Medicines & treatments centre

LERCANIDIPINE HYDROCHLORIDE WARNINGS

Lercanidipine should be used with caution in: heart disease, patients with a pacemaker, mild or moderate liver or kidney disease, patients on dialysis, intolerance to certain sugars.

It should not be used in:

• patients who are allergic to lercanidipine or to any other ingredients contained in the medicine, patients who are allergic to the closely related medicines amlodipine, nicardipine, felodipine, isradipine, nifedipine or lacidipine, children aged under 18 years, pregnancy, breastfeeding, patients who are trying to become pregnant or who are not using any method of contraception, uncontrolled heart failure, a heart condition associated with obstruction of blood flow from the heart, unstable angina (pain in the chest on exertion caused by a lack of oxygen), within one month of a heart attack, severe liver or kidney disease, the inherited condition acute porphyria, patients who are taking grapefruit juice or the drugs ciclosporin, ketoconazole, itraconazole, erythromycin, troleandomycin or ritonavir.

Also see list of precautions and interactions

STORAGE

Do not store above 25ºC.

LERCANIDIPINE HYDROCHLORIDE USES

What is it used for?

• Lercanidipine is used to lower high blood pressure.
• It is a calcium channel blocker, sometimes known as an antihypertensive.
• It is used to treat high blood pressure.
• In general this drug is used lower blood pressure in patients with high blood pressure (hypertension).
• Benefits of being on this drug can include a reduction in blood pressure which is associated with a reduction in the risk of stroke, heart attack, heart failure or kidney failure.

Listed below are the typical uses of lercanidipine.

• High blood pressure (hypertension) in adults over 18 years old.

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

How often do I take it?

• Take this medication by mouth usually in the morning at least 15 minutes before breakfast. Swallow the tablet whole with some water.
• Use this medication regularly in order to get the most benefit from it.
• Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
• It may take up to 2 weeks before the full benefit of this drug takes effect.
• Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

• Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

• Lercanidipine should not affect your ability to drive or use machinery. However, lercanidipine can cause dizziness, weakness and tiredness. Do not drive or use machinery until you know how lercanidipine affects you. You should not drink grapefruit juice while taking lercanidipine. Taking lercanidipine with a high fat meal can significantly increase the blood levels of your medicine. Therefore do not eat a high fat meal at the same time as taking lercanidipine. Consult your doctor or pharmacist for more details.

When can I stop?

• It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.

LERCANIDIPINE HYDROCHLORIDE SIDE EFFECTS

• Headache
• Dizziness
• Ankleswelling
• Faster heart beat
• Awareness of the beating or your heart (palpitations)
• Redness of the face and neck
• Sleepiness
• Feeling and being sick
• Rash
• Muscle pain
• Passing large amounts of urine (water) and passing urine more frequently
• Tiredness
• Fainting
• Light-headedness
• Indigestion
• Diarrhoea
• Angina (chest pain)
• Pain in the stomach
• Allergic reactions
• Swelling of the gums
• Changes to the way the liver functions
• Low blood pressure
• If any of these persist or you consider them severe then tell your doctor immediately.

Tell your doctor immediately if you develop any of the following symptoms:

• Chest pain, fall in blood pressure, fainting and allergic reactions including itching, rash and hives

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the UK you may report side-effects to the MHRA

LERCANIDIPINE HYDROCHLORIDE PRECAUTIONS

Before taking lercanidipine, tell your doctor or pharmacist if you are allergic to it; or to other calcium channel blockers; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of: an allergy to lercanidipine or to any other ingredients contained in the medicine, are allergic to the closely related medicines amlodipine, nicardipine, felodipine, isradipine, nifedipine or lacidipine, are pregnant or breastfeeding, are trying to become pregnant or are not using any method of contraception, you have uncontrolled heart failure, a heart condition associated with obstruction of blood flow from the heart, unstable angina (pain in the chest on exertion caused by a lack of oxygen), had a heart attack less than one month ago, have severe liver or kidney disease, the inherited condition acute porphyria, are taking grapefruit juice or the drugs ciclosporin, ketoconazole, itraconazole, erythromycin, troleandomycin or ritonavir.

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following: you have a pacemaker, mild or moderate liver or kidney disease, you are on dialysis, have an intolerance to certain sugars.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

• Drinking alcohol while taking lercanidipine may increase the effect of your medicine. You should therefore stop or strictly limit your intake of alcohol while taking lercanidipine.

The elderly: lercanidipine can be used in the elderly. However, special care should be taken when starting lercanidipine treatment in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Lercanidipine is not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Lercanidipine is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

LERCANIDIPINE HYDROCHLORIDE INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

• Ciclosporin
• Grapefruit juice
• Ketoconazole
• Itraconazole
• Macrolide antibiotics such as erythromycin or troleandomycin
• Antivirals such as ritonavir

If you are currently using any of these medications, tell your doctor or pharmacist before starting lercanidipine.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

• ACE-inhibitors
• Adrenergic neurone blockers
• Aldesleukin
• Alpha-blockers
• Alprostadil
• Anaesthetics
• Angiotensin-II receptor antagonists
• Antipsychotics
• Medicines for anxiety
• Medicines to help you sleep
• Baclofen
• Beta-blockers
• Clonidine
• Corticosteroids
• Cimetidine
• Diazoxide
• Water tablets (diuretics)
• Hydralazine
• Isoflurane
• Levodopa
• Monoamine-oxidase inhibitors (MAOIs)
• Mefloquine
• Methyldopa
• Minoxidil
• Moxisylyte
• Moxonidine
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Oestrogens
• Nitrates
• Digoxin
• Midazolam
• Rifampicin
• Astemizole
• Terfenadine
• Amiodarone
• Quinidine
• Phenytoin
• Primidone
• Sodium nitroprusside
• Carbamazepine
• Barbiturates
• Theophylline
• Tizanidine

This information does not contain all possible interactions. Therefore, before using lercanidipine, tell your doctor or pharmacist of all the products you use.

LERCANIDIPINE HYDROCHLORIDE OVERDOSE

Taking too much lercanidipine may cause the following: dizziness and low blood pressure, irregular or fast or slow heart beat and unconsciousness.

People who have taken too much lercanidipine should seek medical advice immediately and, if possible, take their tablets and/or container with them.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of lercanidipine or intentional overdose is suspected, contact your local hospital, GP or if in the UK call NHS Direct on 0845 4647.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.