Lercanidipine

Lercanidipine belongs to a group of drugs called calcium-channel blockers and is used to lower blood pressure if you have hypertension.

Calcium is what makes your muscles able to tighten (contract). Taking lercanidipine lowers the amount of calcium entering your muscle cells. This allows muscles cells in your blood vessels to relax and widen which lowers your blood pressure.

Lercanidipine is suitable for adults over 18 who have been diagnosed with mild to moderate high blood pressure. Whether you are prescribed lercanidipine or another blood pressure medication by your GP depends on your age, ethnicity and any other health conditions you may suffer from.

ZAVA doctors can only prescribe lercanidipine if you’ve already been prescribed this by your GP and are not experiencing any side effects. It’s important that you keep going to your regular GP check-ups to monitor your blood pressure and blood tests.

Lercanidipine is not suitable for everyone, and it should not be used in certain situations. You should not take lercanidipine if you’re allergic to any of its ingredients, or if you have had an allergic reaction to any other calcium-channel blocker.

You should also not take lercanidipine if you have:

• unstable angina
• left ventricular outflow obstruction (for example, aortic stenosis or hypertrophic obstructive cardiomyopathy)
• untreated heart failure
• severe kidney or liver problems
• had a heart attack in the last month

You should discuss with your doctor before taking lercanidipine if you have:

• heart failure
• angina
• sick sinus syndrome:
• ischaemic heart disease
• mild to moderate kidney or liver problems

Pregnancy and breastfeeding

You should not take lercanidipine if you are pregnant or breastfeeding. If you already take lercanidipine talk to your GP about the risks, benefits and alternative treatments available prior to stopping this if you plan to conceive.

When breastfeeding, small amounts of lercanidipine can be present in breast milk. Because it’s not known if this can harm a child, breastfeeding mothers should not take the medication.

If you’re taking lercanidipine and think you might be pregnant or are breastfeeding you should talk to your doctor for advice.

Taking certain medicines while taking lercanidipine can change both the effects of lercanidipine and your other medication.

It’s best to talk to your doctor before taking lercanidipine if you’re already taking another high blood pressure medication, or if you’re taking medication for:

• epilepsy (phenytoin or carbamazepine)
• tuberculosis (TB; rifampicin)
• insomnia (midazolam)
• stomach problems (cimetidine)
• heart conditions (digoxin or beta blockers)
• allergies (terfenadine or astemizole)
• medicines used to treat a fast heartbeat (amiodarone or quinidine)
• high cholesterol (simvastatin)
• antifungals (ketoconazole, itraconazole, or voriconazole)
• antibiotics (erythromycin, clarithromycin, or troleandomycin)
• HIV (ritonavir, cobicistat, darunavir, foramprenavir, lopinavir, saquinavir, or tipranavir)
• immune system suppression (ciclosporin)
• malaria prevention (mefloquine)
• cancer (idelalisib)

If you take any medication, either prescribed or over-the-counter, you should talk to your doctor or pharmacist about whether this is safe to take with lercanidipine.

Lercanidipine should not be taken with grapefruit juice, and alcohol should also be avoided (alcohol can increase the blood pressure lowering effect of lercanidipine and lead to dizziness or fainting).

You should take lercanidipine exactly as prescribed. It’s best to swallow each tablet whole with half a glass of water.

Dose

Your GP will prescribe a dose of lercanidipine based on your current blood pressure reading, as well as your past medical history.

It’s available in two doses: 10mg or 20mg. Usually, you would start on 10mg once a day. This can be increased if your blood pressure is still high when you go for your checkup. It takes about two weeks for lercanidipine to become fully effective.

You should never increase or decrease the dose without consulting your doctor.

When to take it

Normally, lercanidipine is taken once per day. It’s usually recommended that you take it in the morning before breakfast, but it can be taken at any time. Whenever you decide to take it, you should try to do it at the same time every day.

You should wait at least 15 minutes before you eat after you’ve taken the medication. Foods high in fat can increase the concentration of lercanidipine in your body which increases the risk of side effects. This means it’s best to take the medication on an empty stomach.

What to do if you forget to take it

If you forget to take lercanidipine at your usual time, take it as soon as you remember, preferably 15 minutes before you have your next meal.

If you do not remember until the next day, just leave out the missed dose and carry on as normal.

What to do if you take too much

If you take too much lercanidipine, talk to your GP straight away, or go to your nearest A&E department Take the medication with you so the doctor can see exactly what you have taken.

Taking too much lercanidipine can cause side effects like sleepiness, dizziness and vomiting. In severe cases an overdose of lercanidipine can lead to heart and kidney problems.

Common side effects include:

• headaches
• dizziness
• sudden reddening of the face, neck, or chest (known as flushing)
• swollen ankles
• a faster heartbeat
• heart palpitations (when you can feel your heartbeat in your chest)

Less common side effects include:

• sleepiness
• weakness
• feeling sick (nausea)
• being sick (vomiting)
• diarrhoea
• pain in your lower stomach
• indigestion
• muscle pain
• skin rash
• an increased volume of pee
• chest pain caused by heart disease (angina pectoris)

Very rare side effects include:

• an allergic reaction
• swollen gums
• peeing more often
• chest pain
• heart attack
• fainting
• liver problems

If you suffer from chest pain after taking lercanidipine this can be a sign of a problem with your heart and you should call an ambulance. If you have a skin rash, your lips swell, you’re wheezing, or having difficulty breathing, these can be signs of a severe allergic reaction and you should stop the medication and go to A&E.

Other medications

Calcium-channel blockers like lercanidipine are not the only medications available for high blood pressure.

• ACE (Angiotensin-converting enzyme) inhibitors work by widening your blood vessels, which increases the amount of blood your heart can pump and increases blood flow, and as a result lowers blood pressure.
• Angiotensin receptor blockers have the same effect as ACE inhibitors but work by blocking a chemical which narrows blood vessels called angiotensin II.
• Beta-blockers slow your heart rate and relax blood vessels by blocking the effect of the hormones adrenaline and noradrenaline
• Diuretics work by removing excess water and salt from your body. They do this by making you pee more often. Thiazide diuretics are prescribed to help lower blood pressure
• Alpha-blockers relax your blood vessels which makes it easier for blood to flow through them. These are not normally the first choice for treating hypertension

Lifestyle changes

For some people, changing their day-to-day life can reduce blood pressure. If you’re taking medication, making positive lifestyle changes will also increase how effective the treatment is.

Actions to consider include:

• exercising more – aim for 30 minutes a day of moderate exercise, like walking, at least 5 times a week
• keeping to a healthy weight for your size – if you’re overweight, your body needs to work harder to pump blood around your body which can increase your blood pressure. Even a small amount of weight loss can help bring your blood pressure down
• eating a healthy, balanced diet – you should eat plenty of fruit, vegetables, and whole grains. Swap these for foods that are high in saturated fat or sugar
• reducing your salt intake – eating too much salt can increase your blood pressure. You should check the labels of the foods you eat to see how much salt is in them. Aim to eat no more than 6g of salt per day
• quitting smoking – smoking can cause your arteries to become narrow, so your heart must work harder to pump blood through them which increases your blood pressure
• limiting how much alcohol you drink – regularly drinking too much alcohol increases your blood pressure. Current advice states you should not regularly drink more than 14 units of alcohol per week
• limiting how much caffeine you drink – caffeine is present in drinks like tea, coffee and energy drinks. Cutting back can be helpful to some people with high blood pressure
• getting at least 6 hours of sleep a night – sleep deprivation can cause your blood pressure to rise