Lercanidipina Sandoz (Lercanidipine Hydrochloride)

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

• Hypertension: lowers systolic and diastolic blood pressure in patients with essential hypertension, helping to reduce cardiovascular risk.

• Lercanidipine selectively antagonizes L‑type calcium channels in vascular smooth muscle, inhibiting calcium influx. This causes dose‑dependent vasodilation of arterial beds, decreasing peripheral vascular resistance and ultimately reducing systemic blood pressure without significant negative inotropic effects.

Lercanidipine is generally well tolerated, but several adverse reactions have been reported.

Common Side Effects

• Headache: mild to moderate intensity, often transient.
• Flushing: sensation of warmth and redness, especially after the first dose.
• Peripheral edema: swelling of ankles or feet due to vasodilation.
• Dizziness: may occur with rapid posture changes.
• Fatigue: feeling of reduced energy or tiredness.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure requiring medical attention.
• Angioedema: swelling of face, lips, tongue or throat, potentially airway‑obstructing.
• Hepatic dysfunction: abnormal liver enzymes or hepatitis.
• Myocardial infarction: rare cases of acute coronary events.
• Cardiac arrhythmia: irregular heart rhythms, especially in patients with pre‑existing conduction disorders.

Before initiating therapy, clinicians should consider several safety aspects.

• Blood pressure monitoring: ensure adequate control and avoid excessive drops.
• Hepatic impairment: dose adjustment may be required in patients with liver dysfunction.
• Concomitant antihypertensives: watch for additive hypotensive effects.
• Elderly patients: start at low dose and titrate cautiously.
• Hypersensitivity: discontinue if allergic reactions occur.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lercanidipine may interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): can markedly increase plasma concentrations.
• Other potent antihypertensives (e.g., ACE inhibitors, ARBs): risk of severe hypotension.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce therapeutic effect.
• Non‑dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem): can increase lercanidipine levels.
• Grapefruit juice: may elevate drug exposure.
• NSAIDs: may blunt antihypertensive response.