Lacipil (Lacidipine)

Lacidipine is a dihydropyridine calcium channel blocker indicated for the management of high blood pressure.

• Essential hypertension: reduces systolic and diastolic pressure in patients with primary hypertension.
• Isolated systolic hypertension: lowers elevated systolic readings, especially in older adults.
• Hypertension with coronary artery disease: provides blood pressure control while improving coronary perfusion.

• Lacidipine selectively inhibits L‑type calcium channels in vascular smooth muscle, preventing calcium influx that triggers contraction. This vasodilatory effect decreases peripheral vascular resistance, leading to a reduction in arterial blood pressure without significant negative inotropic impact on the heart.

Lacidipine may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Headache: mild to moderate pain often occurring early in therapy.
• Flushing: transient warmth and redness of the skin.
• Peripheral edema: swelling of ankles or feet due to fluid accumulation.
• Dizziness: sensation of light‑headedness, especially when standing.
• Nausea: mild gastrointestinal discomfort.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure requiring medical attention.
• Angioedema: swelling of face, lips, tongue, or throat that may compromise airway.
• Myocardial infarction: rare occurrence of heart attack.
• Elevated liver enzymes: indication of hepatic stress.
• Severe bradycardia: unusually low heart rate.
• Allergic reactions: rash, itching, or anaphylaxis.

Before initiating Lacidipine therapy, consider the following safety measures.

• Blood pressure monitoring: regularly assess to avoid excessive hypotension.
• Hepatic function: evaluate liver enzymes in patients with liver disease.
• Elderly patients: start at lower doses and monitor for dizziness.
• Concomitant antihypertensives: adjust doses to prevent additive effects.
• Severe aortic stenosis: contraindicated due to risk of reflex tachycardia.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Lacidipine can interact with several medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase Lacidipine plasma levels.
• Other potent vasodilators: risk of additive hypotension.
• Grapefruit juice: can raise drug concentration leading to toxicity.

Moderate Interactions (Monitor Closely):\n- CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce therapeutic effect.

• Diuretics: may enhance blood pressure lowering.
• Beta‑blockers: monitor for excessive heart rate reduction.
• NSAIDs: may blunt antihypertensive response.