Lercanidipine Cristers (Lercanidipine Hydrochloride)

Lercanidipine is a calcium channel blocking agent used in the management of hypertension and related blood‑pressure disorders.

• Essential hypertension: reduces both systolic and diastolic blood pressure, improving overall cardiovascular risk profile in adult patients.
• Isolated systolic hypertension: specifically lowers high systolic pressure, helping to achieve target blood‑pressure goals in older adults.
• Secondary hypertension: assists in controlling blood pressure when hypertension is due to underlying disorders, used as part of combination therapy.

• Lercanidipine selectively inhibits L‑type calcium channels in vascular smooth‑muscle cells, preventing calcium influx that is necessary for contraction. This vasodilatory effect reduces peripheral vascular resistance, leading to a decrease in arterial blood pressure without significant impact on heart rate. The drug’s high lipophilicity allows prolonged action and once‑daily dosing. Its affinity for the calcium channel is enhanced in the presence of high membrane potential, which contributes to its efficacy in hypertensive patients.

Lercanidipine may be associated with a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Headache: mild to moderate headache occurring shortly after dose initiation.
• Flushing: transient facial warmth and redness.
• Peripheral edema: swelling of ankles or lower legs.
• Dizziness: light‑headed sensation, especially when standing quickly.
• Tachycardia: increased heart rate without other cardiac symptoms.
• Fatigue: general feeling of tiredness.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue or airway requiring immediate medical attention.
• Severe hypotension: marked drop in blood pressure leading to fainting or shock.
• Myocardial infarction: rare occurrence of heart attack symptoms.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Allergic reactions: rash, itching, or anaphylaxis.

Before initiating therapy with Lercanidipine, certain precautions should be considered to ensure safe use.

• Monitor blood pressure: check baseline and periodic readings to assess efficacy.
• Assess cardiac status: evaluate for existing heart failure or conduction disorders.
• Avoid abrupt discontinuation: tapering may be needed to prevent rebound hypertension.
• Caution in hepatic impairment: dose adjustment may be required in patients with liver dysfunction.
• Avoid concomitant strong CYP3A4 inhibitors: may increase drug exposure and risk of adverse effects.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Lercanidipine can interact with several medicines, altering its plasma concentration or enhancing pharmacodynamic effects.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may markedly increase Lercanidipine levels.
• Other calcium channel blockers: additive hypotensive effect can lead to excessive blood pressure drop.
• Grapefruit juice: can raise drug exposure and risk of side effects.

Moderate Interactions (Monitor Closely)

• Diuretics: combined effect may enhance antihypertensive response, requiring blood pressure monitoring.
• ACE inhibitors or ARBs: concurrent use may increase risk of renal impairment or hyperkalaemia.
• Beta‑blockers: may mask tachycardia, necessitating careful heart rate observation.