What is happening. Candesartan, an angiotensin II receptor blocker, raises serum potassium by reducing aldosterone-driven renal potassium excretion. Combining it with potassium supplements can produce additive hyperkalemia, which may cause dangerous cardiac arrhythmias, particularly in patients with chronic kidney disease, diabetes, heart failure, or older age.
Mechanism. ARB-mediated suppression of the renin-angiotensin-aldosterone system lowers aldosterone, decreasing renal potassium excretion; added exogenous potassium compounds the rise in serum potassium.
Recommendation. Avoid routine potassium supplements while taking candesartan unless specifically prescribed and monitored by a clinician. Have serum potassium and renal function checked before starting and periodically thereafter. Report muscle weakness, palpitations, or irregular heartbeat promptly.