Lercaprel (Enalapril Maleate, Lercanidipine Hydrochloride)

Lercaprel is indicated for the management of hypertension, a condition characterized by elevated arterial pressure.

• Essential hypertension: lowers systolic and diastolic blood pressure to reduce cardiovascular risk.
• Isolated systolic hypertension: provides effective control of high systolic readings.
• Hypertension uncontrolled by monotherapy: offers combined ACE‑inhibitor and calcium‑channel blockade for patients needing dual therapy.

• Enalapril maleate inhibits angiotensin‑converting enzyme, decreasing formation of angiotensin II and reducing vasoconstriction and aldosterone release. Lercanidipine hydrochloride blocks L‑type calcium channels in vascular smooth muscle, causing arterial relaxation. The combined actions produce additive vasodilation and lower peripheral resistance, resulting in sustained blood‑pressure reduction.

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

Common Side Effects

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

Serious or Rare Side Effects

• Angioedema: rapid swelling of face, lips, tongue, or airway.
• Severe hypotension: marked drop in blood pressure causing faintness.
• Hyperkalemia: elevated blood potassium levels.
• Renal impairment: worsening kidney function.
• Hepatic dysfunction: abnormal liver enzyme elevations.
• Myocardial infarction: rare occurrence of heart attack.

Before prescribing Lercaprel, clinicians should evaluate patient history and comorbid conditions.

• Renal function: assess creatinine clearance and adjust therapy if needed.
• Hepatic disease: monitor liver enzymes and avoid use in severe impairment.
• Electrolyte balance: check potassium levels, especially if combined with potassium‑sparing agents.
• Pregnancy: avoid use unless clearly needed; discuss risks with obstetric specialist.
• Elderly patients: start at lower dose and monitor for hypotension.
• Store at ambient temperature: keep below 25°C, retain in original packaging, protect from moisture and direct sunlight.

Lercaprel can interact with several medicines, requiring careful management.

Major Interactions (Avoid)

• Potassium‑sparing diuretics or supplements: risk of hyperkalemia.
• Aliskiren in diabetic patients: increased renal adverse events.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may blunt antihypertensive effect and impair renal function.

Moderate Interactions (Monitor Closely):\n- Other antihypertensives (beta‑blockers, diuretics): may cause additive hypotension.

• Lithium: risk of lithium toxicity due to reduced clearance.
• CYP3A4 inhibitors (e.g., ketoconazole): may increase lercanidipine plasma levels.
• CYP3A4 inducers (e.g., rifampicin): may reduce lercanidipine efficacy.