Lercanidipine Hydrochloride

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Generic Name of Lercanidipine Hydrochloride - Learn More

Lercanidipine Hydrochloride

Lercanidipine Hydrochloride Precaution - What You Need to Know

Lercanidipine hydrochloride is a calcium channel blocker primarily used in the treatment of hypertension. While it is effective in reducing blood pressure, certain precautions should be considered when prescribing this medication, especially in special populations. In patients with severe liver impairment or active liver disease, lercanidipine should be used cautiously, as the drug is metabolized by the liver and may accumulate in the body, leading to an increased risk of side effects. Liver function should be monitored regularly in these patients.

Patients with severe renal impairment (creatinine clearance less than 30 mL/min) should also be cautious when using lercanidipine, as renal dysfunction can lead to a higher plasma concentration of the drug. As with other antihypertensive agents, blood pressure should be monitored regularly to avoid hypotension, particularly during the initial phase of treatment or after dose adjustments.

Pregnant and breastfeeding women should avoid using lercanidipine unless absolutely necessary. Its safety in pregnancy has not been established, and it may pass into breast milk. It is recommended to discuss the potential risks and benefits with a healthcare provider before starting therapy in these populations.

Lercanidipine should be used with caution in patients with a history of heart failure, as it can potentially exacerbate symptoms in some cases, particularly if the patient has reduced left ventricular function.

Lercanidipine Hydrochloride Indication - Uses and Benefits

Lercanidipine is primarily indicated for the management of hypertension (high blood pressure) in adults. It is often prescribed either as a monotherapy or in combination with other antihypertensive agents, especially in cases of uncontrolled or difficult-to-treat hypertension. Lercanidipine works by inhibiting the entry of calcium into smooth muscle cells of the blood vessels, resulting in vasodilation and a subsequent decrease in blood pressure.

Lercanidipine is particularly useful in patients who require long-acting antihypertensive treatment due to its sustained-release formulation, which allows for once-daily dosing. The drug has also been studied for use in other conditions related to cardiovascular health, though its primary indication remains hypertension management.

Off-label uses of lercanidipine may include the treatment of certain types of angina (chest pain) due to its ability to dilate blood vessels and improve blood flow, though this indication is not as commonly prescribed.

Lercanidipine Hydrochloride Contraindications - Important Warnings

Lercanidipine is contraindicated in several clinical situations. It should not be used in patients who have a known hypersensitivity or allergy to lercanidipine or any of the excipients in the formulation. The drug is also contraindicated in patients with severe hypotension, as it can cause further lowering of blood pressure and lead to symptoms of dizziness, fainting, and shock.

Additionally, lercanidipine should be avoided in patients with severe liver impairment or active liver disease due to the risk of accumulation and potential toxicity. It is also contraindicated in patients with cardiogenic shock or severe aortic stenosis, as the drug may exacerbate these conditions by causing excessive vasodilation and reduced cardiac output.

Lercanidipine is not recommended for use during pregnancy or breastfeeding due to its potential risks to the fetus or infant. It is important to discuss alternative treatment options with a healthcare provider in these cases. For children and adolescents, lercanidipine is typically not prescribed, as its safety and efficacy in this population have not been established.

Lercanidipine Hydrochloride Side Effects - What to Expect

Common side effects of lercanidipine include headache, dizziness, palpitations, and peripheral edema (swelling in the legs or ankles). These are usually mild and tend to resolve as the body adjusts to the medication. In some cases, patients may experience flushing, fatigue, or nausea.

More serious but less common side effects include severe hypotension, particularly in patients who are volume-depleted or taking multiple antihypertensive agents. Symptoms of hypotension include dizziness, fainting, and shock, which require immediate medical attention.

Lercanidipine may also cause elevated liver enzymes or liver toxicity in some patients, so liver function should be monitored regularly, especially in those with pre-existing liver disease.

In rare cases, lercanidipine can cause allergic reactions such as rash, itching, or difficulty breathing, which require immediate medical attention.

If any unusual or severe side effects occur, patients should contact their healthcare provider immediately to assess whether continuation of therapy is appropriate.

Lercanidipine Hydrochloride Pregnancy Category ID - Safety Information

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Lercanidipine Hydrochloride Mode of Action - How It Works

Lercanidipine is a selective calcium channel blocker (CCB) that acts primarily on the vascular smooth muscle. It works by inhibiting the influx of calcium ions into the smooth muscle cells of the blood vessels through voltage-gated L-type calcium channels. This results in vasodilation, or the relaxation and widening of the blood vessels, particularly in the arteries.

The reduction in vascular resistance lowers blood pressure, which is beneficial in the treatment of hypertension. Lercanidipine is more selective for vascular smooth muscle compared to cardiac muscle, which helps reduce the risk of negative effects on the heart, such as excessive bradycardia or heart block, seen with some other calcium channel blockers.

Pharmacokinetically, lercanidipine is well absorbed in the gastrointestinal tract but undergoes significant first-pass metabolism in the liver. Its effects are long-lasting, which allows for once-daily dosing. The drug has a half-life of approximately 8–14 hours, and it reaches peak plasma concentration about 3–6 hours after oral administration.

Lercanidipine Hydrochloride Drug Interactions - What to Avoid

Lercanidipine can interact with a variety of other medications, which may either increase its side effects or reduce its effectiveness. Notable drug interactions include:

- CYP3A4 inhibitors: Lercanidipine is metabolized by the CYP3A4 enzyme in the liver. Therefore, drugs that inhibit CYP3A4, such as ketoconazole, itraconazole, erythromycin, and grapefruit juice, can increase the plasma concentration of lercanidipine, potentially leading to an increased risk of side effects like hypotension, dizziness, and edema. Dose adjustments or close monitoring are recommended when lercanidipine is used in combination with these medications.

- CYP3A4 inducers: Conversely, drugs that induce CYP3A4, such as rifampicin or phenytoin, may reduce the effectiveness of lercanidipine by increasing its metabolism. Patients taking these medications may require higher doses of lercanidipine to achieve the desired blood pressure reduction.

- Other antihypertensive drugs: The use of lercanidipine with other antihypertensive agents (such as ACE inhibitors, diuretics, or beta-blockers) may result in additive blood pressure-lowering effects. This may increase the risk of hypotension, especially during the initiation of treatment or dose titration.

- Alcohol: Alcohol can enhance the blood pressure-lowering effects of lercanidipine, which may increase the risk of side effects like dizziness, lightheadedness, and fainting. Alcohol consumption should be minimized while using this medication.

Patients should always inform their healthcare provider of all medications they are taking, including over-the-counter drugs and supplements, to minimize the risk of harmful interactions.

Lercanidipine Hydrochloride Adult Dose - Recommended Dosage

For adults, the usual starting dose of lercanidipine for hypertension is 10 mg once daily. If necessary, the dose may be increased to a maximum of 20 mg once daily, depending on the patient's blood pressure response and tolerance to the medication. The drug should be taken on an empty stomach, at least 15 minutes before a meal, to avoid interference with its absorption.

In some patients, particularly those with renal or liver impairments, the dose may need to be adjusted. Careful monitoring of blood pressure is recommended during the initial stages of treatment and when the dose is adjusted to ensure that the patient does not experience excessive lowering of blood pressure.

Lercanidipine Hydrochloride Child Dose - Dosage for Children

Lercanidipine is not typically prescribed for children, as its safety and efficacy in pediatric patients have not been established. In general, calcium channel blockers like lercanidipine are not routinely used in the pediatric population unless there is a specific indication and no alternative treatment options are available. If prescribed, careful monitoring for side effects, particularly hypotension, is required.

Lercanidipine Hydrochloride Renal Dose - Dosage for Kidney Conditions

For patients with mild to moderate renal impairment (creatinine clearance greater than 30 mL/min), no dose adjustment is generally required for lercanidipine. However, the drug should be used with caution in these patients, and blood pressure should be monitored closely.

For patients with severe renal impairment (creatinine clearance less than 30 mL/min), lercanidipine should be used with extreme caution. Since the drug is primarily metabolized in the liver, its renal excretion is not as significant, but renal impairment can still lead to increased plasma levels. Regular monitoring and dose adjustment may be necessary based on clinical response.