Lercanidipine hydrochloride

How it works

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

Prescribing in practice

• Vasodilatory adverse effects such as ankle oedema, flushing and headache are common and may be dose-limiting.
• It is contraindicated in significant hepatic or severe renal impairment, in unstable angina, in untreated heart failure and within a short period after myocardial infarction, and grapefruit juice should be avoided as it increases drug exposure.
• It is best taken before food, as taking it with a high-fat meal can substantially increase absorption.

Monitoring

Monitor blood pressure for response and review the patient for ankle oedema and other vasodilatory effects.

Counselling the patient

• Take the medicine before food and avoid grapefruit juice.
• Ankle swelling, flushing or headache may occur, especially when starting treatment.
• Keep taking it regularly, as it controls rather than cures high blood pressure.

Evidence & guidelines

Dihydropyridine calcium-channel blockers such as lercanidipine are recommended for hypertension in NICE guidance, with well-established efficacy in lowering blood pressure.