Lercapin Ace (Enalapril Maleate, Lercanidipine Hydrochloride)

Lercapin Ace, a fixed‑dose antihypertensive combination, acts on the renin‑angiotensin system and vascular smooth‑muscle calcium channels to control elevated blood pressure.

• Hypertension: reduces both systolic and diastolic blood pressure in adults with primary hypertension.
• Essential hypertension: provides effective blood pressure control when monotherapy is insufficient.
• Secondary hypertension (adjunct): used as an add‑on therapy to achieve target blood pressure in patients with secondary causes.

• Enalapril maleate inhibits angiotensin‑converting enzyme, decreasing formation of angiotensin II and reducing vasoconstriction. Lercanidipine hydrochloride blocks L‑type calcium channels in vascular smooth muscle, leading to vasodilation. The combined actions lower systemic vascular resistance and consequently reduce arterial blood pressure.

Common Side Effects

• Cough: dry, persistent throat irritation.
• Dizziness or light‑headedness, especially after standing.
• Headache: mild to moderate intensity.
• Peripheral edema: swelling of ankles or feet.
• Flushing: transient warmth and redness of the skin.
• Fatigue: feeling unusually tired.

Serious or Rare Side Effects

• Angioedema: rapid swelling of face, lips, tongue, or airway.
• Severe hypotension: marked drop in blood pressure causing faintness.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Hyperkalemia: elevated potassium levels in blood.
• Renal impairment: worsening kidney function.
• Allergic reactions: rash, itching, or severe skin eruptions.

Before initiating therapy, clinicians should evaluate patient-specific factors and monitor for adverse events.

• Blood pressure monitoring: regularly assess to ensure therapeutic targets are met.
• Renal function assessment: check serum creatinine and eGFR before and during treatment.
• Electrolyte balance: monitor potassium levels, especially if combined with potassium‑sparing agents.
• Pregnancy caution: avoid use during pregnancy due to potential fetal toxicity.
• Drug‑specific contraindications: do not co‑administer with aliskiren in patients with diabetes.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lercapin Ace may interact with several concomitant medicines, requiring careful management.

Major Interactions (Avoid)

• Aliskiren (in diabetic patients): increased risk of renal impairment and hyperkalemia.
• Potassium‑sparing diuretics or supplements: may cause dangerous hyperkalemia.
• NSAIDs (e.g., ibuprofen, naproxen): can blunt antihypertensive effect and worsen renal function.

Moderate Interactions (Monitor Closely)

• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may raise lercanidipine plasma levels.
• Beta‑blockers: combined use can lead to excessive bradycardia or hypotension.
• Lithium: ACE inhibition can raise lithium concentrations, increasing toxicity risk.