Lercanidipine

If you have high blood pressure (also known as hypertension), lercanidipine can help lower your blood pressure back to healthy levels.

Lercanidipine:

• belongs to a class of drugs called dihydropyridine, calcium-channel blockers
• works by decreasing the contraction of the heart and widening its arteries, this makes it easier for the heart to pump blood around your body at a lower pressure
• can bring the blood pressure within range for around 63% of adults newly-diagnosed with high blood pressure

Blood pressure is measured in millimeters of mercury (mmHg) and is given as two figures. The upper figure is the systolic pressure, which is the pressure when your heart pumps the blood. The lower figure is the diastolic pressure, which is the pressure when your heart rests between beats.

High blood pressure is diagnosed if you have consistent readings that are 140 and/or 90mmHg or above. The ideal blood pressure range is considered to be between 90/60mmHg and 120/80mmHg. A reading between 120/80mmHg and 140/90mmHg could mean that you are at risk of developing high blood pressure in the future if you don’t take steps to keep it under control.

The dangers of high blood pressure - if your high blood pressure is not controlled it increases your risk of serious and potentially life-threatening conditions, like:

• heart attack
• stroke
• kidney damage
• dementia
• other heart problems

Increased diastolic pressure is more commonly seen in adults less than 50 years of age. As a person ages, the systolic blood pressure becomes more of a problem as the arteries become progressively harder.

High blood pressure is responsible for more than half of all heart attacks and strokes. Someone with high blood pressure that is well controlled reduces his or her risk of heart disease and stroke to almost that of a person with normal blood pressure.

It is important to control high blood pressure as the risk of health problems continues to increase the more the blood pressure increases. Each 2mmHg rise in systolic blood pressure is associated with a 7% increased risk of death from heart disease caused by a lack of oxygen and blood supply and also a 10% increased risk of death from stroke.

Lercanidipine is the right treatment for you if your doctor has prescribed it. It is only available on prescription so you need a doctor to check the treatment is right for you before you can purchase it.

How do I know if I need it? The only way to find out you have high blood pressure is to get it checked. High blood pressure rarely has any symptoms and many people do not know they have it until they get it checked or if they have a related condition, such as a heart attack or stroke. You may therefore not feel your medication working but it is important to continue taking it as prescribed by your doctor.

Healthy adults aged over 40 should have their blood pressure checked at least once every five years. If you have an increased risk of high blood pressure then you should get it checked at least once each year.

An NHS health check that includes a blood pressure test is offered to adults in England aged 40 – 74 for free. You can also ask for a blood pressure check at one of the following:

• Your GP surgery
• Some pharmacies
• Some workplaces
• At a health event

Am I more likely to have high blood pressure? In many cases it is not clear what causes high blood pressure, but there are several factors that can increase your risk. These include:

• age – the risk of developing high blood pressure increases with age
• family history of high blood pressure
• being of African or Caribbean origin
• diet – too much fat, salt or caffeine
• a lack of exercise
• being overweight or obese
• drinking large amounts of alcohol regularly
• smoking
• long-term sleep deprivation

Some underlying medical conditions can cause or be linked with high blood pressure. You might be at extra risk if you have:

• diabetes
• kidney disease or long-term kidney infections
• hormone problems such as an under or overactive thyroid
• obstructive sleep apnoea – a condition in which the walls of the throat relax and narrow during sleep, interrupting normal breathing
• lupus – a condition in which the immune system attacks parts of the body such as skin, joints and organs
• scleroderma – a condition that causes thickened skin, and sometimes problems with organs and blood vessels

Medicines can also increase your blood pressure. These include:

• The combined contraceptive pill
• Steroids
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
• Some cough and cold remedies

Could I take lercanidipine? – Lercanidipine is appropriate for adults aged over 18 years who have mild to moderate essential hypertension. Essential hypertension is high blood pressure that doesn’t have an identifiable cause.

Lercanidipine is not suitable in the following situations:

• Untreated congestive heart failure
• Unstable angina
• If you have had a heart attack in the last one month
• Left ventricular outflow tract obstruction (for example aortic stenosis)
• Severe kidney or liver impairment
• If you are taking cyclosporin
• If you drink grapefruit juice
• If you take other medicines that are strong inhibitors of the CYP3A4 enzyme such as amiodarone, ketoconazole, and erythromycin
• Women of childbearing potential unless effective contraception is used
• If you are pregnant or breastfeeding
• Lapp lactase insufficiency
• Galactosaemia or glucose/galactose malabsorption syndrome
• An allergy to lercanidipine, any other dihydropyridine calcium-channel blocker or any of the ingredients in lercanidipine

If you’re already taking lercanidipine you can reorder it online from our online doctor service – our certified online doctors provide fast and convenient assessments will check your order for you. Our service is for patients whose blood pressure is already stable while using lercanidipine. To order your tablets, you need to fill in a brief medical questionnaire. Our doctor will review your information and if your order is approved, we will then post your medication. Standard delivery is usually free.

If you’re not already taking lercanidipine, for your first prescription you would need to see your doctor. Your doctor will measure your blood pressure and check your medical history before diagnosing you with high blood pressure.

Your doctor will only prescribe blood pressure medication if you already have high blood pressure. If you are worried you might be at risk of getting high blood pressure, then get into the habit of getting your blood pressure checked regularly and make some lifestyle changes, if needed, to reduce your risk in the future.

You can also consider buying a blood pressure machine where you can measure your blood pressure in the comfort of your own home. Ensure the machine is properly tested and validated by the British Hypertension Society (BHS) before you buy it.

There are different types of blood pressure medicines that work in different ways to lower your blood pressure.

If you’re already taking another medication for high blood pressure, it may be possible to switch your medication based on the decision of your doctor if you find it isn’t suitable. This could be because it is not lowering your blood pressure enough or you are experiencing side effects. Speak to your doctor if you are concerned.

The health benefits of high blood pressure treatment are important so it's best to see your doctor before you stop your medication, even if you think you are having problems with side effects.

If side effects occur they are not usually troublesome and do not require you to stop treatment. Studies have shown that only about 1.8% of adults taking lercanidipine experience side effects. Studies have also shown that less than 1% of adults experience common side effects. These side effects should usually disappear within the first couple of weeks of starting treatment.

To help manage your side effects, drinking plenty of fluids and getting adequate rest will help alleviate many of the common side effects, especially headaches. If you feel dizzy then stop what you are doing and sit or lie down until you feel better. If you experience flushing, then try cutting down on coffee, tea or alcohol. You could also keep a small fan or water spray with you and sip cold or iced drinks. If you experience swollen ankles then raise your legs when you are sitting down.

If you experience any troublesome side effects (ones that are difficult to put up with), then it may not be the right choice for you. Speak to your doctor about any troublesome or persistent side effects and they can check if you might need to switch medications.

Other uncommon side effects include:

• nausea
• indigestion
• diarrhoea
• vomiting
• abdominal pain
• excessive weakness or sleepiness
• muscle pain
• rash

Rare or very rare side effects include:

• low blood pressure
• excessive passing of urine
• fainting
• chest pain
• heart attack
• gingival hypertrophy – an enlarged growth of your gums

Always seek urgent medical attention if you experience any chest pain, fainting or an increase in angina related symptoms including palpitations and a fast heart rate.

You should stop taking lercanidipine right away and seek urgent medical attention if you have an allergic reaction (swelling of the face, eyelids and lips, itchiness, redness and difficulty breathing).

Medication helps control your symptoms but lifestyle changes can do this too, and they can help you to control your blood pressure long-term. These include:

• Exercise – getting regular exercise lowers your blood pressure by keeping your heart and blood vessels in good condition. Aim for 150 minutes (2 hours and 30 minutes) of moderate-intense aerobic activity such as fast walking each week
• Weight loss – being overweight forces your heart to work harder to pump blood around your body, which can increase your blood pressure. If you do need to lose weight, then even losing a few pounds will benefit your blood pressure
• Healthy diet – eating a low-fat diet that includes plenty of fibre, fruit and vegetables helps to lower blood pressure. Aim to eat five portions of fruit and vegetables a day
• Cut down on salt – Reducing your salt intake has a great impact on reducing your blood pressure. Aim to eat no more than 6g of salt a day, which is around one teaspoon
• Cut down on caffeine – consider cutting down if you drink large quantities of caffeine rich drinks such as energy drinks, coffee or tea. Aim to drink less than four cups of coffee a day
• Limit your alcohol intake – regularly drinking alcohol above the recommended limit can increase your blood pressure over time. It is advised not to drink regularly more than 14 units a week
• Quit smoking – smoking also causes your arteries to narrow and increases your risk of stroke, heart and lung disease.
• Sleep – aim for at least six hours of sleep each night
• Try relaxation therapies - to reduce stress and encourage good sleep

Supplements - although some people might believe it’s the case, calcium, magnesium and potassium supplements don’t seem to work to lower blood pressure and are not recommended.