Lecalpin (Lercanidipine Hydrochloride)

Lercanidipine is a dihydropyridine calcium channel blocker used in the management of high blood pressure conditions.

• Hypertension: reduces systolic and diastolic blood pressure to target levels.
• Essential hypertension: provides long‑lasting blood pressure control in primary hypertension.
• Isolated systolic hypertension: helps lower elevated systolic pressure, especially in older adults.

• Lercanidipine selectively inhibits L‑type calcium channels in vascular smooth muscle, preventing calcium influx that is necessary for contraction. This vasodilatory effect reduces peripheral vascular resistance, leading to a decrease in arterial blood pressure without significantly affecting heart rate.

Lercanidipine may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Headache: mild to moderate pain often occurring after the first dose.
• Flushing: sensation of warmth and redness, especially on the face.
• Peripheral edema: swelling of the ankles or feet due to fluid accumulation.
• Dizziness: light‑headed feeling, particularly when standing quickly.
• Tachycardia: increased heart rate, usually mild.
• Fatigue: general feeling of tiredness.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure that may cause fainting.
• Myocardial infarction: rare occurrence of heart attack.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Allergic reactions: rash, itching, or hives.
• Angioedema: swelling of lips, tongue, or throat.
• Cardiac arrhythmia: irregular heart rhythm.

Before initiating therapy with lercanidipine, consider the following safety measures.

• Blood pressure monitoring: regularly check to avoid excessive hypotension.
• Hepatic impairment: use with caution in patients with liver dysfunction.
• Elderly patients: start at lower doses and monitor for dizziness.
• Concomitant antihypertensives: adjust doses to prevent additive blood pressure lowering.
• Severe aortic stenosis: contraindicated due to risk of reduced cardiac output.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lercanidipine can interact with several drug classes, influencing its efficacy and safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase plasma levels and risk of hypotension.
• Concomitant use with other potent antihypertensives: can cause excessive blood pressure drop.
• Grapefruit juice: enhances absorption leading to higher drug exposure.

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

• Diuretics: may augment antihypertensive effect, requiring dose adjustment.
• Beta‑blockers: combined use may increase risk of bradycardia.
• NSAIDs: may attenuate blood pressure‑lowering effect.
• Alcohol: can increase dizziness and hypotension risk.