Lercanidipine Hydrochloride
Indications
Lercanidipine Hydrochloride is used for:
Mild to moderate essential hypertension, Stroke prevention.
Adult Dose
Oral
Hypertension
Adult: As hydrochloride: 10 mg once daily, increased after 2 wk to 20 mg daily if necessary.
Elderly: The recommended dosage is 10 mg orally once a day at least 15 minutes before meals; the dose may be increased to 20 mg depending on the individual patient's response.
Hepatic impairment: Special care should be exercised in patients with mild to moderate renal or hepatic dysfunction.
Dosage above 20 mg daily must be approached with caution. Lercanidipine is not recommended for use in patients with severe hepatic dysfunction.
Child Dose
Renal Dose
Renal impairment: Dosage may need to be reduced in mild to moderate renal impairment. Avoid in patients with CrCl <12 ml/min.
Administration
Should be taken on an empty stomach. Take on an empty stomach at least 15 min before meals.
Contra Indications
Severe hepatic or renal impairment; aortic stenosis, unstable angina, uncontrolled heart failure, within 1 mth of MI; and known hypersensitivity to any dihydropyridine. Lercanidipine should not be taken with grapefruit juice. lactation, pregnancy.
Precautions
Left ventricular dysfunction, sick sinus syndrome (if pacemaker not fitted), left ventricular dysfunction and ischaemic heart disease.
Pregnancy-Lactation
Interactions
Plasma concentration reduced by inducers of CYP3A4 eg rifampicin, phenytoin, carbamazepine. Bioavailability also reduced by metoprolol and possibly propranolol. Plasma concentrations increased by inhibitors of CYP3A4 eg imidazole antifungals, erythromycin, ritonavir, fluoxetine. Alcohol may potentiate vasodilating effect.
Potentially Fatal: Significantly increased plasma levels of both lercanidipine and ciclosporin when administered together.
Adverse Effects
Side effects of Lercanidipine Hydrochloride :
Tachycardia, oedema, flushing, headache, dizziness, asthenia, rash, diarrhoea, polyuria, palpitations, hypotension, drowsiness, myalgia.
Mechanism of Action
Lercanidipine is a dihydropyridine calcium-channel blocker which acts by inhibiting the influx of calcium ions through the slow channels of the vascular smooth muscle and myocardium during depolarization. Its main effect is vasodilatation because it has greater selectivity for vascular smooth muscle than cardiac smooth muscle.