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Drug Safety-related Labeling Changes (SrLC)

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ATACAND HCT (NDA-021093)

(CANDESARTAN CILEXETIL; HYDROCHLOROTHIAZIDE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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08/20/2020 (SUPPL-21)

Approved Drug Label (PDF)

5 Warnings and Precautions

PRECAUTIONS

Information for Patients

Newly added following ‘Hyperkalemia’:

Non-melanoma Skin Cancer

Instruct patients taking hydrochlorothiazide to protect skin from the sun and undergo regular skin cancer screening.

6 Adverse Reactions

Postmarketing Experience

Newly added information underlined:

Musculoskeletal: muscle spasm

Non-melanoma Skin Cancer: Hydrochlorothiazide is associated with an increased risk of non- melanoma skin cancer. In a study conducted in the Sentinel System, increased risk was predominantly for squamous cell carcinoma (SCC) and in white patients taking large cumulative doses. The increased risk for SCC in the overall population was approximately 1 additional case per 16,000 patients per year, and for white patients taking a cumulative dose of greater than or equal to 50,000 mg the risk increase was approximately 1 additional SCC case for every 6,700 patients per year.

Skin

02/09/2016 (SUPPL-19)

Approved Drug Label (PDF)

7 Drug Interactions

Interactions with Candesartan Cilexetil

  • Coadministration of ATACAND HCT with potassium sparing diuretics, potassium supplements, potassium-containing salt substitutes or other drugs that raise serum potassium levels may result in hyperkalemia. Monitor serum potassium in such patients.
Interactions with Hydrochlorothiazide
  • Diazoxide - the hyperglycemic effect of diazoxide may be enhanced by thiazides.
  • Noradrenaline - Thiazides may decrease arterial responsiveness to noradrenaline, but not enough to preclude effectiveness of the pressor agent for therapeutic use.
  • Steroids or Adrenocorticotropic Hormone - Hypokalemia may develop during concomitant use of steroids or adrenocorticotropic hormone (ACTH).
  • Cytotoxic products - Thiazides may reduce the renal excretion of cytotoxic medicinal products (e.g. cyclophosphamide, methotrexate) and potentiate their myelosuppressive effects.
  • Cyclosporine - Concomitant treatment with cyclosporine may increase the risk of hyperuricemia and gout-type complications.