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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> ATACAND
        
(Message started by: catlind on Feb 14^th, 2005, 12:32pm)

Title: ATACAND
Post by catlind on Feb 14^th, 2005, 12:32pm

Okay, got this info from Svenn today, and I would like to get some feedback from everyone especially the resident gurus.

A 45 year old female with chronic clusters - has tried all abortives, all preventatives and transitional drugs with no success. Has been through surgery again, with no success.

By accident a doctor at the drug center came across Atacand and prescribed it (I hope that's right) She is currently taking 32 mg of Atacand (max dose according to RXList) and has been completely pain free for 3 weeks.

Atacand is a blood pressure medication.

Can anyone shed some light on why this particular blood pressure medication has worked (in her opinion miraculously) when others such as verapamil have failed?

Cat

Edited to add the doctor comes from a highly regarded headache center in trondheim.

Title: Re: ATACAND
Post by floridian on Feb 14^th, 2005, 2:47pm

Well, its labeled a "angiotensin II receptor blocker" although it may be doing other things as well. Some other info about atacand (candesartand) - purely speculative as to how it works at this point.

A direct neuroprotective effect: ?

Quote:

Curr Hypertens Rep. 2004 Aug;6(4):257-66.
Are angiotensin receptor blockers neuroprotective?
Thone-Reineke C, Zimmermann M, Neumann C, Krikov M, Li J, Gerova N, Unger T. Center for Cardiovascular Research (CCR)/Institut fur Pharmakologie und Toxikologie, Campus Charite Mitte Charite--Universitatsmedizin Berlin, Hessische Strasse 3-4, 10115 Berlin, Germany.

Improved blood flow: ?

Quote:

Am J Physiol Heart Circ Physiol. 2004 Apr;286(4):H1425-32. Epub 2003 Nov 26. ACE inhibitors and statins acutely improve endothelial dysfunction of human coronary arterioles. Tiefenbacher CP, Friedrich S, Bleeke T, Vahl C, Chen X, Niroomand F.

atacand affects several neurotransmitters in the hypothalamus:

Quote:

Brain Res Bull. 2001 Apr;54(6):689-94. The differential effect of angiotensin II and angiotensin 1-7 on norepinephrine, epinephrine, and dopamine concentrations in rat hypothalamus: the involvement of angiotensin receptors.
Pawlak R, Napiorkowska-Pawlak D, Takada Y, Urano T, Nagai N, Ihara H, Takada A.

Title: Re: ATACAND
Post by Bob P on Feb 14^th, 2005, 2:53pm

Women don't get clusters?

Title: Re: ATACAND
Post by sandie99 on Feb 15^th, 2005, 1:34am

on 02/14/05 at 14:53:59, Bob P wrote:

Women don't get clusters?

Bob... ::)

Title: Re: ATACAND
Post by Svenn on Feb 18^th, 2005, 6:46am

Was talking to my GP about atacand today:

What he said was : I would NEVER give out Verap as a preventative for headaches as first option,but ATACAND.Less sideeffects and all tests shows that it work better as preventative then verap.
Main problem as i see it is that ATACAND is NOT reqognized for clustertreatment.
Guess that is one reason because they have started a double blind study on this here

Will be back with more news as i get it.

BTW im off verap now and testing atacand mainly for my bp.Going to the GP next mnth for a resume on atacand

Svenn

Title: Re: ATACAND
Post by Gator on Feb 21^st, 2005, 5:20am

We're just a bunch of willing guinea pigs aren't we. Always willing to test that next drug that may be the one. Atacand sounds like it has promise. Keep us posted on how the atacand is working for you.

Title: Re: ATACAND
Post by Svenn on Feb 25^th, 2005, 12:54pm

My first day on ATACAND folks.
Had to stay of verap for 4 days before starting ATACAND
this weekend im on only 8mg , but from Monday im on my full doze=16mg
Going to a test at the GP on 18/3 to check if everything is OK

Svenn

Title: Re: ATACAND
Post by Svenn on Feb 28^th, 2005, 4:04am

Strange but my ch has decreased to MILD shadows now after been on atacand for 5 days today.

Not sure i can blame all that on Atacand though.

I did start the treatment on 8mg/daily

Im on 16mg/daily on that stuff.

No more info,but will post as soon as i get more news

Svenn

Title: Re: ATACAND
Post by Gator on Feb 28^th, 2005, 6:42pm

on 02/28/05 at 04:04:26, Svenn wrote:

I guess the first real question is how good is this working as compared to Verapamil?

Second question would be what side effects are you having?

The last question you won't be able to help me with, but does anyone know the cost of Atacand in the US?

I'm glad it seems to be working for you, Svenn. This is another thread I'm going to keep watching.

Title: Re: ATACAND
Post by Svenn on Feb 28^th, 2005, 7:10pm

on 02/28/05 at 18:42:37, Gator wrote:

I feel its starts kick in sooner then verap.Had to stay off verap 120X7 verap retard daily for 4 days before starting on atacand

I do NOT have the "sleepy" feeling that verap gave me .None what so ever

And you`re right Gator,i cant help you with the 3 ?

Damn im lucky to live on this side of the pond when its about medication and healthissue

Will post more as soon as i know more

Svenn

Title: Re: ATACAND
Post by Svenn on Mar 6^th, 2005, 6:14am

Still no hits so far

Title: Re: ATACAND
Post by Svenn on Mar 10^th, 2005, 1:44pm

Still no hits

Title: Re: ATACAND
Post by E-Double on Mar 10^th, 2005, 9:54pm

so great to hear!!!!

Title: Re: ATACAND
Post by Svenn on May 27^th, 2005, 9:21am

Bumping to tell you all still no hits.None what so ever

Svenn

Title: Re: ATACAND
Post by PerryGR on May 28^th, 2005, 3:05pm

That's great news Svenn! Thank you for sharing this with us!

PFDAN to all,
Perry.

Title: Re: ATACAND
Post by Gator on May 28^th, 2005, 11:38pm

I love hearing about someone being pain free. Means there is still hope for the rest of us schlubs. My next neuro appointment is June 2. Will discuss it with the doc then.

Title: Re: ATACAND
Post by lionsound on May 30^th, 2005, 8:12am

WOW!!! That's wonderful, Svenn!!!! :)

Title: Re: ATACAND
Post by Giovanni on May 30^th, 2005, 10:03am

Candesartan (Atacand) PREVENTS the constriction of blood vessels. I wonder if it is any conflict with abortives such as imitrex?

John

Title: Re: ATACAND
Post by magman on May 30^th, 2005, 6:43pm

on 05/30/05 at 10:03:26, Giovanni wrote:

Candesartan (Atacand) PREVENTS the constriction of blood vessels. I wonder if it is any conflict with abortives such as imitrex?

John

Doc put me on 16mg of Atacand, 150mg x 2 of Lithium (headed to 300mg x2 Tue), Imitrex 6mg (I use only 2mg or 1/3 of a stat dose per attack), and DHE NS.

The Atacand appears to work well with Trex as relief arrives in about 5 to 10 minutes.

Title: Re: ATACAND
Post by Renee on May 31^st, 2005, 5:07am

Magman,

It's GREAT to hear you are finding some relief. ;)

I hope your new cocktail continues to work for a long time.

Renee

Title: Re: ATACAND
Post by javi_spain on May 31^st, 2005, 11:49am

Svenn

Thanks for keeping us updated.

Javier

Title: Re: ATACAND
Post by Roxy on May 31^st, 2005, 12:02pm

Svenn, I'm so glad you have found relief with Atacand. You deserve it!

I've been on 16mg for the last three weeks, and it doesn't seem to be working for me. I'm going through triptans like candy. Head is breaking through the Amerge and Relpax, Zomig NS will keep me for about 5 hours. After that, I'm getting hit pretty much every hour and a half like clockwork. O2 isn't doing it's thing either for some reason. It's been bad enough that I have readily mixed my triptans......scared the shit out of my family....... :o.

I'm calling the neuro today to up the Atacand....I'm going to at least give it a shot at 32mg.

T 8)

Title: Re: ATACAND
Post by Margi on May 31^st, 2005, 12:07pm

on 05/31/05 at 12:02:05, Roxy wrote:

It's been bad enough that I have readily mixed my triptans......scared the shit out of my family.......
T 8)

Roxy!! :o Please don't do that! I know you're hurting, honey - but please be careful. BIG hugs - you WILL get through this, you're a strong gal. Please try to back off the med mixing though, ok? Could it be that all those are making things worse for you? Mike really gets a lot more hits when he takes more 'trex. O2 has also failed him at times, too, but he gets to the point you're at, he backs off everything and lets his system rebalance itself for a couple of days and does a water flush. That really seems to help him.

Please, darlin - don't play with fire, ok? :'(

hugs,
Margi

Title: Re: ATACAND
Post by Woobie on May 31^st, 2005, 1:43pm

Roxy.........
I am no one - i dont get clusters..... so i cannot phathom being in so much pain that you would do something you know already almost killed you...

so - dont get mad at me - cuz i really dont GET IT - and I KNOW that I dont....... but dammit....

DONT DO THAT!!!!!!!!!!!

It's been discussed here several times about people's theory that more meds make things worse... but I can see how when you're in the moment - you dont care - you just want it gone. It's a hard place to be in, i'm sure.

Prayin for you Rox.............

Great news for you Svenn!!!!!!!!!!

tina :-*

Title: Re: ATACAND
Post by thomas on May 31^st, 2005, 1:49pm

on 05/31/05 at 13:43:36, Woobie wrote:

when you're in the moment - you dont care - you just want it gone. It's a hard place to be

That's exactly how it can be. :-/

Title: Re: ATACAND
Post by Bob P on May 31^st, 2005, 4:00pm

Quote:

After that, I'm getting hit pretty much every hour and a half like clockwork.

I've become a firm believer that triptans increase attack frequency for me.

This cycle I tried imitrex tabs (100's cut in half to make 50's). First day good. Second day the attacks started coming every 1.5 to 2 hours. Quit and went back to cafergot - 2 to 3 attacks a day. Same thing happened with Maxalt and Frova. I don't think I'll ever use the triptans again (sure hope they hurry with the CGRP antagonists).

Title: Re: ATACAND
Post by Lizzie2 on Jun 7^th, 2005, 1:54am

Just some more random drug info on Atacand -- I haven't tried this one yet or any AngiotensinII Receptor Blockers. My mom takes one for hypertension and does very well on it. I don't think she's had any notable side effects on the med she takes...it's not Atacand, but I'm blanking on the name - just know it's in the same category. At any rate, here's a little more info:

Quote:

DrugPoints(R) System: CANDESARTAN CILEXETIL

Common Tradenames (See Complete Tradename Listing)
ATACAND
Class
angiotensin ii receptor antagonist
antihypertensive
cardiovascular
Dosage, Adult (usual)
Hypertension: 16 mg ORALLY once daily or in 2 divided doses; range 8-32 mg ORALLY once or twice daily
Heart failure: initial, 4 mg ORALLY once daily, double dose at approximately 2-wk intervals, as tolerated; target dose 32 mg daily
Dosage, Pediatric, (usual)
safety and efficacy not established in pediatric patients
Dose Adjustments:
hepatic insufficiency: consider a lower starting dose in patients with moderate hepatic impairment
renal impairment: moderate to severe (CrCl 15-60 mL/min/1.73m(2)), 8 mg daily
Administration
may be given with/without food
Monitoring
renal and hepatic function
serum potassium
How Supplied
4 MG, 8 MG, 16 MG, 32 MG TAB
Indications
FDA labeled indications
Hypertension, alone or in combination with other antihypertensive agents
Heart failure (NYHA class II to IV, ejection fraction 40% or less) to reduce cardiovascular mortality and hospitalizations
Contraindications
hypersensitivity to candesartan products
Precautions
angioedema (past or present)
excessive hypotension - volume depletion
hepatic or renal impairment
hyperkalemia
hypertrophic cardiomyopathy
pregnancy, second and third trimesters
stenosis, aortic, renal artery, or mitral valve
surgery/anesthesia
Adverse Effects
COMMON
dizziness
headache
Drug Interactions
licorice
lithium
ma huang
yohimbine
Pregnancy Category
D
Breast Feeding
potential risk; change in therapy or care plan may be advisable

© 1974 - 2005 Thomson MICROMEDEX. All rights reserved.

There's a whooooooole bunch more in depth info on another site, but I know it would make me post it over like 4 pages because it is long, but here are just two more informative points from this other site - one is on contraindications with lithium and the other is the drug pricing info...HTH:

Quote:

Lithium
Reversible increases in serum lithium concentrations and toxicity have been reported during concomitant administration of lithium with ACE inhibitors, and with some angiotensin II receptor antagonists. An increase in serum lithium concentration has been reported during concomitant administration of lithium with candesartan cilexetil, so careful monitoring of serum lithium levels is recommended during concomitant use.

Quote:

HOW SUPPLIED - EQUIVALENTS NOT AVAILABLE:

Tablet -- Oral -- 4 mg:

30.0's $44.45 Atacand Astra-Zeneca Pharmaceuticals 00186000431
Tablet -- Oral -- 8 mg:

30.0's $37.26 Atacand Allscripts Healthcare Solutions 54569471900

30.0's $44.45 Atacand Astra-Zeneca Pharmaceuticals 00186000831

60.0's $74.52 Atacand Allscripts Healthcare Solutions 54569471901
Tablet -- Oral -- 16 mg:

30.0's $43.40 Atacand Allscripts Healthcare Solutions 54569471400

30.0's $44.45 Atacand Astra-Zeneca Pharmaceuticals 00186001631

90.0's $133.38 Atacand Astra-Zeneca Pharmaceuticals 00186001654

100.0's $134.21 Atacand Astra-Zeneca Pharmaceuticals 00186001628

Tablet -- Oral -- 32 mg:

30.0's $60.13 Atacand Astra-Zeneca Pharmaceuticals 00186003231

90.0's $180.44 Atacand Astra-Zeneca Pharmaceuticals 00186003254

100.0's $168.00 Atacand Astra-Zeneca Pharmaceuticals 00186003228

Also is available as a combination of Candesartan Cilexetil and Hydrochlorothiazide, which is a diuretic.