Fenton Caroline, Scott Lesley J
Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand.
Drugs. 2005;65(4):537-58. doi: 10.2165/00003495-200565040-00007.
Candesartan cilexetil is the orally administered pro-drug of candesartan, a highly selective antagonist of the angiotensin II subtype 1 receptor that mediates the pressor activities of angiotensin II. Candesartan cilexetil is widely used for the treatment of hypertension and has recently been approved in Europe for the treatment of chronic heart failure (CHF) in patients with impaired left ventricular (LV) systolic function. Results of the CHARM (Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity) programme suggest that oral candesartan cilexetil reduces morbidity and mortality in patients with CHF and LV ejection fraction (LVEF) < or =40%. There are cardiovascular benefits when candesartan cilexetil is administered as an alternative to an ACE inhibitor, or as an add-on to current treatment regimens that include an ACE inhibitor, in symptomatic CHF. While tolerability is generally good, renal monitoring is required. The recent approval of candesartan cilexetil as both add-on and alternative therapy to ACE inhibitors in patients with CHF and impaired LV systolic function recognises the cardiovascular benefits of candesartan cilexetil in both types of treatment regimens.
坎地沙坦酯是坎地沙坦的口服前体药物，坎地沙坦是一种高选择性血管紧张素II 1型受体拮抗剂，可介导血管紧张素II的升压活性。坎地沙坦酯广泛用于治疗高血压，最近在欧洲已被批准用于治疗左心室（LV）收缩功能受损患者的慢性心力衰竭（CHF）。CHARM（坎地沙坦治疗心力衰竭：死亡率和发病率降低评估）项目的结果表明，口服坎地沙坦酯可降低CHF和左心室射血分数（LVEF）≤40%患者的发病率和死亡率。在有症状的CHF中，当坎地沙坦酯作为ACE抑制剂的替代品或作为包括ACE抑制剂的当前治疗方案的附加药物给药时，具有心血管益处。虽然耐受性一般良好，但需要进行肾脏监测。最近坎地沙坦酯被批准作为CHF和LV收缩功能受损患者ACE抑制剂的附加治疗和替代治疗，这认可了坎地沙坦酯在两种治疗方案中的心血管益处。
