Hi

Conclusion about no interactions probably cover lack of meaningful PD observations see:

" Candesartan cilexetil produced a 7% decrease in trough plasma warfarin concentration but this had no effect on prothrombin time. "

https://pubmed.ncbi.nlm.nih.gov/9331003/

So in some cases pharmacokinetic interaction can exist but have no impact on clinical findings. Probably this is why you find conclusions about lack of interaction. Finally protein binding in blood plasma not must be most important aspect of interactions between both drugs

from another hand:

" Candesartan had no effect on S-warfarin 7-hydroxylation. In contrast, S-warfarin inhibited candesartan metabolism by the wild-type (K = 17microM) greater than by the Leu359 variant (Ki = 36 microM). These findings suggest that CYP2C9*3 may change not only the metabolic activity but also the inhibitory susceptibility compared with CYP2C9*1. "

Article CYP 2C9*3 influences the metabolism and the drug-interaction...

Best regards

Tomasz

Thanks a lot Dr.Tomasz!

The possible explanation can be;

1.If the drugs binds to different loci and the binding sites (qualitative difference)- e.g. albumin for acidic drug or alpha1 acid glycoprotein for basic drug

2.The drugs follow first order kinetics so the clearance of the free drug after displacement also increases proportionately.

3. Large volume of distribution

Thanks Dr.Mira!