTS If any of these persist or you consider them severe then contact your doctor or pharmacist. Stop taking candesartan and tell your doctor immediately if you develop any of the following symptoms: swollen face. lips, tongue, eyes and or throat jaundice. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs.

Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing. This is not a plete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking.

It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website. CANDESARTAN PRECAUTIONS This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe liver disease or biliary obstruction are pregnant or are planning to bee pregnant breastfeeding. Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: kidney disease or kidney transplant liver disease renal artery stenosis abnormally low blood pressure obstructive hypertrophic cardiomyopathy primary hyperaldosteronism hyperkalaemia (high potassium levels) severe congestive heart failure intolerance to any of the ingredients. Before having surgery, tell your doctor or dentist that you are taking this medication. Does alcohol intake affect this drugIf you are being treated for heart failure, your doctor may remend that you avoid alcohol.

The elderly. Candesartan can be used in the elderly. Pregnancy and breastfeeding - please ensure you read the detailed information below Candesartan is not safe to take if you are, or are planning to bee, pregnant. It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation. If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING Candesartan is not safe to take if you are breastfeeding. It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation. If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist. CANDESARTAN INTERACTIONS Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first. This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: none known.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:Lithium for mania and depression Potassium sparing diuretics (e. g. amiloride, triamteren, spironolactone) Potassium supplements Salt substitutes containing potassium heparin ACE inhibitors (such as enalapril, captopril, lisinopril or ramipril) Diuretics (water tablets) Non-steroidal anti-inflammatory painkillers (such as ibuprofen, naproxen or diclofenac) COX-2 inhibitors (such as celecoxib or etoricoxib) More than 3 g of aspirin This information does not contain all possible interactions. Therefore, before using Candesartan, tell your doctor or pharmacist of all the products you use. CANDESARTAN OVERDOSE If you take too many tablets by mistake, contact a doctor as soon as possible. Candesartan Generic Name: Candesartan cilexetil Dosage Form: tablet WARNING: FETAL TOXICITY When pregnancy is detected, discontinue Candesartan cilexetil tablets as soon as possible. (5.1 ) Indications and Usage for Candesartan Hypertension Candesartan cilexetil tablets are indicated for the treatment of hypertension in adults and in children 1 to 17 years of age, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including the class to which this drug principally belongs. Control of high blood pressure should be part of prehensive cardiovascular risk management, including, as appropriate, lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and limited sodium intake. Many patients will require more than one drug to achieve blood pressure goals.

For specific advice on goals and management, see published guidelines, such as those of the National High Blood Pressure Education Programrsquos Joint National mittee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC). Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular oute benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly. Elevated systolic or diastolic pressure causes increased cardiovascular risk, and the absolute risk increase per mmHg is greater at higher blood pressures, so that even modest reductions of severe hypertension can provide substantial benefit. Relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk, so the absolute benefit is greater in patients who are at higher risk independent of their hypertension (for example, patients with diabetes or hyperlipidemia), and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal. Some antihypertensive drugs have smaller blood pressure effects (as monotherapy) in black patients, and many antihypertensive drugs have additional approved indications and effects (eg, on angina, heart failure, or diabetic kidney disease). These considerations may guide selection of therapy. Candesartan cilexetil tablets may be used alone or in bination with other antihypertensive agents. Heart Failure Candesartan cilexetil tablets are indicated for the treatment of heart failure (NYHA class II to IV) in adults with left ventricular systolic dysfunction (ejection fraction le 40) to reduce cardiovascular death and to reduce heart failure hospitalizations see CLINICAL STUDIES (14.2) . Candesartan cilexetil tablets also have an added effect on these outes when used with an ACE inhibitor.

Candesartan Dosage and Administration Adult Hypertension Dosage must be individualized. Blood pressure response is dose related over the range of 2 to 32 mg. The usual remended starting dose of Candesartan cilexetil tablets are 16 mg once daily when it is used as monotherapy in patients who are not volume depleted. Candesartan cilexetil tablets can be administered once or twice daily with total daily doses ranging from 8 mg to 32 mg. Larger doses do not appear to have a greater effect, and there is relatively little experience with such doses. Most of the antihypertensive effect is present within 2 weeks, and maximal blood pressure reduction is generally obtained within 4 to 6 weeks of treatment with Candesartan cilexetil tablets. Use in Hepatic Impairment: Initiate with 8 mg Candesartan cilexetil tablets in patients with moderate hepatic insufficiency.

Dosing remendations cannot be provided for patients with severe hepatic insufficiency see CLINICAL PHARMACOLOGY (12.3) . Candesartan cilexetil tablets may be administered with or without food. If blood pressure is not controlled by Candesartan cilexetil tablets alone, a diuretic may be added. Candesartan cilexetil tablets may be administered with other antihypertensive agents. Pediatric Hypertension 1 to 17 Years of age Candesartan cilexetil tablets may be administered once daily or divided into two equal doses.

Adjust the dosage according to blood pressure response. For patients with possible depletion of intravascular volume (e. g. patients treated with diuretics, particularly those with impaired renal function), initiate Candesartan cilexetil tablets under close medical supervision and consider administration of a lower dose see WARNINGS AND PRECAUTIONS (5.3) . Slideshow: Love Your Dad Heres 10 Heart-Healthy Gifts For Fathers Day Children 1 to 6 years of age The dose range is 0.05 to 0.4 mg/kg per day. The remended starting dose is 0.20 mg/kg (oral suspension). Children 6 to 17 years of age For those less than 50 kg, the dose range is 2 to 16 mg per day. The remended starting dose is 4 to 8 mg. For those greater than 50 kg, the dose range is 4 to 32 mg per day. The remended starting dose is 8 to 16 mg. Doses above 0.4 mg/kg (1 to 6 year olds) or 32 mg (6 to 17 year olds) have not been studied in pediatric patients see CLINICAL STUDIES (14.1) . An antihypertensive effect is usually present within 2 weeks, with full effect generally obtained within 4 weeks of treatment with Candesartan cilexetil tablets. Children 1 year of age must not receive Candesartan cilexetil tablets for hypertension. All pediatric patients with a glomerular filtration rate less than 30 ml/min/1.73m 2 should not receive Candesartan cilexetil tablets since Candesartan cilexetil has not been studied in this population see SPECIAL POPULATIONS (8) . For children who cannot swallow tablets, an oral suspension may be substituted as described below: Preparation of Oral Suspension Candesartan cilexetil oral suspension can be prepared in concentrations within the range of 0.1 to 2.0 mg/mL. Typically, a concentration of 1 mg/mL will be suitable for the prescribed dose. Any strength of Candesartan cilexetil tablets can be used in the preparation of the suspension. Follow the steps below for preparation of the suspension. The number of tablets and volume of vehicle specified below will yield 160 mL of a 1 mg/mL suspension.

Prepare the vehicle by adding equal volumes of Ora-Plus reg (80 mL) and Ora-Sweet SF reg (80 mL) or, alternatively, use , dagger Ora-Blend SF reg (160 mL). Add a small amount of vehicle to the required number of Candesartan cilexetil tablets (five 32 mg tablets) and grind into a smooth paste using a mortar and pestle. Add the paste to a preparation vessel of suitable size. Rinse the mortar and pestle clean using the vehicle and add this to the vessel. Repeat, if necessary.

Prepare the final volume by adding the remaining vehicle. Mix thoroughly. Dispense into suitably sized amber PET bottles. Label with an expiry date of 100 days and include the following instructions: Store at room temperature (below 30degC/86degF). Use within 30 days after first opening. Do not use after the expiry date stated on the bottle. Do not freeze. Shake well before each use. Ora-Plus reg. Ora-Sweet SF reg. and Ora-Blend SF reg are registered trademarks of Paddock Laboratories, Inc. dagger Supplied as a 50/50 pre-mix of Ora-Plus reg and Ora-Sweet SF reg . Adult Heart Failure The remended initial dose for treating heart failure is 4 mg once daily.

The target dose is 32 mg once daily, which is achieved by doubling the dose at approximately 2-week intervals, as tolerated by the patient. Dosage Forms and Strengths 4 mg are white to off-white, round, biconvex-shaped tablets, engraved ldquoAPOrdquo on one side and ldquoCArdquo bisect ldquo4rdquo on other side. 8 mg are pink to light-pink, round, biconvex-shaped tablets, engraved ldquoAPOrdquo on one side and ldquoCArdquo bisect ldquo8rdquo on other side. 16 mg are pink to light-pink, round, biconvex-shaped tablets, engraved ldquoAPOrdquo on one side and ldquoCArdquo bisect ldquo16rdquo on other side. 32 mg are pink to light-pink, round, biconvex-shaped tablets, engraved ldquoAPOrdquo on one side and ldquoCArdquo bisect ldquo32rdquo on other side.

Contraindications Candesartan cilexetil tablets are contraindicated in patients who are hypersensitive to Candesartan. Do not co-administer aliskiren with Candesartan cilexetil tablets in patients with diabetes see DRUG INTERACTIONS (7) . Warnings and Precautions Fetal Toxicity Pregnancy Category D 8203 Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure and death. When pregnancy is detected, discontinue Candesartan cilexetil tablets as soon as possible see USE IN SPECIFIC POPULATIONS (8.1) . Oral doses ge10 mg of Candesartan cilexetil/kg/day administered to pregnant rats during late gestation and continued through lactation were associated with reduced survival and an increased incidence of hydronephrosis in the offspring.

The 10-mg/kg/day dose in rats is approximately 2.8 times the maximum remended daily human dose (MRHD) of 32 mg on a mg/m 2 basis (parison assumes human body weight of 50 kg). Candesartan cilexetil given to pregnant rabbits at an oral dose of 3 mg/kg/day (approximately 1.7 times the MRHD on a mg/m 2 basis) caused maternal toxicity (decreased body weight and death) but, in surviving dams, had no adverse effects on fetal survival, fetal weight, or external, visceral, or skeletal development. No maternal toxicity or adverse effects on fetal development were observed when oral doses up to 1000 mg of Candesartan cilexetil/kg/day (approximately 138 times the MRHD on a mg/m 2 basis) were administered to pregnant mice. Morbidity in Infants Children 1 year of age must not receive Candesartan cilexetil tablets for hypertension. Drugs that act directly on the renin-angiotensin system (RAS) can have effects on the development of immature kidneys. Hypotension Candesartan cilexetil tablets can cause symptomatic hypotension.

Symptomatic hypotension is most likely to occur in patients who have been volume and/or salt depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. Patients with symptomatic hypotension may require temporarily reducing the dose of Candesartan cilexetil tablets, diuretic or both, and volume repletion. Volume and/or salt depletion should be corrected before initiating therapy with Candesartan cilexetil tablets. In the CHARM program (heart failure patients), hypotension was reported in 18.8 of patients on Candesartan cilexetil tablets versus 9.8 of patients on placebo. The incidence of hypotension leading to drug discontinuation in Candesartan cilexetil-treated patients was 4.1 pared with 2.0 in placebo-treated patients.

In the CHARM-Added program, where Candesartan or placebo was given in addition to ACE inhibitors, hypotension was reported in 22.6 of patients treated with Candesartan cilexetil tablets versus 13.8 treated with placebo see DRUG INTERACTIONS (7) . Monitoring of blood pressure is remended during dose escalation and periodically thereafter. Major Surgery/Anesthesia Hypotension may occur during major surgery and anesthesia in patients treated with angiotensin II receptor antagonists, including Candesartan cilexetil tablets, due to blockade of the renin-angiotensin system. Very rarely, hypotension may be severe such that it may warrant the use of intravenous fluids and/or vasopressors. Impaired Renal Function Monitor renal function periodically in patients treated with Candesartan cilexetil. Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system. Patients whose renal function may depend, in part, on the activity of the renin-angiotensin system (e. g. patient with renal artery stenosis, chronic kidney disease, severe heart failure, or volume depletion) may be at particular risk of developing oliguria, progressive azotemia or acute renal failure when treated with Candesartan cilexetil tablets. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function on Candesartan cilexetil. In the CHARM program (heart failure patients), the incidence of abnormal renal function (e. g. creatinine increase) was 12.5 in patients treated with Candesartan cilexetil tablets versus 6.3 in patients treated with placebo. The incidence of abnormal renal function (e. g. creatinine increase) leading to drug discontinuation in Candesartan cilexetil tablets-treated patients was 6.3 pared with 2.9 in placebo-treated patients.

In the CHARM-Added program, where Candesartan or placebo was given in addition to ACE inhibitors, the incidence of abnormal renal function (e. g. creatinine increase) was 15 in patients treated with Candesartan cilexetil tablets versus 9 in patients treated with placebo see DRUG INTERACTIONS (7) . Hyperkalemia Drugs that inhibit the renin-angiotensin system can cause hyperkalemia. Monitor serum potassium periodically. In the CHARM program (heart failure patients), the incidence of hyperkalemia was 6.3 in patients treated with Candesartan cilexetil tablets versus 2.1 in patients treated with placebo. The incidence of hyperkalemia leading to drug discontinuation in Candesartan cilexetil-treated patients was 2.4 pared with 0.6 in placebo-treated patients. In the CHARM-Added program where Candesartan or placebo was given in addition to ACE inhibitors, the incidence of hyperkalemia was 9.5 in patients treated with Candesartan cilexetil tablets versus 3.5 in patients treated with placebo see DRUG INTERACTIONS ( 7) . Adverse Reactions Clinical Studies Experience Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly pared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. Adult Hypertension Candesartan cilexetil tablets have been evaluated for safety in more than 3600 patients/subjects, including more than 3200 patients treated for hypertension.

About 600 of these patients were studied for at least 6 months and about 200 for at least 1 year. In general, treatment with Candesartan cilexetil tablets was well tolerated. The overall incidence of adverse events reported with Candesartan cilexetil tablets were similar to placebo. The rate of withdrawals due to adverse events in all trials in patients (7510 total) was 3.3 (ie, 108 of 3260) of patients treated with Candesartan cilexetil tablets as monotherapy and 3.5 (ie, 39 of 1106) of patients treated with placebo. In placebo-controlled trials, discontinuation of therapy due to clinical adverse events occurred in 2.4 (ie, 57 of 2350) of patients treated with Candesartan cilexetil tablets and 3.4 (ie, 35 of 1027) of patients treated with placebo. The most mon reasons for discontinuation of therapy with Candesartan cilexetil tablets were headache (0.6) and dizziness (0.3). The adverse events that occurred in placebo-controlled clinical trials in at least 1 of patients treated with Candesartan cilexetil tablets and at a higher incidence in Candesartan cilexetil (n 2350) than placebo (n 1027) patients included back pain (3 vs. 2), dizziness (4 vs. 3), upper respiratory tract infection (6 vs. 4), pharyngitis (2 vs. 1), and rhinitis (2 vs. 1). Pediatric Hypertension Among children in clinical studies, 1 in 93 children age 1 to 6 and 3 in 240 age 6 to 17 experienced worsening renal disease. The association between Candesartan and exacerbation of the underlying condition could not be excluded. Heart Failure The adverse event profile of Candesartan cilexetil tablets in adult heart failure patients was consistent with the pharmacology of the drug and the health status of the patients. In the CHARM program, paring Candesartan cilexetil tablets in total daily doses up to 32 mg once daily (n3803) with placebo (n3796), 21.0 of patients discontinued Candesartan cilexetil tablets for adverse events vs. 16.1 of placebo patients.

Postmarketing Experience The following adverse reactions were identified during post-approval use of Candesartan cilexetil tablets. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The following have been very rarely reported in post-marketing experience: Abnormal hepatic function and hepatitis. Neutropenia, leukopenia, and agranulocytosis. Immunologic Angioedema. Metabolic and Nutritional Disorders Skin and Appendages Disorders Pruritus, rash and urticaria. Rare reports of rhabdomyolysis have been reported in patients receiving angiotensin II receptor blockers. Drug Interactions Because Candesartan is not significantly metabolized by the cytochrome P450 system and at therapeutic concentrations has no effects on P450 enzymes, interactions with drugs that inhibit or are metabolized by those enzymes would not be expected. Non-Steroidal Anti-Inflammatory Agents including Selective Cyclooxygenase-2 Inhibitors (COX-2 Inhibitors) In patients who are elderly, volume-depleted (including those on diuretic therapy), or with promised renal function, co-administration of NSAIDs, including selective COX-2 inhibitors, with angiotensin II receptor antagonists, including Candesartan, may result in deterioration of renal function, including possible acute renal failure.

These effects are usually reversible. Monitor renal function periodically in patients receiving Candesartan and NSAID therapy. The antihypertensive effect of angiotensin II receptor antagonists, including Candesartan may be attenuated by NSAIDs including selective COX-2 inhibitors. Increases in serum lithium concentrations and toxicity have been reported during conitant administration of lithium with angiotensin II receptor antagonists, including Candesartan cilexetil. Monitor serum lithium levels. Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) pared to monotherapy.

Closely monitor blood pressure, renal function and electrolytes in patients on Candesartan cilexetil and other agents that affect the RAS. Do not co-administer aliskiren with Candesartan cilexetil in patients with diabetes. Avoid use of aliskiren with Candesartan cilexetil in patients with renal impairment (GFR 60 ml/min) see CONTRAINDICATIONS (4) . USE IN SPECIFIC POPULATIONS Pregnancy Category D Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue Candesartan cilexetil tablets as soon as possible.

These adverse outes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outes for both mother and fetus. In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus. Perform serial ultrasound examinations to assess the intra-amniotic environment.

If oligohydramnios is observed, discontinue Candesartan cilexetil tablets, unless it is considered lifesaving for the mother. Fetal testing may be appropriate, based on the week of pregnancy. Patients and physicians should be aware, however, that oligohydramnios may not appear until after the fetus has sustained irreversible injury. Closely observe infants with histories of in utero exposure to Candesartan cilexetil tablets for hypotension, oliguria, and hyperkalemia see USE IN SPECIFIC POPULATIONS (8. 4) . Labor and Delivery The effect of Candesartan cilexetil tablets on labor and delivery in humans is unknown see WARNINGS AND PRECAUTIONS (5.1) . Nursing Mothers It is not known whether Candesartan is excreted in human milk, but Candesartan has been shown to be present in rat milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue Candesartan cilexetil tablets, taking into account the importance of the drug to the mother. Pediatric Use Neonates with a history of in utero exposure to Candesartan cilexetil tablets If oliguria or hypotension occurs, direct attention toward support of blood pressure and renal perfusion.

Exchange transfusions or dialysis may be required as a means of reversing hypotension and/or substituting for disordered renal function. The antihypertensive effects of Candesartan cilexetil tablets were evaluated in hypertensive children 1 to 17 years of age in randomized, double-blind clinical studies see CLINICAL STUDIES (14.1) . The pharmacokinetics of Candesartan cilexetil tablets have been evaluated in pediatric patients 1 to 17 years of age see Pharmacokinetics (12.3) . Children 1 year of age must not receive Candesartan cilexetil tablets for hypertension see WARNINGS AND PRECAUTIONS (5.2) . Overdosage No lethality was observed in acute toxicity studies in mice, rats, and dogs given single oral doses of up to 2000 mg/kg of Candesartan cilexetil. In mice given single oral doses of the primary metabolite, Candesartan, the minimum lethal dose was greater than 1000 mg/kg but less than 2000 mg/kg. The most likely manifestation of overdosage with Candesartan cilexetil tablets would be hypotension, dizziness, and tachycardia bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted. Candesartan cannot be removed by hemodialysis. Treatment: To obtain up-to-date information about the treatment of overdose, consult your Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physiciansrsquo Desk Reference (PDR). In managing overdose, consider the possibilities of multiple-drug overdoses, drug-drug interactions, and altered pharmacokinetics in your patient. Candesartan Description Candesartan cilexetil tablets (Candesartan cilexetil), a prodrug, is hydrolyzed to Candesartan during absorption from the gastrointestinal tract. Candesartan is a selective AT 1 subtype angiotensin II receptor antagonist.

Candesartan cilexetil, a nonpeptide, is chemically described as (plusmn)-1-Hydroxyethyl 2-ethoxy-1- p-(o -1 H - tetrazol-5-ylphenyl)benzyl-7-benzimidazolecarboxylate, cyclohexyl carbonate (ester). Its empirical formula is C 33 H 34 N 6 O 6. and its structural formula is: Candesartan cilexetil is a white to off-white powder with a molecular weight of 610.67. It is practically insoluble in water and sparingly soluble in methanol. Candesartan cilexetil is a racemic mixture containing one chiral center at the cyclohexyloxycarbonyloxy ethyl ester group. Following oral administration, Candesartan cilexetil undergoes hydrolysis at the ester link to form the active drug, Candesartan, which is achiral. Candesartan cilexetil tablets are available for oral use as tablets containing either 4 mg, 8 mg, 16 mg, or 32 mg of Candesartan cilexetil and the following inactive ingredients: lactose monohydrate, corn starch, hydroxypropyl cellulose, carboxymethyl cellulose calcium, triacetin and magnesium stearate. Euroxide red iron oxide is added to the 8-mg, 16-mg, and 32-mg tablets as a colorant. Candesartan - Clinical Pharmacology Mechanism of Action Angiotensin II is formed from angiotensin I in a reaction catalyzed by angiotensin-converting enzyme (ACE, kininase II). Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium. Candesartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT 1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland.

Its action is, therefore, independent of the pathways for angiotensin II synthesis. There is also an AT 2 receptor found in many tissues, but AT 2 is not known to be associated with cardiovascular homeostasis. Candesartan has much greater affinity (10,000-fold) for the AT 1 receptor than for the AT 2 receptor. Blockade of the renin-angiotensin system with ACE inhibitors, which inhibit the biosynthesis of angiotensin II from angiotensin I, is widely used in the treatment of hypertension. ACE inhibitors also inhibit the degradation of bradykinin, a reaction also catalyzed by ACE. Because Candesartan does not inhibit ACE (kininase II), it does not affect the response to bradykinin. Whether this difference has clinical relevance is not yet known. Candesartan does not bind to or block other hormone receptors or ion channels known to be important in cardiovascular regulation.

Blockade of the angiotensin II receptor inhibits the negative regulatory feedback of angiotensin II on renin secretion, but the resulting increased plasma renin activity and angiotensin II circulating levels do not overe the effect of Candesartan on blood pressure. Pharmacodynamics Candesartan inhibits the pressor effects of angiotensin II infusion in a dose-dependent manner. After 1 week of once daily dosing with 8 mg of Candesartan cilexetil, the pressor effect was inhibited by approximately 90 at peak with approximately 50 inhibition persisting for 24 hours. Plasma concentrations of angiotensin I and angiotensin II, and plasma renin activity (PRA), increased in a dose-dependent manner after single and repeated administration of Candesartan cilexetil to healthy subjects, hypertensive, and heart failure patients.

ACE activity was not altered in healthy subjects after repeated Candesartan cilexetil administration. The once-daily administration of up to 16 mg of Candesartan cilexetil to healthy subjects did not influence plasma aldosterone concentrations, but a decrease in the plasma concentration of aldosterone was observed when 32 mg of Candesartan cilexetil was administered to hypertensive patients. In spite of the effect of Candesartan cilexetil on aldosterone secretion, very little effect on serum potassium was observed. Hypertension In multiple-dose studies with hypertensive patients, there were no clinically significant changes in metabolic function, including serum levels of total cholesterol, triglycerides, glucose, or uric acid. In a 12-week study of 161 patients with non-insulin-dependent (type 2) diabetes mellitus and hypertension, there was no change in the level of HbA 1c . Heart Failure In heart failure patients, Candesartan ge 8 mg resulted in decreases in systemic vascular resistance and pulmonary capillary wedge pressure. Pharmacokinetics Distribution The volume of distribution of Candesartan is 0.13 L/kg. Candesartan is highly bound to plasma proteins (99) and does not penetrate red blood cells. The protein binding is constant at Candesartan plasma concentrations well above the range achieved with remended doses. In rats, it has been demonstrated that Candesartan crosses the blood-brain barrier poorly, if at all. It has also been demonstrated in rats that Candesartan passes across the placental barrier and is distributed in the fetus.

Metabolism and Excretion Total plasma clearance of Candesartan is 0.37 mL/min/kg, with a renal clearance of 0.19 mL/min/kg. When Candesartan is administered orally, about 26 of the dose is excreted unchanged in urine. Following an oral dose of 14 C-labeled Candesartan cilexetil, approximately 33 of radioactivity is recovered in urine and approximately 67 in feces. Following an intravenous dose of 14 C-labeled Candesartan, approximately 59 of radioactivity is recovered in urine and approximately 36 in feces. Biliary excretion contributes to the elimination of Candesartan. Candesartan cilexetil is rapidly and pletely bioactivated by ester hydrolysis during absorption from the gastrointestinal tract to Candesartan, a selective AT 1 subtype angiotensin II receptor antagonist.

Candesartan is mainly excreted unchanged in urine and feces (via bile). It undergoes minor hepatic metabolism by O-deethylation to an inactive metabolite. The elimination half-life of Candesartan is approximately 9 hours. After single and repeated administration, the pharmacokinetics of Candesartan are linear for oral doses up to 32 mg of Candesartan cilexetil. Candesartan and its inactive metabolite do not accumulate in serum upon repeated once-daily dosing. Following administration of Candesartan cilexetil, the absolute bioavailability of Candesartan was estimated to be 15. After tablet ingestion, the peak serum concentration (C max ) is reached after 3 to 4 hours. Food with a high fat content does not affect the bioavailability of Candesartan after Candesartan cilexetil administration. Pediatrics In children 1 to 17 years of age, plasma levels are greater than 10ndashfold higher at peak (approximately 4 hours) than 24 hours after a single dose. Children 1 to 6 years of age, given 0.2 mg/kg had exposure similar to adults given 8 mg. Children 6 years of age had exposure similar to adults given the same dose.

The pharmacokinetics (C max and AUC) were not modified by age, sex or body weight. Candesartan cilexetil pharmacokinetics have not been investigated in pediatric patients less than 1 year of age. From the dose-ranging studies of Candesartan cilexetil, there was a dose related increase in plasma Candesartan concentrations. The renin-angiotensin system (RAS) plays a critical role in kidney development. RAS blockade has been shown to lead to abnormal kidney development in very young mice. Children 1 year of age must not receive Candesartan cilexetil tablets. Administering drugs that act directly on the renin-angiotensin system (RAS) can alter normal renal development.

Geriatric and Sex The pharmacokinetics of Candesartan have been studied in the elderly (ge 65 years) and in both sexes. The plasma concentration of Candesartan was higher in the elderly (C max was approximately 50 higher, and AUC was approximately 80 higher) pared to younger subjects administered the same dose. The pharmacokinetics of Candesartan were linear in the elderly, and Candesartan and its inactive metabolite did not accumulate in the serum of these subjects upon repeated, once-daily administration. No initial dosage adjustment is necessary see DOSAGE AND ADMINISTRATION (2) . There is no difference in the pharmacokinetics of Candesartan between male and female subjects. Renal Insufficiency In hypertensive patients with renal insufficiency, serum concentrations of Candesartan were elevated. After repeated dosing, the AUC and C max were approximately doubled in patients with severe renal impairment (creatinine clearance 30 mL/min/1.73m 2 ) pared to patients with normal kidney function.

The pharmacokinetics of Candesartan in hypertensive patients undergoing hemodialysis are similar to those in hypertensive patients with severe renal impairment. Candesartan cannot be removed by hemodialysis. No initial dosage adjustment is necessary in patients with renal insufficiency see DOSAGE AND ADMINISTRATION (2.1) . In heart failure patients with renal impairment, AUC 0 to 72h was 36 and 65 higher in mild and moderate renal impairment, respectively. C max was 15 and 55 higher in mild and moderate renal impairment, respectively. Pediatrics Candesartan cilexetil tablets pharmacokinetics have not been determined in children with renal insufficiency. Hepatic Insufficiency The pharmacokinetics of Candesartan were pared in patients with mild and moderate hepatic impairment to matched healthy volunteers following a single oral dose of 16 mg Candesartan cilexetil. The increase in AUC for Candesartan was 30 in patients with mild hepatic impairment (Child-Pugh A) and 145 in patients with moderate hepatic impairment (Child-Pugh B). The increase in C max for Candesartan was 56 in patients with mild hepatic impairment and 73 in patients with moderate hepatic impairment.

The pharmacokinetics after Candesartan cilexetil administration have not been investigated in patients with severe hepatic impairment. No initial dosage adjustment is necessary in patients with mild hepatic impairment. In hypertensive patients with moderate hepatic impairment, consideration should be given to initiation of Candesartan cilexetil tablets at a lower dose see DOSAGE AND ADMINISTRATION (2.1) . Heart Failure The pharmacokinetics of Candesartan were linear in patients with heart failure (NYHA class II and III) after Candesartan cilexetil doses of 4, 8, and 16 mg. After repeated dosing, the AUC was approximately doubled in these patients pared with healthy, younger patients. The pharmacokinetics in heart failure patients is similar to that in healthy elderly volunteers see DOSAGE AND ADMINISTRATION (2.3) . Nonclinical Toxicology Carcinogenesis, Mutagenesis, Impairment of Fertility There was no evidence of carcinogenicity when Candesartan cilexetil was orally administered to mice and rats for up to 104 weeks at doses up to 100 and 1000 mg/kg/day, respectively. Rats received the drug by gavage, whereas mice received the drug by dietary administration. These (maximally-tolerated) doses of Candesartan cilexetil provided systemic exposures to Candesartan (AUCs) that were, in mice, approximately 7 times and, in rats, more than 70 times the exposure in man at the maximum remended daily human dose (32 mg). Candesartan and its O-deethyl metabolite tested positive for genotoxicity in the in vitro Chinese hamster lung (CHL) chromosomal aberration assay. Neither pound tested positive in the Ames microbial mutagenesis assay or the in vitro mouse lymphoma cell assay. Candesartan (but not its O-deethyl metabolite) was also evaluated in vivo in the mouse micronucleus test and in vitro in the Chinese hamster ovary (CHO) gene mutation assay, in both cases with negative results. Candesartan cilexetil was evaluated in the Ames test, the in vitro mouse lymphoma cell and rat hepatocyte unscheduled DNA synthesis assays and the in vivo mouse micronucleus test, in each case with negative results.

Candesartan cilexetil was not evaluated in the CHL chromosomal aberration or CHO gene mutation assay. Fertility and reproductive performance were not affected in studies with male and female rats given oral doses of up to 300 mg/kg/day (83 times the maximum daily human dose of 32 mg on a body surface area basis). Clinical Studies Hypertension The antihypertensive effects of Candesartan cilexetil tablets were examined in 14 placebo-controlled trials of 4- to 12- weeks duration, primarily at daily doses of 2 to 32 mg per day in patients with baseline diastolic blood pressures of 95 to 114 mm Hg. Most of the trials were of Candesartan cilexetil as a single agent, but it was also studied as add-on to hydrochlorothiazide and amlodipine. These studies included a total of 2350 patients randomized to one of several doses of Candesartan cilexetil and 1027 to placebo. Except for a study in diabetics, all studies showed significant effects, generally dose related, of 2 to 32 mg on trough (24 hour) systolic and diastolic pressures pared to placebo, with doses of 8 to 32 mg giving effects of about 8-12/4-8 mm Hg. There were no exaggerated first-dose effects in these patients.

Most of the antihypertensive effect was seen within 2 weeks of initial dosing and the full effect in 4 weeks. With once-daily dosing, blood pressure effect was maintained over 24 hours, with trough to peak ratios of blood pressure effect generally over 80. Candesartan cilexetil had an additional blood pressure lowering effect when added to hydrochlorothiazide. The antihypertensive effects of Candesartan cilexetil and losartan potassium at their highest remended doses administered once daily were pared in two randomized, double-blind trials. In a total of 1268 patients with mild to moderate hypertension who were not receiving other antihypertensive therapy, Candesartan cilexetil 32 mg lowered systolic and diastolic blood pressure by 2 to 3 mm Hg on average more than losartan potassium 100 mg, when measured at the time of either peak or trough effect.

The antihypertensive effects of twice daily dosing of either Candesartan cilexetil or losartan potassium were not studied. The antihypertensive effect was similar in men and women and in patients older and younger than 65. Candesartan was effective in reducing blood pressure regardless of race, although the effect was somewhat less in blacks (usually a low-renin population). This has been generally true for angiotensin II antagonists and ACE inhibitors. In long-term studies of up to 1 year, the antihypertensive effectiveness of Candesartan cilexetil was maintained, and there was no rebound after abrupt withdrawal. There were no changes in the heart rate of patients treated with Candesartan cilexetil in controlled trials. The antihypertensive effects of Candesartan cilexetil tablets were evaluated in hypertensive children 1 to 6 years old and 6 to 17 years of age in two randomized, double-blind multicenter, 4-week dose ranging studies. There were 93 patients 1 to 6 years of age, 74 of whom had renal disease, that were randomized to receive an oral dose of Candesartan cilexetil suspension 0.05, 0.20 or 0.40 mg/kg once daily. The primary method of analysis was slope of the change in systolic blood pressure (SBP) as a function of dose. Since there was no placebo group, the change from baseline likely overestimates the true magnitude of blood pressure effect.

Nevertheless, SBP and diastolic blood pressure (DBP) decreased 6.0/5.2 to 12.0/11.1 mmHg from baseline across the three doses of Candesartan. In children 6 to 17 years, 240 patients were randomized to receive either placebo or low, medium, or high doses of Candesartan cilexetil tablets in a ratio of 1: 2: 2: 2. For children who weighed 50 kg the doses of Candesartan cilexetil tablets were 2, 8, or 16 mg once daily. For those 50 kg the Candesartan cilexetil tablets doses were 4, 16 or 32 mg once daily. Those enrolled were 47 Black and 29 were female mean age /- SD was 12.9 /- 2.6 years. The placebo subtracted effect at trough for sitting systolic blood pressure/sitting diastolic blood pressure for the different doses were from 4.9/3.0 to 7.5/6.2 mmHg. In children 6 to 17 years there was a trend for a lesser blood pressure effect for Blacks pared to other patients. There were too few individuals in the age group of 1 to 6 years old to determine whether Blacks respond differently than other patients to Candesartan cilexetil tablets. Heart Failure Candesartan was studied in two heart failure oute studies: 1. The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity trial in patients intolerant of ACE inhibitors (CHARMndashAlternative), 2. CHARMndashAdded in patients already receiving ACE inhibitors. Both studies were international double-blind, placebo-controlled trials in patients with NYHA class II to IV heart failure and LVEF le40.

In both trials, patients were randomized to placebo or Candesartan cilexetil tablets (initially 4 to 8 mg once daily, titrated as tolerated to 32 mg once daily) and followed for up to 4 years. Patients with serum creatinine 3 mg/dL, serum potassium 5.5 mEq/L, symptomatic hypotension or known bilateral renal artery stenosis were excluded. The primary end point in both trials was time to either cardiovascular death or hospitalization for heart failure. CHARMndashAlternative included 2028 subjects not receiving an ACE inhibitor due to intolerance. The mean age was 67 years and 32 were female, 48 were NYHA II, 49 were NYHA III, 4 were NYHA IV, and the mean ejection fraction was 30. Sixty-two percent had a history of myocardial infarction, 50 had a history of hypertension, and 27 had diabetes.

Conitant drugs at baseline were diuretics (85), digoxin (46), beta-blockers (55), and spironolactone (24). The mean daily dose of Candesartan cilexetil tablets was approximately 23 mg and 59 of subjects on treatment received 32 mg once daily. After a median follow-up of 34 months, there was a 23 reduction in the risk of cardiovascular death or heart failure hospitalization on Candesartan cilexetil tablets (p0.001), with both ponents contributing to the overall effect (Table 1). Table 1. CHARM mdash Alternative: Primary Endpoint and its ponents/media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-patientcare. jpg / Quality Care Find out why Mayo Clinic is the right place for your health care. Make an appointment. /media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-docsdepts. jpg / Meet the Staff Find a directory of doctors and departments at all Mayo Clinic campuses. Visit now. /media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-research. jpg / Research and Clinical Trials See how Mayo Clinic research and clinical trials advance the science of medicine and improve patient care. Explore now. /media/kcms/gbs/research/images/2013/05/02/10/56/globalnav-meded.

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/media/kcms/gbs/research/images/2014/04/29/12/35/globalnav-you-are-blue. jpg / Give to Mayo Clinic Help set a new world standard in care for people everywhere. Give now. On this page Take candesartan once each day. You can take the tablets either before or after a meal. Any side-effects are usually mild. They include headache and feeling dizzy.

About candesartan Related discussions Before taking candesartan Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking candesartan it is important that your doctor knows: If you are pregnant, trying for a baby or breast-feeding. If you have a problem with your kidneys, particularly if it is a blockage of the artery which supplies blood to your kidneys. If you have any problems with your heart valves or heart muscle. If you have a problem with the way your liver works, or if you have a condition which blocks the flow of bile from your liver called cholestasis. If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and plementary medicines. If you have ever had an allergic reaction to a medicine.

How to take candesartan Getting the most from your treatment Can candesartan cause problems Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most mon ones associated with candesartan. You will find a full list in the manufacturers information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or bee troublesome. SIDE EFFECTS Clinical Studies Experience Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly pared to rates in the clinical studies of another drug and may not reflect the rates observed in practice. Adult Hypertension ATACAND has been evaluated for safety in more than 3600 patients/subjects, including more than 3200 patients treated for hypertension. About 600 of these patients were studied for at least 6 months and about 200 for at least 1 year.

In general, treatment with ATACAND was well tolerated. The overall incidence of adverse events reported with ATACAND was similar to placebo. The rate of withdrawals due to adverse events in all trials in patients (7510 total) was 3.3 (ie, 108 of 3260) of patients treated with ATACAND as monotherapy and 3.5 (ie, 39 of 1106) of patients treated with placebo. In placebo-controlled trials, discontinuation of therapy due to clinical adverse events occurred in 2.4 (ie, 57 of 2350) of patients treated with ATACAND and 3.4 (ie, 35 of 1027) of patients treated with placebo. The most mon reasons for discontinuation of therapy with ATACAND were headache (0.6) and dizziness (0.3). The adverse events that occurred in placebo-controlled clinical trials in at least 1 of patients treated with ATACAND and at a higher incidence in candesartan cilexetil (n 2350) than placebo (n 1027) patients included back pain (3 vs. 2), dizziness (4 vs. 3), upper respiratory tract infection (6 vs. 4), pharyngitis (2 vs. 1), and rhinitis (2 vs. 1). Pediatric Hypertension Among children in clinical studies, 1 in 93 children age 1 to 6 and 3 in 240 age 6 to 17 experienced worsening renal disease. The association between candesartan and exacerbation of the underlying condition could not be excluded. Heart Failure The adverse event profile of ATACAND in adult heart failure patients was consistent with the pharmacology of the drug and the health status of the patients.

In the CHARM program, paring ATACAND in total daily doses up to 32 mg once daily (n3803) with placebo (n3796), 21.0 of patients discontinued ATACAND for adverse events vs. 16.1 of placebo patients. The following adverse reactions were identified during post-approval use of ATACAND. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The following have been very rarely reported in post-marketing experience:IMPORTANT WARNING: Tell your doctor if you are pregnant or plan to bee pregnant.

Do not take candesartan if you are pregnant. If you bee pregnant while you are taking candesartan, stop taking candesartan and call your doctor immediately. Candesartan may cause death or serious injury to the fetus when taken in the last 6 months of pregnancy. Why is this medication prescribed Candesartan is used alone or in bination with other medications to treat high blood pressure. Candesartan is also used alone or in bination with other medications to treat congestive heart failure (a condition when your heart can not pump enough blood to the other parts of the body). Candesartan is in a class of medications called angiotensin II receptor antagonists. It works by blocking the action of certain natural substances that tighten the blood vessels, allowing the blood to flow more smoothly and the heart to pump more efficiently.

What Is Candesartan Hydrochlorothiazide Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention. Candesartan is an angiotensin II receptor antagonists. Candesartan keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow. Hydrochlorothiazide and candesartan is a bination medicine used to treat high blood pressure (hypertension). Hydrochlorothiazide and candesartan may also be used for purposes not listed in this medication guide. You should not use this medicine if you are allergic to sulfa drugs, or if you are unable to urinate. Do not use if you are pregnant. Stop using this medicine and tell your doctor right away if you bee pregnant.

If you have diabetes, do not use hydrochlorothiazide and candesartan together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna). You should not use this medicine if you are allergic to candesartan or hydrochlorothiazide, if you are allergic to sulfa drugs, or if you are unable to urinate. If you have diabetes, do not use hydrochlorothiazide and candesartan together with any medication that contains aliskiren (Amturnide, Tekturna, Tekamlo, Valturna). You may also need to avoid taking hydrochlorothiazide and candesartan with aliskiren if you have kidney disease. To make sure hydrochlorothiazide and candesartan is safe for you, tell your doctor if you have any of these other conditions: kidney disease liver disease congestive heart failure glaua low or high levels of potassium in your blood asthma or allergies high cholesterol or triglycerides (a type of fat in the blood) gout lupus diabetes an allergy to penicillin or if you are on a low-salt diet. FDA pregnancy category D. Do not use if you are pregnant. Stop using and tell your doctor right away if you bee pregnant. Hydrochlorothiazide and candesartan can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

It is not known whether hydrochlorothiazide and candesartan passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine. Candesartan Hydrochlorothiazide Side Effects Get emergency medical help if you h

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Now for the room, well it8217spact but the bed was SOfy, it was the best nights sleep I8217ve had in a hotel bed for a long time, the tv was crystal clear with plenty of channels to choose from. My only gripe if there has to be something, I sleep on the right hand side of the bed and it was VERY close to the wall and the curtains so getting up in the night was a bit of a challenge There was a hanging rack with coat hangers and a luggage rack. The shower was 5 in every sense of the word, it was a great power shower with plenty of room in cubicle. Ian is a little over enthusiastic when ites to showering and found it did leak a bit of water under the door, but that was all. The bathroom door has no lock on it and can swing either in or out 823082308230.. The only problem was the room doors, they were very noisy when you opened them (but since staying in another hotel we have found that they also have very noisy doors) and we were lucky there didn8217t seem to be anyone in the rooms opposite us so it didn8217t worry us but a friend who also stayed in the Tune for a couple of days had said he8217d noticed the noise from other rooms.

He8217s actually stayed in Tune hotels before and had no qualms about staying in the Melbourne Tune Hotel. He said he is more than happy with each Tune Hotel he8217s stayed in and always checks to see if there is one locally before he books anywhere else. The hotel hasn8217t got it8217s restaurant up andnning yet but it has a cafe which serves the breakfast which was really nice, egg, bacon, on a slice of toasted bread, with cherry tomatoes and salad Yes I did say salad, which was odd for breakfast and which we felt was a little over the top. The Tune has a laundry room with washers and dryers and a space to do your ironing. All in all the hotel was great and it8217s a fantastic idea for the penny conscious traveller who wantsfort at a reasonable price.

The girls and I have talked about having a weekend away in London and I will definitely be looking at the Tune Hotels there as they are perfect for what we want. The concept works well on all levels, you pay for what you want, in most hotels you don8217t utilise half of the facilities they offer so this way you choose what you want to suit you. Perfect. Thank you to the Tune Hotel for a great night and it certainly won8217t be the last time we stay with you. How about a few more hotels in Europe Tune Hotel Melbourne offers double rooms from 65AUD (approx 35). For more information or to book please visit:tunehotels/uk Disclosure:- We stayed at the Tune Hotel for the purpose of this review but all opinions are our own honest opinions. P20 Sun Protection Review P20 Sun Protection P20 Sun Protection is aonce a day sun screen, well once a day if you don8217t sb your skin after going for a swim, which most of us don8217t so it8217s ideal to put on and et. Now I know I8217m bad but I don8217t tend to wear any form of sun protection at all, it really doesn8217t agree with my skin, I end up burnt and with lovely blisters Please don8217t follow my lead, always use sun protection and protect your skin. I am an unusual case. So my lovely hubby was my willing tester, plus a couple of other people who we met on holiday I usedthe P20 factor 15 on Ian and was really impressed just how easy it was to apply, it was so much easier than cream. It didn8217t feel greasy at all. It made getting ready to hit the sun so easy, no greasiness or stickiness, so that meant no worries about clothes getting covered in it. Ian didn8217t burn at all so it definitely worked. One of the guys we met, got quite badly burned on the first day as he stupidly brought some 8220lotion8221 locally which he found out had no factor in at all and within a few days he had blisters and it was painful to touch so he used some of the P20 spray and found it didn8217t sting at all and he didn8217t have tob it to get it to absorb.

About an hour later he said his skin felt so much cooler and the P20 seemed to have taken the burn out of it. I was really impressed with the P20 and Ian has already eyed up the P20 spray to use before he goes to the cricket test match next month Active 15 minutes after application Provides protection for up to 10 hours a day Superior Water Resistance: Categorised as Very Water Resistant according to Colipa Guidelines, the highest classification available Easy to apply: Clear, non-greasy gel, is absorbed rapidly leaving no messy white marks SPF 15(UVB) Medium protection Very water resistant UVA protection (1/3 SPF), 3-Star rating Absorbs 95 of UVB raysmore about this later.. Very photo stable UVAUVB filters Skin stable 10 hours Sun Protection after application Allows for a slow, gradual tan without burning P20 once a day sun protection provides you with 10 hours of sun protection after only one application as well as being very water resistant. No re-application also means you dont have to worry about staying sun safe throughout the day. After over three decades of success, the new range of P20 which launched in 2013prises 3 new products. SPFs 15, 30 and 50 join the iconic SPF20 providing long-lasting protection for all skin types. Active 15 minutes after application, P20 contains both UVA and UVB filters, providing broad specm sun protection for up to 10 hours and uses a unique, alcohol-based formula that sets it apart from traditional cream-type sun products. The very water resistant formula is clear, non-greasy, fragrance and paraben free, to provide the ultimate coverage. The long-lasting formula is clear, fragrance and paraben free and is available in SPFs 15, 30 and 50 as well as the iconic SPF20. The new range is available in both 200ml and a travel friendly 100ml size from all major grocery and pharmacy retailers. The RRP (rmended retail price) of P20 is 100ml 13.29 and 200ml 24.49. Disclosure:- I was sent the P20 Sun Protection FOC for the purpose of this review but all opinions are my own honest opinions.

Bake Your Dreamse e with Tate 038 Lyle Tate amp Lyle Bake Your Dreamse e Bake Your Dreamse e from Tate amp LyleSugars8211 launched toinspirebudding bakers to follow their baking dreams, with 1million worth of prizes and rewards available to be won. Tate amp Lyle the family friend to us all are aiming to help people realize their dreams. Prizesinclude a 5,000 cash reward for up to five baking entrepreneurs to provide financial support to kick start their baking business. Up-anding bakers can apply for the prizes by picking up a participating Bake Your Dreamse e pack of Tate amp Lyle Baking Sugaror Lyles Golden Sp Baking bottles and submit their pack code and baking dream attasteandsmile/bakingdreams . The campaign launched last week, with the creation of an installation of an edible bank (see below for the images)es on the back of research which reveals that 40 per cent of Brits dream of ditching their day job and starting their own business with 20 per cent dreaming of opening their own baking business. So why not Bake Your Dreamse e Meringue Words These meringue words are a fun way of writing some edible messages for a birthday, anniversary or festive celebration. They also make a lovely place name for dinner or wedding parties. Makes: about 36 words Prep time: 30 minutes Cooking time: 1 hours, plus overnight in the oven 3 large egg whites or 95g (3oz) liquid egg white 185g (6oz) Tate amp Lyle Fairtrade Golden Caster Sugar Christmas red, egg yellow, rose, lilac, mint green and baby blue paste food colours, or fewer or more as youd like, fromsquires-shop You will also need 3 baking trays lined with parchment paper, 6 disposable piping bags fitted with 1cm () plain nozzles or snip off the tips instead, and 6 paint shes, or fewer or more depending on your colour choices.

Preheat the oven to 200C/Fan180, 400F, Gas 6. Tip the sugar onto one of the baking trays and spread it out in an even layer. Warm through on the middle shelf of the oven for about 3-4 minutes or until the sugar feel hot to touch and has lightly coloured, stirring once. Dont let it caramelize. Pour into a small bowl. Reduce the oven heat down to its lowest, 110C/Fan90C, 225F, Gas . As soon as the sugar is ready, using an electric mixer, add the whites to the bowl and whisk at high speed until it is light and foamy, for about 1 minute. Slowly add the hot sugar. a dessertspoon at a time, and continue whisking until the mixture has cooled and is very thick and glossy. Scrape down the sides halfway through.

This will take about 5 minutes. Turn the sides of the piping bag down to the nozzle and, using a paintsh, paint 3 lengths of one of the food colour pastes from the nozzle to about 10cm (4) upwards. Carefully spoon in some of the meringue, and carefully pull the bag upwards over the nozzle and use a little to stick down the paper on the baking tray. Alternatively, if youre not using nozzles, just snip the tips off with a pair of scissors. Pipe some letters on the baking trays, slightly spaced apart. Then repeat with the rest of the meringue and food colours. Bake on the top and middle shelves of the oven for 1 hour, swapping the trays over halfway through.

The meringues are ready when they are crisp on the outside and the bases are dry and not at all sticky. Turn off the oven and leave them to cool in the oven for a few hours or overnight. Make-ahead The meringues can be made up to 2 weeks ahead and stored in an air-tight container.

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