Lacidipine

How it works

It selectively blocks L-type calcium channels in vascular smooth muscle, causing arterial vasodilatation that reduces peripheral vascular resistance and lowers blood pressure.

Prescribing in practice

• Vasodilatory effects such as ankle oedema, flushing, headache and palpitations are common and may limit treatment.
• Use with caution in significant hepatic impairment, which can increase exposure to the drug.
• It is contraindicated in patients with hypersensitivity to dihydropyridines, and caution is needed in unstable or significant aortic stenosis.

Monitoring

Monitor blood pressure for response and review the patient for dose-related ankle swelling and other vasodilatory effects.

Counselling the patient

• Ankle swelling, flushing or headache may occur, particularly early in treatment.
• Report palpitations or significant dizziness.
• Continue taking the medicine regularly even when you feel well, as it controls rather than cures high blood pressure.

Evidence & guidelines

Dihydropyridine calcium-channel blockers are a recommended class for hypertension in NICE guidance, with established blood-pressure-lowering efficacy.