Lercanidipine

What is Lercanidipine?

Lercanidipine is a type of medicine known as a calcium channel blocker. It is used to treat high blood pressure (hypertension) and reduce the risk of heart disease, heart attacks and strokes.

How does Lercanidipine work?

High blood pressure causes the heart and blood vessels to work too hard to pump blood around the body, which can lead to damaged blood vessels in the brain, heart and kidneys, heart failure, stroke or kidney failure. Lercanidipine works by blocking the narrowing effect of calcium on blood vessels, causing them to relax and allowing blood to flow more easily. 

How long does it take for Lercanidipine to work?

Lercanidipine starts to work immediately, but it takes a couple of week for it to take full effect.

Active ingredients

The active ingredient in Lercanidipine is lercanidipine hydrochloride.

Inactive ingredients

The inactive ingredients in Lercanidipine are magnesium stearate, povidone, sodium starch glycolate (Type A), lactose monohydrate, microcrystalline cellulose, macrogol, polyvinyl alcohol (partly hydrolysed), talc, titanium dioxide (E171) and yellow iron oxide (E172). The 20 mg tablets also include red iron oxide (E172).

How to take Lercanidipine

Lercanidipine should be taken once daily, preferably in the morning at least 15 minutes before food. Tablets should be swallowed whole with a small glass of water. The tablet can be split in half along the score line if you have difficulty swallowing it whole. Avoid drinking too much grapefruit juice while using this medication, particularly around the time of day you take your dose.

If you forget to take a dose of Lercanidipine, try and take it as soon as you remember. However, if it is nearly time for your next dose, just skip the missed dose and take the next one at the normal time. Never take a double dose to make up for a missed one.  

Lercanidipine Dosage

Lercanidipine comes as 10 mg and 20 mg tablets. Your doctor will decide your dosage dependent on your blood pressure level. The recommended dose is 10 mg taken once daily, although your doctor may increase the dose to 20 mg if needed.

Lercanidipine Side Effects

Like all medication, Lercanidipine can cause side effects in some people. The following side effects may affect up to 1 in 100 people:

• Headache
• Dizziness
• Increased heart rate
• Awareness of heartbeat
• Flushing
• Ankle swelling

Rarely (1 in 1 000 people) the following side effects are experienced:

• Sleepiness
• Weakness
• Tiredness
• Nausea
• Vomiting
• Diarrhoea
• Abdominal pain
• Indigestion
• Rash
• Muscle pain
• Urinating more frequently
• Angina pectoris

The following side effects are very rare, and only occur in up to 1 in 10 000 patients:

• Decrease in blood pressure leading to fainting
• Allergic reaction
• Swelling of gums
• Increase in liver enzyme blood test values
• Fall in blood pressure causing dizziness, lightheadedness or fainting
• Significant increase in frequency of urination
• Chest pain
• Heart attack  

Contraindications

Do NOT take Lercanidipine if:

• You are allergic to any of the ingredients in this medication
• You have previously experienced an allergic reaction to similar medications such as Amlodipine, Nicardipine, Felodipine, Isradipine, Nidefipine or Lacidipine
• You are suffering from certain heart diseases such as uncontrolled cardiac failure, obstruction to flow of blood from the heart, and unstable angina, or you have had a heart attack in the past month
• You have severe liver or kidney problems
• You are pregnant or wish to become pregnant, or if you are a women of childbearing age and do not use any method of contraception
• You are breastfeeding

Before taking Lercanidipine, speak to a doctor if any of the following applies to you:

• You have a heart condition known as sick sinus syndrome and do not have a pacemaker
• You suffer from angina pectoris (chest pain)
• You have problems with your liver or kidney, or you are on dialysis

Drug Interactions

Do NOT take Lercanidipine if you are taking medicines that are inhibitors of CYP3A4 isoenzyme, including:

• Antifungal medications such as ketoconazole or itraconazole
• Macrolide antibiotics such as erythromycin or troleandomycin
• Antivirals such as ritonavir
• Cyclosporin

Before taking Lercanidipine, tell your doctor if you are taking any other medicines, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking any of the following:

• Phenytoin or carbamazepine (for epilepsy)
• Rifampicin (for tuberculosis)
• Midazolam (sleep aid)
• Cimetidine (for ulcers, indigestion or heartburn)
• Digoxin
• Terfenadine or astemizole (for allergies)
• Amiodarone or quinidine (for increased heart rate)
• Metoprolol (for high blood pressure)
• Simvastatin (for high cholesterol)  

How to cope with Lercanidipine side effects

Most people who take Lercanidipine do not have any trouble with side effects. However, around 1 in 100 patients my experience dizziness or headaches. If you feel dizzy, find somewhere safe to lie down until the feeling passess. If dizziness persists, try cutting down on  alcohol and caffeine, as these can make symptoms worse. Headaches can be managed by drinking plenty of fluids and taking painkillers such as paracetamol or ibuprofen where necessary. If headaches are severe or persist for longer than a week, speak to your doctor for advice.

Lercanidipine and pregnancy

Do not take this medication if you are pregnant or wish to become pregnant. Speak to your doctor for advice on alternative high blood medications. 

Lifestyle changes to reduce blood pressure

Alongside medications, there are a few important lifestyle changes you can make to help reduce your blood pressure. Try and limit your salt intake to the recommended maximum of 6g per day, while cutting back on fatty foods and including plenty of fruit and vegetables, wholegrains and lean meats in your diet. Reduce the amount of alcohol you drink to below the recommended limit of 14 units per week, and if you haven’t already done so, stop smoking. Exercising regularly helps to keep your heart and blood vessels in good condition and also reduces stress. Stress is another cause of rising blood pressure, so try and avoid it by spending time with friends and family, going for daily walks and finding the time to relax where possible. 

Lercanidipine Alternatives

There are a few different varieties of calcium channel blockers, and your doctor will help you decide which is best for you. While Diltiazem and Verapamil are used in the treatment of different heart conditions, Amlodipine, Nifedipin, Felodipine and Lacidipine are also used in the treatment of high blood pressure.

Alternative treatments include angiotensin converting enzyme (ACE) inhibitors such as Ramipril, Lisinopril, Perindopril and Enalapril which work by blocking a different substance in the body which also causes blood vessels to constrict. ACE inhibitors may be less effective in patients over the age of 55, or of Afro-Caribbean descent, in which case a doctor may chose to prescribe a diuretic instead. Diuretics, sometimes taken in combination with the ACE inhibitor Enalapril, also help to relax the walls of the blood vessels. ALternatively, Beta-blockers work by blocking angiotensin II (a hormone which causes narrowing of the arteries) and by slowing your heart rate. A similar function is carried out by angiotensin receptor blockers (ARBs) such as Losartan, Irbesartan, CAndesartan and Valsartan. High blood pressure medications should only be taken following a consultation with a doctor, who will be able to decide which is most suitable for you.  

Can I drink when taking Lercanidipine?

Alcohol can increase the blood pressure-lowering effect of Lercanidipine and cause you to feel dizzy or give you headaches. If you experience dizziness or headaches while taking this medication, it is best to refrain from drinking alcohol at all.

Is Lercanidipine a cure?

Lercanidipine is an effective treatment for high blood pressure and works best when taken over a long period of time. However, if you stop taking this medication, your blood pressure is likely to rise again. If you are taking high blood pressure medications, you will most likely need to take them for the rest of your life.

Will Lercanidipine affect my fertility?

There is no evidence to suggest that Lercanidipine affects fertility in men or women. If you are planning on getting pregnant while taking this medication, speak to your doctor for advice.

Will Lercanidipine affect my contraception?

Lercanidipine will not affect any type of contraception. However, some hormonal contraceptives such as the combined pill and the contraceptive patch are not recommended for women with high blood pressure. Your doctor will be able to recommend a type of contraceptive that is best for you.

Why should you take Lercanidipine before food?

Eating high fat meal significantly increases your blood levels of this medicine. It is therefore best to take your tablet at least 15 minutes before breakfast, and try to make sure your breakfast is low in fat content.

Sources

• Patient Information Leaflet
• NHS > Lercanidipine
• WebMD > Calcium Channel Blockers