What is lercanidipine?
Lercanidipine is a third-generation calcium channel blocker of the dihydropyridine type. It is distinguished by a high lipophilia (fat solubility) which leads to a slow, uniform flooding in the vessel walls.
An essential advantage over amlodipine: Lercanidipine causes significantly rare ankle edema. This makes it particularly suitable for patients suffering from this typical side effect of calcium channel blockers.
Lercanidipine is available as a mono preparation and in combination with Enalapril (Enalapril/Lercanidipine-ratiopharm). It is taken once a day.
Active Ingredients & Mechanism of Action
Active ingredient: Lercanidipin
Lercanidipin blocks voltage-dependent L-type calcium channels in vascular muscles:
Active mechanism:
- Blocks calcium inflow into smooth vascular muscle cells
- Arteries and arteries expand
- Peripheral vascular resistance drops
- Blood pressure falls
Special (3rd generation):
- Extremely high lipophilia
- Slow enrichment in the cell membranes of the vascular wall
- Uniform, slow action
- No reflective heart rate increase
- Less edema through uniform vascular expansion
Advantages over amlodipine:
- Significantly less ankle edema
- Less facial redness (Flush)
- Less reflective sympathy activation
- Renale Vasodilatation
Initiation of action: Maximum plasma level after 1.5-3 hours. The membrane storage keeps the action 24 hours.
Who is it suitable for?
Lercanidipine is suitable for:
- Adults with light to medium blood pressure
Especially recommended at:
- Patients with ankle edema under amlodipine
- Patients who develop flush under nifedipine
- In combination with ACE inhibitors (Enalapril)
- Older patients
Not suitable:
- Heavy heart failure (NYHA III-IV)
- unstable angina pectoris
- Heavy aortic stenosis
- Within 4 weeks after heart attack
- Heavy liver or kidney failure
- Pregnancy and breastfeeding
Available Dosages
High blood pressure:
- usual dose: 10 mg once a day
- If required, increase to 20 mg once a day
- Maximum dose: 20 mg daily
In older patients:
- Start dose: 10 mg once a day
- No dose adjustment required for normal organ function
Available starches:
- 10 mg, 20 mg tablets
Combination preparation:
- Lercanidipine + Enalapril (Enalapril/Lercanidipine-ratiopharm)
How to Take
Intake:
- Once a day, preferably morning
- Take at least 15 minutes before a meal
- Suck with sufficient water
- NO grapefruit juice (inhibits degradation)
Important – sober intake: Lercanidipine should be taken before eating, as a rich meal can increase the intake by four times. This can lead to an undesirably high blood pressure reduction.
**
- No alcohol in temporal proximity to intake (reinforced vasodilatation)
- Regular blood pressure controls
- No abrupt termination necessary (but medical consultation)
Contraindications
**Lercanidipine must not be taken at:* *
- hypersensitivity to Lercanidipine or other dihydropyridines
- Heavy heart failure (NYHA III-IV)
- unstable angina pectoris
- Heavy aortic stenosis
- Within 4 weeks after heart attack
- Heavy liver or kidney failure (GFR under 30 ml/min)
- Pregnancy and breastfeeding
- Simultaneously with strong CYP3A4 inhibitors (Ketoconazole, Itraconazole, Ritonavir)
- At the same time with ciclosporin
Preview at:
- Sick sine syndrome (without pacemaker)
- Left ventricular dysfunction
- Easy to moderate kidney or liver failure
pregnant: Contraindicated. No sufficient data for safety in pregnancy.
Possible Side Effects
** Occasionally (0,1-1%):* *
- Headaches
- Squeeze
- Face redness (Flush) – more rare than Amlodipine
- Heart palp
- Ankle edema – significantly less rare than Amlodipine (about 1-2% vs. 10-15%)
Selten:
- Gastrointestinal complaints
- fatigue
- Skin rash
- muscle pain
- Chest pain
Very rare:
- Angina pectoris
- Synkope (Ohnmacht)
- Gingivahyperplasia
- liver value increases
- Increased hurdle
Advantage: The rate of ankle edema is significantly lower under larcanidipine than under amlodipine or nifedipine. This is the main reason for the choice of Lercanidipine.
Interactions
Contraint with:
- Strong CYP3A4 inhibitors (Ketoconazole, Itraconazole, Ritonavir)
- Ciclosporin (reverse mirror elevation)
Preview at:
- Medium CYP3A4 inhibitors (erythromycin, fluconazole)
- CYP3A4 inductors (rifampicin, phenytoin, carbamazepine) → reduced action
- Digoxin → light mirror increase
- Simvastatin → close-mesh surveillance
- Betablocker → increased blood pressure reduction (usually desired)
- Cimetidine → increased Lercanidipine mirror
Grapefruit: Grapefruit juice inhibits CYP3A4 and can significantly increase the Lercanidipine level. Avoid grapefruit juice!
Alcohol: Alcohol strengthens the vascular expansion effect. Avoidance recommended in time to take.
Frequently Asked Questions
Similar Medications
Is lercanidipine right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.