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Candesartan Cilexetil-Hydrochlorothiazide brings together two medicines with different actions: Candesartan Cilexetil, an angiotensin II receptor blocker, and Hydrochlorothiazide, a diuretic (water tablet).

Candesartan Cilexetil is itself inactive; it is a prodrug that gets converted to its active form, Candesartan, as it is absorbed from the gut. Candesartan works by selectively blocking angiotensin II from attaching to the AT1 receptor found in tissues such as blood vessel walls and the adrenal glands. Since angiotensin II is what causes blood vessels to narrow and triggers the release of aldosterone, blocking its action in this way helps blood vessels relax and lowers aldosterone secretion.

Hydrochlorothiazide, the diuretic component, belongs to the thiazide group. It acts on the kidney tubules, where it directly increases the excretion of sodium. This diuretic effect also reduces the volume of plasma in the body, and this in turn indirectly raises renin activity and aldosterone secretion, increases potassium loss in the urine, and lowers potassium levels in the blood. Because this renin-aldosterone response is itself driven by angiotensin II, giving Candesartan alongside Hydrochlorothiazide helps counteract the potassium loss that Hydrochlorothiazide would otherwise cause on its own.

Not recommended for use during pregnancy or while breastfeeding.

For children, the safety and effectiveness of candesartan cilexetil with hydrochlorothiazide have not been established.