Blopress is used for:

• treating high blood pressure (hypertension) in adult patients and in children and adolescents aged 6 to under 18 years.
• treating adult heart failure patients with reduced heart muscle function, when Angiotensin Converting Enzyme (ACE) inhibitors cannot be used or in addition to ACE inhibitors when symptoms persist despite treatment and mineralocorticoid receptor antagonists (MRA) cannot be used (ACE inhibitors and MRAs are medicines used to treat heart failure).

Do not take Blopress

• if you are allergic to candesartan cilexetil or any of the other ingredients of this medicine.
• if you are more than 3 months pregnant (it is also better to avoid Blopress in early pregnancy).
• if you have severe liver disease or biliary obstruction (a problem with the drainage of the bile from the gall bladder).
• if the patient is a child under 1 year of age.
• if you are taking a blood pressure lowering medicine containing aliskiren and you have diabetes or impaired kidney function. If you are not sure if any of these apply to you, talk to your doctor or pharmacist before taking Blopress.

Talk to your doctor before taking Blopress

• if you have heart, liver or kidney problems, or are on dialysis.
• if you have recently had a kidney transplant.
• if you are vomiting, have recently had severe vomiting, or have diarrhoea.
• if you have a disease of the adrenal gland called Conn’s syndrome (also called primary
  hyperaldosteronism).
• if you have low blood pressure.
• if you have ever had a stroke.
• you must tell your doctor if you think you are (or might become) pregnant. Blopress is not
  recommended in early pregnancy, and must not be taken if you are more than 3 months pregnant, as it may cause serious harm to your baby if used at that stage.
• if you are taking any of the following medicines used to treat high blood pressure:
  - an ACE-inhibitor (for example enalapril, lisinopril, ramipril), in particular if you have diabetes related kidney problems.
  - aliskiren
• if you are taking an ACE-inhibitor together with a medicine which belongs to the class of medicines known as mineralocorticoid receptors antagonists (MRA). These medicines are for the treatment of heart failure. Your doctor may check your kidney function, blood pressure, and the amount of electrolytes (e.g. potassium) in your blood at regular intervals.
• if you are going to have an operation (tell your doctor/dentist), this is because Blopress, when combined with some anaesthetics, may cause a drop in blood pressure.

Children and adolescents

Blopress must not be given to children under 1 year of age due to the potential risk to the developing kidneys.

Other medicines and Blopress

Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines. Blopress can affect the way some other medicines work and some medicines can have an effect on Blopress. If you are using certain medicines, your doctor may need to do blood tests from time to time. In particular, tell your doctor if you are using any of the following medicines as your doctor may need to change your dose and/or take other precautions:

• Other medicines to help lower your blood pressure, including beta-blockers, diazoxide and ACE inhibitors such as enalapril, captopril, lisinopril or ramipril.
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, diclofenac, celecoxib or etoricoxib (medicines to relieve pain and inflammation).
• Acetylsalicylic acid (if you are taking more than 3 g each day) (medicine to relieve pain and inflammation).
• Potassium supplements or salt substitutes containing potassium (medicines that increase the amount of potassium in your blood).
• Heparin (a medicine for thinning the blood).
• Water tablets (diuretics).
• Lithium (a medicine for mental health problems).
• If you are taking an ACE-inhibitor or aliskiren
• If you are being treated with an ACE-inhibitor together with certain other medicines to treat your
  heart failure, which are known as mineralocorticoid receptors antagonists (MRA) (for example spironolactone, eplerenone).

Pregnancy

Blopress is not recommended in early pregnancy, and must not be taken when more than 3 months pregnant, as it may cause serious harm to your baby if used after the third month of pregnancy.

Breast-feeding

Tell your doctor if you are breast-feeding or about to start breast-feeding. Blopress is not recommended for mothers who are breast-feeding.

Driving and using machines
Some people may feel tired or dizzy when taking Blopress. If this happens to you, do not drive or use any tools or machines.

Blopress contains lactose.

Lactose is a type of sugar. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.

How to take Blopress

• You can take Blopress with or without food.
• Swallow the tablet with a drink of water.
• Try to take the tablet at the same time each day. This will help you to remember to take it. Blopress 4mg, 8mg, 16mg and 32mg tablets: The tablet can be divided into equal doses.
• When you are prescribed Blopress, discuss with your doctor before drinking alcohol. Alcohol may make you feel faint or dizzy.

Possible side effects

Stop taking Blopress and seek medical help immediately if you have any of the following allergic reactions:

• difficulties in breathing, with or without swelling of the face, lips, tongue and/or throat
• swelling of the face, lips, tongue and/or throat, which may cause difficulties in swallowing
• severe itching of the skin (with raised lumps).
• Blopress may cause a reduction in number of white blood cells. Your resistance to infection may be decreased and you may notice tiredness, an infection or a fever. If this happens contact your doctor. Your doctor may occasionally do blood tests to check whether Blopress has had any effect on your blood (agranulocytosis).

Other possible side effects include:

• Feeling dizzy/spinning sensation.
• Headache.
• Respiratory infection.
• Low blood pressure. This may make you feel faint or dizzy.
• Changes in blood test results: an increased amount of potassium in your blood, especially if you already have kidney problems or heart failure. If this is severe you may notice tiredness, weakness, irregular heart beat or pins and needles.
• Effects on how your kidneys work, especially if you already have kidney problems or heart failure. In very rare cases, kidney failure may occur.
• Swelling of the face, lips, tongue and/or throat.
• A reduction in your red or white blood cells. You may notice tiredness, an infection or a fever.
• Skin rash, lumpy rash (hives).
• Itching.
• Back pain, pain in joints and muscles.
• Changes in how your liver is working, including inflammation of the liver (hepatitis). You may notice tiredness, yellowing of your skin and the whites of your eyes and flu like symptoms.
• Cough.
• Nausea.
• Changes in blood test results: a reduced amount of sodium in your blood. If this is severe then you may notice weakness, lack of energy, or muscle cramps.

In children treated for high blood pressure, side effects appear to be similar to those seen in adults, but they happen more often. In addition, sore throat is a very common side effect in children and runny nose, fever and increased heart rate are common side effects in children.

References:

https://www.hpra.ie/img/uploaded/swedocuments/2185134.PA1547_002_002.55e7378b-c9e0-4ca8-9e13-021d271d9f83.000001pil.170228.pdf

https://www.drugs.com/uk/blopress-tablets-16mg-leaflet.html

https://www.medicines.ie/medicines/blopress-tablets-31455/smpc