Dihydropyridine calcium-channel blocker Pregnancy: There are no data on the safety of lacidipine in human pregnancy. Animal data in rat and rabbit show no evidence of a teratogenic effect, but at doses far above the therapeutic range there is maternal toxicity with increased pre- and post-implantation losses and possibly delayed ossification; animal administration prolonged gestation and produced prolonged, difficult labour through uterine muscle relaxation. Use in pregnancy only when the potential benefits for the mother outweigh possible adverse effects in the foetus or neonate; consider possible uterine relaxation at term. Breast-feeding: animal milk transfer studies suggest lacidipine or its metabolites are likely excreted into breast milk — use only when maternal benefit outweighs possible adverse effects.

Lacidipine

Brand names: Motens

Lacidipine is a dihydropyridine calcium-channel blocker used in the treatment of hypertension.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Hypertension: recommended initial dose 2 mg once daily; may be increased to 4 mg, and then if necessary to 6 mg, after adequate time has been allowed for the full pharmacological effect to occur (in practice not less than 3 to 4 weeks between increases)

Route: Oral

Frequency: Once daily, at the same time each day, preferably in the morning

Max: Daily doses above 6 mg have not been shown to be significantly more effective

Treatment of hypertension should be adapted to the severity of the condition and the individual response. Treatment may be continued indefinitely. Hepatic impairment: lacidipine is metabolised primarily by the liver, so bioavailability may be increased and the hypotensive effect enhanced — monitor carefully and, in severe cases, a dose reduction may be necessary. Paediatric population: no experience has been gained with lacidipine in children (no paediatric posology stated).

Dose adjustments

Renal

As lacidipine is not cleared by the kidneys, the dose does not require modification in patients with kidney disease.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Aortic stenosis (dihydropyridines reduce coronary arterial blood flow in these patients)
During or within one month of a myocardial infarction
Rare hereditary conditions incompatible with an excipient of the product (contains lactose)
Discontinue in patients who develop cardiogenic shock or unstable angina; use only with great care in patients with a previous allergic reaction to another dihydropyridine (theoretical cross-reactivity risk)

Side effects

Dizziness and headache (common)
Palpitations and tachycardia (common); syncope and angina pectoris (uncommon)
Flushing (common); hypotension (uncommon)
Rash, erythema, pruritus (common); abdominal discomfort and nausea (common)
Oedema and asthenia (common); polyuria and increased blood alkaline phosphatase (common)

Interactions

Other agents with a hypotensive effect (diuretics, beta-blockers, ACE inhibitors) — additive hypotensive effect (no specific interaction problems identified with common antihypertensives, digoxin, tolbutamide or warfarin)
Cimetidine — plasma level of lacidipine may be increased
Grapefruit juice — should not be taken with lacidipine as bioavailability may be altered
CYP3A4 inhibitors and inducers (e.g. itraconazole, rifampicin) — may interact with the metabolism and elimination of lacidipine
Corticoids or tetracosactide — may decrease the antihypertensive effect
Ciclosporin — in renal transplant patients, lacidipine reversed the ciclosporin-induced decrease in renal plasma flow and glomerular filtration rate
Caution with medicines known to prolong the QT interval (class I and III antiarrhythmics, tricyclic antidepressants, some antipsychotics, some antibiotics e.g. erythromycin, some antihistamines e.g. terfenadine)

Clinical monograph

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.

Reference: NICE NG136; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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