Treatment with Candesartancilexetil, also known as Candesartan

The medication 

Candesartan was developed to treat high blood pressure, but it can also be effective against migraines. When you are prescribed this medication, it is therefore not to lower your blood pressure, but to treat your migraines. 

Mechanism of action 

Candesartan may work as a migraine preventive by stabilizing blood vessels, but the exact mechanism of action is not known. 

The effect of candesartan usually sets in after 1-3 weeks. On average, candesartan halves the number of migraine attacks. However, there is a great deal of individual variation in how well the medication works.

Side effects 

Candesartan is generally well tolerated. The medication rarely lowers normal blood pressure. In patients with low blood pressure, dizziness may occur when standing up. In rare cases, rashes, elevated potassium levels in the blood, as well as kidney and liver impairment may occur. 

Before starting treatment 

Before you begin treatment, your pulse and blood pressure must be measured, and the following blood tests must be performed: kidney/fluid levels and liver function tests. 

What is the dosage 

Typically, you start by taking 8 mg once daily for one week. Thereafter, 16 mg once daily. If there is no effect after 1-2 months, the dose may be increased to 24 mg once daily for one week, followed by 32 mg once daily. If there is no effect after 2 months, the dose is tapered down by 8 mg per week until you are off the medication entirely. 

If the treatment is effective, you continue for ½-1 year, after which the dose can often be slowly tapered off in consultation with your doctor. Some patients, however, need to use candesartan for several years.