Monitor Closely (1)candesartan increases and ethacrynic acid decreases serum potassium. Use Caution/Monitor. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Modify Therapy/Monitor Closely. candesartan increases and hydrochlorothiazide decreases serum potassium. candesartan increases effects of insulin aspart by unspecified interaction mechanism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. Either increases toxicity of the other by pharmacodynamic synergism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. Monitor Closely (1)candesartan increases and terbutaline decreases serum potassium. Monitor Closely (2)pindolol, candesartan. Modify Therapy/Monitor Closely. Candesartan may harm an unborn baby. Modify Therapy/Monitor Closely. Monitor Closely (1)candesartan, insulin degludec/insulin aspart. 2.1 Adult Hypertension 2.2 Pediatric Hypertension 1 to < 17 Years of Age 2.3 Adult Heart Failure DOSAGE FORMS AND STRENGTHS CONTRAINDICATIONS WARNINGS AND PRECAUTIONS 5.1 Fetal Toxicity 5.2. candesartan increases and chlorthalidone decreases serum potassium. Either increases toxicity of the other by pharmacodynamic synergism. candesartan and propranolol both increase serum potassium. Use Caution/Monitor. Avoid life-threatening adverse drug events. Use Caution/Monitor. Coadministration of ARBs with sparsentan is associated with increased risks of hypotension, syncope, hyperkalemia, and changes in renal function (eg, acute renal failure). Use Caution/Monitor. This website also contains material copyrighted by 3rd parties. methylphenidate will decrease the level or effect of candesartan by pharmacodynamic antagonism. Either increases toxicity of the other by Other (see comment). Monitor Closely (1)candesartan increases and gentamicin decreases serum potassium. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Use Caution/Monitor. Use Caution/Monitor. Decrease dose of angiotensin receptor blockers and monitor patients for signs and symptoms of hypotension and/or worsening renal function; if such events occur, consider further dose reduction of angiotensin receptor blocker or switching to alternative to angiotensin receptor blocker. Modify Therapy/Monitor Closely. Use Caution/Monitor. Monitor Closely (3)candesartan, nabumetone. Monitor Closely (1)amifostine, candesartan. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. Use Caution/Monitor. candesartan cilexetil/hydrochlorothiazide: Dosing, contraindications PRECAUTIONS: Before taking candesartan, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Risk of fetal compromise if given during pregnancy. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor.aspirin decreases effects of candesartan by pharmacodynamic antagonism. candesartan cilexetil - Drug Summary - PDR.Net Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Avoid or Use Alternate Drug. responsible for maintaining . indomethacin decreases effects of candesartan by pharmacodynamic antagonism. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxaprozin decreases effects of candesartan by pharmacodynamic antagonism. candesartan and propranolol both increase serum potassium. Risk of fetal compromise if given during pregnancy. Risk of hypotension. View the formulary and any restrictions for each plan. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for changes in glycemic control. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. aspirin/citric acid/sodium bicarbonate decreases effects of candesartan by pharmacodynamic antagonism. . Access your plan list on any device mobile or desktop. Use Caution/Monitor.betaxolol, candesartan. Use Caution/Monitor. Use Caution/Monitor. candesartan cilexetil + aliskiren contraindicated in diabetic patients; avoid combo in pts w/ CrCl 60; for all other pts, use alternative or monitor BP, potassium, renal fxn : combo may incr. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Either increases toxicity of the other by Other (see comment). Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. Both drugs decrease blood glucose.candesartan increases effects of insulin inhaled by unspecified interaction mechanism. sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of candesartan by Other (see comment). Use Caution/Monitor.ketoprofen decreases effects of candesartan by pharmacodynamic antagonism. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. candesartan and meloxicam both increase serum potassium. Use Caution/Monitor. cornsilk increases effects of candesartan by pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. ibuprofen IV decreases effects of candesartan by pharmacodynamic antagonism. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. candesartan and aceclofenac both increase serum potassium. Risk of fetal compromise if given during pregnancy. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. Either increases toxicity of the other by pharmacodynamic synergism. . voclosporin, candesartan. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of ARBS with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. candesartan increases effects of exenatide injectable suspension by Other (see comment). Minor (1)agrimony increases effects of candesartan by pharmacodynamic synergism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aliskiren, lithium, drugs that may increase the level of potassium in the blood (such as sparsentan, ACE inhibitors including benazepril/lisinopril, birth control pills containing drospirenone).Some products have ingredients that could raise your blood pressure or worsen your heart failure. Either increases effects of the other by pharmacodynamic synergism. risk of hypotension, hyperkalemia, renal impairment w/o additional benefit (additive effects, dual blockade of renin-angiotensin-aldosterone system) Use Caution/Monitor. Both drugs decrease blood glucose. Use Caution/Monitor. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, fenoprofen. Risk of hyperkalemia. Minor (1)candesartan, entecavir. Use Caution/Monitor. DRUG INTERACTIONS: See also Precautions section.Drug interactions may change how your medications work or increase your risk for serious side effects. ibuprofen IV decreases effects of candesartan by pharmacodynamic antagonism. Monitor Closely (1)candesartan increases and chlorthalidone decreases serum potassium. . Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Modify Therapy/Monitor Closely. candesartan and indomethacin both increase serum potassium. Use Caution/Monitor. Avoid or Use Alternate Drug. Candesartan: Indication, Dosage, Side Effect, Precaution - MIMS NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).Although candesartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Use Caution/Monitor. candesartan, eplerenone. Minor/Significance Unknown. Digoxin is indicated for the treatment of symptomatic heart failure and for the control of ventricular response in patients with atrial fibrillation . Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Either increases toxicity of the other by Other (see comment). Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Either increases toxicity of the other by pharmacodynamic synergism. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. candesartan increases and chlorothiazide decreases serum potassium. Use Caution/Monitor. Use Caution/Monitor. salsalate decreases effects of candesartan by pharmacodynamic antagonism. Monitor Closely (1)candesartan and salicylates (non-asa) both increase serum potassium. nabumetone decreases effects of candesartan by pharmacodynamic antagonism. Do not double the dose to catch up. Effect of interaction is not clear, use caution. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. candesartan and nebivolol both increase serum potassium. Use Caution/Monitor. candesartan and pindolol both increase serum potassium. While there may be individual differences with respect to recommendations for initial drug selection and use in specific patient populations, current evidence indicates that these antihypertensive drug classes all generally produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes. Either increases toxicity of the other by Other (see comment). Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Monitor Closely (1)methylphenidate transdermal decreases effects of candesartan by anti-hypertensive channel blocking. Monitor Closely (2)nadolol, candesartan. Monitor patients for changes in glycemic control. Avoid or Use Alternate Drug. Either increases toxicity of the other by Other (see comment). Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Monitor Closely (2)penbutolol, candesartan. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. dalteparin increases toxicity of candesartan by Other (see comment). Either increases toxicity of the other by Other (see comment). ibuprofen oral brand names and other generic formulations include: Aches-N-Pain Oral, Advanced Pain Relief Oral, Advil . Either increases toxicity of the other by Other (see comment). High blood pressure adds to the workload of the heart and arteries. Use Caution/Monitor. Avoid or Use Alternate Drug. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. candesartan and meloxicam both increase serum potassium. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. If I lose weight and am skinny my b.p. Use Caution/Monitor. Use Caution/Monitor. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, etodolac. This information is not individual medical advice and does not substitute for the advice of your health care professional. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Monitor Closely (3)candesartan, aspirin/citric acid/sodium bicarbonate. loss in sexual ability, desire, drive, or performance. Mechanism: pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. Monitor Closely (3)candesartan, ibuprofen. Use Caution/Monitor. Minor/Significance Unknown. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Modify Therapy/Monitor Closely. Use Caution/Monitor. candesartan and nabumetone both increase serum potassium. Use Caution/Monitor.voclosporin, candesartan. Monitor patients for changes in glycemic control. Candesartan Monograph for Professionals - Drugs.com Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (1)trimethoprim and candesartan both increase serum potassium. Use Caution/Monitor. enoxaparin increases toxicity of candesartan by Other (see comment). Monitor Closely (2)atenolol, candesartan. Either increases effects of the other by pharmacodynamic synergism. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, oxaprozin. SIDE EFFECTS: Dizziness, tiredness, or lightheadedness may occur as your body adjusts to the medication. candesartan, perindopril. Use Caution/Monitor. PDF Pr SANDOZ CANDESARTAN - pdf.hres.ca sparsentan, candesartan. Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of candesartan by Other (see comment). Serious - Use Alternative (1)candesartan, ramipril. Use Caution/Monitor.bisoprolol, candesartan. reishi increases effects of candesartan by pharmacodynamic synergism. candesartan and sulfasalazine both increase serum potassium. candesartan and sotalol both increase serum potassium. candesartan and etodolac both increase serum potassium. Risk of fetal compromise if given during pregnancy. Use Caution/Monitor. Monitor Closely (1)candesartan and acemetacin both increase serum potassium. Either increases toxicity of the other by Other (see comment). Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Either increases toxicity of the other by pharmacodynamic synergism. baroreceptors, renin-angiotensin-aldosterone system, etc.) Either increases effects of the other by pharmacodynamic synergism. "I was given these candesartan to control my blood pressure they have caused severe nasal problems for months and constantly needing to clear my throat and dry mouth not great during a pandemic when you cant get to see a doctor-has anyone else experienced nasal problems with this medication as I know it is one of the listed side effects ?" 2 / 10 2010atacand-hct-candesartan-hydrochlorothiazide-342344Drugs, 2010dyazide-triamterene-hydrochlorothiazide-342342Drugs, encoded search term (candesartan (Atacand)) and candesartan (Atacand), Follow-up Sinks Candesartan as Cardioprotection in Breast Cancer, AHS Releases Updated Guidance on Migraine Treatment, Protection From Trastuzumab Cardiotoxicity in Breast Cancer, Medscape Cardiologist Wealth & Debt Report 2021. candesartan and meclofenamate both increase serum potassium. Monitor Closely (1)candesartan increases and methyclothiazide decreases serum potassium. Either increases toxicity of the other by pharmacodynamic synergism. Both drugs decrease blood glucose. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, sulfasalazine. candesartan oral brand names and other generic formulations include: Atacand Oral. candesartan and oxaprozin both increase serum potassium. candesartan and canagliflozin both increase serum potassium. Monitor Closely (3)candesartan, etodolac. Use Caution/Monitor. heparin increases toxicity of candesartan by Other (see comment). candesartan increases and furosemide decreases serum potassium. I use periodically and it takes only a few days to drop my blood pressure. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. candesartan and triamterene both increase serum potassium. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. Modify Therapy/Monitor Closely. Use Caution/Monitor. candesartan increases and ethacrynic acid decreases serum potassium. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine. Both drugs decrease blood glucose. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor Closely (3)candesartan, sulfasalazine. Serious - Use Alternative (1)candesartan, perindopril. Common side effects of candesartan include back pain, dizziness, and cold- or flu-like symptoms such as sore throat and nasal congestion. Monitor Closely (1)candesartan and sacubitril/valsartan both increase serum potassium. Effect of interaction is not clear, use caution. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Monitor Closely (3)candesartan, oxaprozin. patiromer, candesartan. Monitor Closely (2)metoprolol, candesartan. Effect of interaction is not clear, use caution. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. candesartan increases and terbutaline decreases serum potassium. Monitor Closely (1)candesartan increases effects of insulin isophane human/insulin regular human by unspecified interaction mechanism. Use Caution/Monitor. Contraindicated. Effect of interaction is not clear, use caution. Monitor blood pressure and adjust dose of antihypertensive agent as needed. Use Caution/Monitor. Candesartan and Hydrochlorothiazide | Memorial Sloan Kettering Cancer Monitor Closely (1)candesartan and aceclofenac both increase serum potassium. candesartan increases effects of insulin regular human by unspecified interaction mechanism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. ketoprofen decreases effects of candesartan by pharmacodynamic antagonism. Minor (1)patiromer, candesartan. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Monitor Closely (1)candesartan, eplerenone. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Risk of fetal compromise if given during pregnancy. Monitor Closely (1)candesartan increases and cyclopenthiazide decreases serum potassium. aldesleukin increases effects of candesartan by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of fetal compromise if given during pregnancy. Effect of interaction is not clear, use caution. candesartan and ketorolac intranasal both increase serum potassium. Monitor Closely (3)candesartan, diflunisal. Either increases toxicity of the other by Other (see comment). Either increases toxicity of the other by pharmacodynamic synergism. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. candesartan cilexetil + aliskiren contraindicated in diabetic patients; avoid combo in pts w/ CrCl 60; for all other pts, use alternative or monitor BP, potassium, renal fxn : combo may incr. candesartan, benazepril. candesartan increases and torsemide decreases serum potassium. Modify Therapy/Monitor Closely. Candesartan: Uses, Price, Dosage, Side Effects, Substitute - myUpchar Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Modify Therapy/Monitor Closely. Monitor Closely (3)candesartan, flurbiprofen. candesartan and ketorolac both increase serum potassium. Modify Therapy/Monitor Closely. Either increases toxicity of the other by Other (see comment). Monitor Closely (3)candesartan, choline magnesium trisalicylate. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. candesartan, insulin degludec. Atacand is a prescription medicine used to treat the symptoms of high blood pressure (Hypertensio). Candesartan Contraindications. Use Caution/Monitor.penbutolol, candesartan. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Either increases toxicity of the other by Other (see comment). Monitor Closely (2)labetalol, candesartan. Monitor Closely (1)candesartan increases and furosemide decreases serum potassium. Monitor Closely (1)candesartan increases and bendroflumethiazide decreases serum potassium. Monitor Closely (1)candesartan and triamterene both increase serum potassium. candesartan and digoxin both increase serum potassium. Risk of fetal compromise if given during pregnancy. Minor (1)cornsilk increases effects of candesartan by pharmacodynamic synergism. Either increases toxicity of the other by Other (see comment). Minor (1)shepherd's purse, candesartan. Monitor Closely (1)candesartan and spironolactone both increase serum potassium. Otherwise, call a poison control center right away. Mechanism: pharmacodynamic synergism. 258 significant drug interactions. BSE procedure guidelines for the clinical application of stress - Heart Monitor Closely (1)candesartan and lornoxicam both increase serum potassium. Use Caution/Monitor. Atacand HCT may be used alone or with other medications. Use Caution/Monitor. Monitor Closely (1)lurasidone increases effects of candesartan by Other (see comment). Risk of fetal compromise if given during pregnancy. Use Caution/Monitor.naproxen decreases effects of candesartan by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. Mechanism: pharmacodynamic synergism. Either increases toxicity of the other by Other (see comment). All generic drug interactions for aspirin oral (lists will include brand and generic names): 2 contraindicated drug interactions. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor.esmolol, candesartan. Use Caution/Monitor. candesartan increases and gentamicin decreases serum potassium. Runny nose or sore throat may also occur. 8 serious drug interactions. Consult your doctor before breast-feeding. Consider decreasing dosage of antihypertensive agent. commonly, these are generic drugs. Use Caution/Monitor. The patient have to talk with a doctor if such clinical problems exist as diabetes, heart disease, heart illness, liver illness or renal system illness. Use Caution/Monitor. If it is near the time of the next dose, skip the missed dose. Monitor Closely (3)candesartan, sulindac. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, ketorolac. The 9 Tramadol Drug Interactions You'll Want to Avoid - GoodRx Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. Block angiotensin II receptor Inhibits vasoconstriction and aldosterone release Candesartan. Minor (1)candesartan and noni juice both increase serum potassium. Use Caution/Monitor. Use Caution/Monitor. Mechanism: pharmacodynamic synergism. Either increases toxicity of the other by pharmacodynamic synergism. I would like to know if there are any contraindications with taking the herb red yeast rice with these prescription medications: Topromax 100 mg bid; Zoloft 200 mg @ hs; Xanax 0.5 mg @ hs PRN and oxycodone 5 mg 2 tabs bid for chronic pain. Serious - Use Alternative (1)candesartan, trandolapril. Candesartan: Uses, Interactions, Mechanism of Action - DrugBank Online Antihypertensive drugs affect different areas of blood pressure control so in most cases, these agents are combined for synergistic effect.. Ninety percent of cases of hypertension have no known cause. Use Caution/Monitor. Effect of interaction is not clear, use caution. Use Caution/Monitor. Monitor patients for changes in glycemic control. Use Caution/Monitor. Monitor Closely (3)candesartan, ketorolac intranasal. Mechanism: pharmacodynamic synergism. meloxicam decreases effects of candesartan by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of fetal compromise if given during pregnancy. To help you remember to take candesartan, take it at around the same time (s) every day. Minor/Significance Unknown. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.candesartan, salsalate. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.