Lercanidipine; Uses, Dosage, Side Effects, Interactions

Lacidipine is a lipophilic dihydropyridine calcium antagonist with an intrinsically slow onset? of activity. Due to its long duration of action, lacidipine does not lead to reflex tachycardia?. It displays specificity in the vascular smooth muscle, where it acts as an antihypertensive agent to dilate peripheral arterioles and reduce blood pressure. Compared to other dihydropyridine calcium antagonists, lacidipine exhibits a greater antioxidant activity which may confer potentially beneficial antiatherosclerotic effects. Lacidipine is a highly lipophilic molecule that interacts with the biological membranes. Through radiotracer analysis, it was determined that lacidipine displays a high membrane partition coefficient leading to accumulation of the drug in the membrane and slow rate of membrane washout.

Mechanism of Action of Lercanidipine

By deforming the channel, inhibiting ion-control gating mechanisms, and/or interfering with the release of calcium from the sarcoplasmic reticulum, Lercanidipine inhibits the influx of extracellular calcium across the myocardial and vascular smooth muscle cell membranes The decrease in intracellular calcium inhibits the contractile processes of the myocardial smooth muscle cells, causing dilation of the coronary and systemic? arteries?, increased oxygen delivery to the myocardial tissue, decreased total peripheral resistance, decreased systemic blood pressure, and decreased afterload.

Indications of Lercanidipine

• High blood pressure (Hypertension)
• Angina pectoris prophylaxis
• Raynaud’s Syndrome?
• Heart failure
• Angina pectoris prophylaxis
• Hypertrophic cardiomyopathy?

Contra-Indications of Lercanidipine

• The acute? syndrome of the heart
• Severe? narrowing of the aortic heart valve?
• Severe heart failure
• Abnormally low blood pressure
• Kidney? disease with a reduction in kidney function
• Fluid Retention in the Legs, arms or hands
• Blood Circulation Failure due to Serious Heart Condition
• Chronic? idiopathic constipation
• Stomach or intestine blockage
• Narrowing of the intestines
• Decreased motility function of stomach or intestines
• Heart attack
• Allergies to Calcium Channel Blockers
• Calcium Channel Blocking Agents-Dihydropyridines

Dosage? of Lercanidipine

Strengths: 10 mg, 20 mg

Hypertension?

• 10 mg once daily, increased after 2 wk to 20 mg daily if necessary.

Side Effects of Lercanidipine

The most common 

• a severe headache, rapid heartbeat, stiffness in your neck,  
• chest pain, fast or slow heart rate?;
• swelling, rapid weight gain;
• Xerostomia (dry mouth)
• A headache 
• Fatigue
• Skin reactions 
• Hypotension
• Anxiety
• Constipation
• Nausea/vomiting
• Weight gain/loss
• Erectile dysfunction

More common

• Abdominal or stomach pain, discomfort, or tenderness?
• chills or fever
• difficulty with moving
• a headache, severe and throbbing
• joint or back pain
• muscle aching or cramping
• muscle pains or stiffness
• chest pressure or squeezing pain in the chest
• discomfort in arms, shoulders, neck or upper back
• excessive sweating
• feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis?
• sudden tingling or coldness in an arm or leg
• sudden slow or difficult speech
• sudden drowsiness or need to sleep
• fast breathing
• sharp pain when taking a deep breath
• fast or slow heartbeat
• coughing up blood
• rust colored urine
• decreased amount of urine

Rare

• Anxiety
• change in vision
• chest pain or tightness
• confusion
• a cough
• Agitation
• arm, back, or jaw pain?
• blurred vision
• chest pain or discomfort
• convulsions
• extra heartbeats
• fainting?
• hallucinations
• headache
• irritability
• lightheadedness?
• mood or mental changes
• muscle pain or cramps
• muscle spasm or jerking of all extremities
• nervousness

Drug Interactions of Lercanidipine

Lercanidipine  may interact with following drugs, supplements, & may change the efficacy of drug

• alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
• alpha agonists (e.g., clonidine, methyldopa)
• angiotensin II receptor blockers (ARBs; e.g., candesartan, losartan)
• antidiabetes medications (e.g., insulin?, metformin, glyburide)
• atypical? antipsychotics (e.g., clozapine, olanzapine, quetiapine, risperidone)
• azathioprine
• barbiturates (e.g., butalbital, pentobarbital phenobarbital)
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• canagliflozin
• ciprofloxacin
• calcium supplements (e.g., calcium carbonate, calcium citrate)
• carbamazepine
• clopidogrel
• cyclosporine
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
• duloxetine
• “gliptin” diabetes? medications (e.g., linagliptin, saxagliptin, sitagliptin)
• guanfacine
• heparin
• levodopa
• medications that increase potassium levels (e.g., potassium supplements, spironolactone, amiloride, and salt substitutes containing potassium)
• metformin
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, indomethacin, naproxen)
• other angiotensin-converting-enzyme inhibitors (ACEIs; e.g., captopril,  ramipril)
• pentoxifylline
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• methylphenidate
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline,selegiline, tranylcypromine)
• phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
• pregabalin
• sodium phosphates
• tizanidine
• trimethoprim
• valproic acid
• warfarin

Pregnancy Category of Lercanidipine

FDA Pregnancy Category C

Pregnancy

This medication should not be taken by women who are or may become pregnant, as lercanidipine may cause harm to the developing baby if it is taken by the mother during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Lactation

This medication should not be taken by women who are breastfeeding. The safety and effectiveness of using this medication have not been established for children.

References