Lercapress (Enalapril Maleate, Lercanidipine Hydrochloride)

Lercapress is an antihypertensive combination that acts on the renin‑angiotensin system and vascular smooth‑muscle calcium channels.

• Essential hypertension: lowers systolic and diastolic pressure in patients with primary hypertension.
• Isolated systolic hypertension: helps control elevated systolic pressure, especially in older adults.
• Secondary hypertension: may be incorporated into therapy when high blood pressure results from another underlying condition.

• Enalapril maleate inhibits angiotensin‑converting enzyme, reducing formation of angiotensin II and decreasing vasoconstriction. Lercanidipine hydrochloride blocks L‑type calcium channels in arterial smooth muscle, producing vasodilation. The complementary actions result in additive reduction of systemic vascular resistance and blood pressure.

Common Side Effects

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

Serious or Rare Side Effects

• Angioedema: swelling of face, lips, tongue, or airway.
• Severe hypotension: markedly low blood pressure causing fainting.
• Hepatic dysfunction: abnormal liver enzymes or jaundice.
• Acute renal impairment: sudden decrease in kidney function.
• Myocardial infarction: chest pain indicative of heart attack.
• Cardiac arrhythmias: irregular heart rhythms.

Before initiating therapy, consider the following precautions:

• Renal impairment: monitor kidney function and adjust therapy as needed.
• Hepatic impairment: use with caution and observe liver enzymes.
• Pregnancy: contraindicated; avoid use during pregnancy.
• Elderly patients: start at lower dose and titrate slowly.
• Concomitant potassium‑sparing diuretics or supplements: monitor serum potassium levels.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Lercapress can interact with several medicines.

Major Interactions (Avoid)

• ACE inhibitor with aliskiren in diabetic patients: risk of severe hypotension and renal dysfunction.
• Lercanidipine with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may cause excessive blood‑pressure lowering.
• Concurrent use with other potent antihypertensives: can lead to profound hypotension.
• Potassium‑containing supplements or salts: increase risk of hyperkalaemia.

Moderate Interactions (Monitor Closely)

• NSAIDs (ibuprofen, naproxen): may blunt antihypertensive effect.
• Loop or thiazide diuretics: can amplify electrolyte disturbances.
• Lithium: enalapril may raise lithium levels, requiring serum monitoring.