Drug Interaction Report

Candesartan and Carboplatin Injection: Interaction Details

A pharmacist-reviewed analysis of the Candesartan and Carboplatin Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Candesartan

Atacand Atacand®
+

Carboplatin Injection

Kyxata Paraplatin Paraplatin®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 51 documented Candesartan interactions, 15 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
delayed
Evidence
probable
Severity
Major

What happens

Increased risk of severe neutropenia

Interaction Deep Dive

Concomitant use of candesartan with paclitaxel and CARBOplatin combination (TC) therapy may significantly increase the risk of severe neutropenia (Grade 3 or 4) and may occur with the first cycle2. Neutropenia can occur with either paclitaxel 3 or CARBOplatin 1. Concomitant use of other ARBs (irbesartan, losartan, olmesartan, telmisartan or valsartan) had a significantly lower risk. Consider the possible increased risk of severe neutropenia when using candesartan in combination with TC therapy 2.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) In a study of patients who received paclitaxel and CARBOplatin combination (TC) therapy (N=173), concomitant treatment with candesartan (n=15) resulted in a significantly higher rate of severe neutropenia (Grade 3 or 4) compared with other angiotensin II receptor blockers (ARB) combined (n=50; 86.7% vs 28%; odds ratio, 15.9; 95% CI, 3.03 to 162) over the entire course of therapy. Severe neutropenia rates for the other ARB group were 25% for irbesartan, 25% for losartan, 25% for olmesartan, 40% for telmisartan and 25% for valsartan. Severe neutropenia occurred in all 6 patients that received candesartan during the first cycle of TC therapy. An interaction between candesartan and paclitaxel via the CYP2C8-mediated pathway is probable, though the influence of CARBOplatin could not be excluded 2.

Common questions

Can I take Candesartan and Carboplatin Injection together?

Increased risk of severe neutropenia Always confirm with your pharmacist or prescriber before making any change.

How serious is the Candesartan and Carboplatin Injection interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Candesartan or Carboplatin Injection need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (3)

  1. Product Information: carboplatin intravenous injection, carboplatin intravenous injection. Teva Parenteral Medicines, Inc. (per DailyMed), Irvine, CA, 2014. DailyMed
  2. Katsube Y, Hira D, Tsujimoto M, et al: Concomitant administration of candesartan cilexetil in patients on paclitaxel and carboplatin combination therapy increases risk of severe neutropenia. Int J Clin Pharmacol Ther 2018; 56(7):328-336. DOI
  3. Product Information: ABRAXANE(R) intravenous injection suspension, paclitaxel protein-bound particles intravenous injection suspension. Celgene Corporation (per FDA), Summit, NJ, 2018. DailyMed
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Candesartan

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