英文药名：ECARD Combination Tablets(Candesartan Cilexetil/Hydrochlorothiazide) 中文药名：坎地沙坦酯/氢氯噻嗪配合片 生产厂家：武田制药 エカード配合錠LD／エカード配合錠HD 治疗类别名称 血管紧张素II受体拮抗剂/利尿的药物组合 批准上市时间：2009年3月 商標名 ECARD Combination Tablets LD ECARD Combination Tablets HD 坎地沙坦酯 化学構造式 一般名 カンデサルタン　シレキセチル（Candesartan Cilexetil）〔JAN〕 化学名 （1RS）-1-（Cyclohexyloxycarbonyloxy）ethyl 2-ethoxy-1-｛［2´-（1H-tetrazol-5-yl）biphenyl-4-yl］methyl｝-1H-benzo[d]imidazole-7-carboxylate 分子式 C33H34N6O6 分子量 610.66 性状 坎地沙坦酯是一种白色晶体或结晶粉末。酯（100），以促进微溶，稍少溶于甲醇，微溶于乙醇（99.5），和几乎不溶于水。甲醇溶液（1→100）示出了没有旋光性。水晶多态性观察。 氢氯噻嗪 化学構造式 一般名 ヒドロクロロチアジド（Hydrochlorothiazide）〔JAN〕 化学名 6-Chloro-3，4-dihydro-2H-1，2，4-benzothiadiazine-7-sulfonamide 1，1-dioxide 分子式 C7H8ClN3O4S2 分子量 297.74 性状 氢氯噻嗪是一种白色结晶或结晶性粉末，无臭，味微苦。它易溶于丙酮，稍难溶于乙腈，极微溶于水或乙醇中（95），并在乙醚中几乎不溶。易溶于氢氧化钠试液。 适应症 高血压 用法用量 成人每天口服一次（坎地沙坦酯/4毫克/6.25mg或为8mg/6.25mg的氢氯噻嗪），每次1片。 药效药理 1. 通过联合使用坎地沙坦酯和双氢的降血压作用 在自发性高血压大鼠，通过联合使用坎地沙坦酯和氢氯噻嗪，已经观察到增强坎地沙坦酯的降血压作用的。此外，不允许在通过坎地沙坦西酯利尿双氢影响。 2. 降压作用机制 坎地沙坦酯的降压作用，被迅速水解在体内成为活性代谢坎地吸收过程，拮抗血管紧张素II主要在血管平滑肌受体，其强大的血管的血管紧张素II类型1（AT1）由于由抑制收缩效应在周围血管阻力的降低。此外，在经由AT1受体肾上腺醛固酮释放的抑制作用被认为是参与关于抗高血压作用一部分。 降压嗪的作用机制尚不清楚。布什政府最初减少细胞外液量和心输出量。然而，持续的在长期给药时的降压效应是由于血管阻力的降低，但细胞外液体积将保持稍微减弱，心输出被返回到起始值前的治疗。轻微但伴随着细胞外液体积的降低体内的Na +量减少，降低了次级细胞内Ca 2+浓度由血管平滑肌细胞中的Na +浓度的降低，血管平滑肌细胞，血管收缩激素的反应性还原Yowashi，机制可以被认为是由于这样的事实，外周血管阻力降低。 3. 肾素 - 血管紧张素系统的影响 高血压74例（原发性高血压56例，高血压18例，肾功能衰竭）的目标，坎地沙坦酯每日一次1-12毫克，血浆肾素活性，血管紧张素I的结果重复剂量研究增加的浓度和血浆血管紧张素II浓度能够被看见。 包装规格 配合錠LD ：100錠（10錠×10）、140錠（14錠×10）、500錠（バラ、10錠×50）、700錠（14錠×50）、1,000錠（10錠×100） 配合錠HD ：100錠（10錠×10）、140錠（14錠×10）、500錠（バラ、10錠×50）、700錠（14錠×50）、1,000錠（10錠×100） 制造厂商 武田化学工业有限公司 ECARD Combination Tablets LD/HD(Candesartan Cilexetil/Hydrochlorothiazide) ECARD Combination Tablets LD（エカード配合錠LD）  Brand name : ECARD Combination Tablets LD 　Active ingredient: Candesartan cilexetil  Hydrochlorothiazide 　Dosage form: very pale yellow oval tablets, major axis 8.6 mm, minor axis 5.1 mm, thickness 3.0 mm 　Print on wrapping: (Face) エカードLD 293 (Back) エカードLD -------------------------------------------------- ECARD Combination Tablets HD（エカード配合錠HD）  Brand name : ECARD Combination Tablets HD 　Active ingredient: Candesartan cilexetil  Hydrochlorothiazide 　Dosage form: very pale pink oval tablets, major axis 8.6 mm, minor axis 5.1 mm, thickness 3.0 mm 　Print on wrapping: (Face) エカードHD 294 (Back) エカードHD -------------------------------------------------- Effects of this medicine This medicine lowers blood pressure by reducing peripheral vascular resistance via antagonism against receptor for the pressor substance angiotensin II as well as by increasing urine output via inhibition of sodium and water reabsorption in the kidney. Usually, used for treatment of hypertension. Before using this medicine, be sure to tell your doctor and pharmacist •If you ever experienced any allergic reaction (itch, rash etc.) to any medicine. If you scarcely void urine; are on hemodialysis; or have electrolyte imbalance (abnormal blood sodium, potassium, calcium levels), renal disease, liver disorder, coronary arterial sclerosis, cerebral arterial sclerosis, diarrhea/vomiting, or hyperparathyroidism. If you are on low-salt diet, in a post-sympathectomy state, in a preoperative state. If you or any one among your parents and siblings have gout/diabetes mellitus. •If you are pregnant or breastfeeding. •If you are taking any other medicinal products. (Some medicines may interact to enhance or diminish medicinal effects. Beware of over-the-counter medicines and dietary supplements as well as other prescription medicines.) Dosing schedule (How to take this medicine) •Your dosing schedule prescribed by your doctor is <<to be written by a healthcare professional>> •For adults, take 1 tablet at a time, once a day. Strictly follow the instructions of your doctor/pharmacist. •If you miss a dose, take the missed dose as soon as possible. However, let more than 8 hours pass before taking the next dose. DO NOT take double doses to make up for the missed dose. •If you took too much of the medicine (more than ordered), check with your doctor/pharmacist. •Do not stop taking the medicine without the instructions of your doctor. Precautions while taking this medicine •As dizziness and light-headedness may appear due to excessive lowering of blood pressure, take extra care when working at heights or operating dangerous machinery such as driving a car. •Caution should be exercised as alcohol drinking may intensify orthostatic hypotension (dizziness on standing up). Possible adverse reactions to this medicine Common side effects are reported as below. If any of them occurs, check with your doctor/pharmacist: rash, itching, photosensitivity, breathing difficulty, hot flush, dizziness, light-headedness, dizziness on standing up, palpitation, glow, extrasystoles, headache, nausea, stomatitis, taste abnormality, constipation, dry mouth, anemia, malaise, frequent urination, edema, cough, erectile dysfunction, abnormal vision, etc. The symptoms described below are rarely seen as initial symptoms of the adverse reactions indicated in brackets. If any of these symptoms occur, stop taking this medicine and see your doctor immediately. •swelling of face/tongue/throat, breathlessness [angioedema] •feeling cold, vomiting, loss of consciousness [shock, syncope, loss of consciousness] •decreased urination output, swelling of face and hands/feet, fever [acute renal failure] •numbness of hands/feet and lips, muscle weakness [hyperkalemia] •dullness, loss of appetite, nausea [hyponatremia] •yellowing of the skin or whites of the eyes, dullness, loss of appetite [liver dysfunction, jaundice] •fever, sore throat, dullness [agranulocytosis] •lassitude, muscle pain, brown urine  [rhabdomyolysis] •fever, dry cough, breathlessness [interstitial pneumonia, pulmonary edema] •fever, muscle pain/arthralgia, facial erythema [exacerbation of systemic lupus erythematosus] •cold sweat, feeling hungry, tremor in hands [hypoglycemia] •bleeding tendency, purpura, fever [aplastic anemia, hemolytic anemia] •bleeding tendency, purpura [necrotizing angiitis] •numbness of hands/feet and lips, nausea [anaphylactic reaction] •fever, dullness, rash [toxic epidermal necrolysis] •fever, rash, joint pain [interstitial nephritis] The above symptoms do not describe all the adverse reactions to this medicine. Consult with your doctor or pharmacist if you notice any symptoms of concern other than those listed above. Storage conditions and other information •Keep out of the reach of children. Store away from heat and humidity. •Discard the remainder. Do not store them. http://www.info.pmda.go.jp/go/pack/2149111F1028_1_11/