Lertec (Enalapril Maleate, Lercanidipine Hydrochloride)

• Lertec acts on the renin‑angiotensin system and vascular smooth‑muscle calcium channels to lower blood pressure in hypertensive patients.
• Essential hypertension: provides additive blood‑pressure reduction for patients with primary high blood pressure.
• Secondary hypertension: assists in controlling blood pressure when the underlying cause is identifiable.
• General high blood pressure: helps achieve target blood‑pressure goals in adults with elevated readings.

• Enalapril maleate inhibits angiotensin‑converting enzyme, reducing formation of angiotensin II and aldosterone, which leads to vasodilation and decreased peripheral resistance. Lercanidipine hydrochloride blocks L‑type calcium channels in arterial smooth muscle, preventing calcium influx and promoting arterial relaxation. The dual action produces additive lowering of systemic blood pressure.

Lertec may cause a range of adverse reactions, from mild to serious.

Common Side Effects

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

Serious or Rare Side Effects

• Angio‑edema: rapid swelling of lips, tongue, or airway.
• Severe hypotension: marked drop in blood pressure causing fainting.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Hyperkalemia: elevated potassium levels, potentially causing cardiac issues.
• Renal impairment: worsening kidney function, especially in patients with pre‑existing disease.
• Myocardial infarction: rare reports of heart attack in susceptible individuals.

Before initiating Lertec, consider patient‑specific factors and monitor for potential risks.

• Renal function: assess baseline creatinine and adjust if impairment exists.
• Electrolytes: monitor potassium levels, especially if combined with potassium‑sparing agents.
• Pregnancy: avoid use unless clearly needed; discuss risks with a healthcare professional.
• Concomitant antihypertensives: watch for additive blood‑pressure lowering effects.
• Elderly patients: start at lower dose and monitor for orthostatic symptoms.

Store at ambient temperature: keep tablets below 25 °C in the original container, protected from moisture and direct sunlight.

Lertec can interact with several medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Aliskiren: combined use may cause excessive hypotension and renal dysfunction.
• Lithium: increased lithium levels leading to toxicity.
• Potassium‑sparing diuretics or supplements: risk of severe hyperkalemia.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs (NSAIDs): may blunt antihypertensive effect and affect renal function.
• Other ACE inhibitors or ARBs: additive risk of hypotension and renal impairment.
• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may increase lercanidipine plasma concentrations.
• Diuretics: may enhance orthostatic hypotension, especially at therapy initiation.