Lercanidipine - EM Doctors

1. About lercanidipine

Lercanidipine is a medicine used to treat high blood pressure.

If you have high blood pressure, taking lercanidipine helps prevent heart disease, heart attacks and strokes.

Lercanidipine is only available on prescription. It comes as tablets.

2. Key facts

Lercanidipine lowers your blood pressure and makes it easier for your heart to pump blood around your body.
It's usual to take lercanidipine once a day. You can take it at any time of day, but try to make sure it's around the same time each day.
It's best to take lercanidipine on an empty stomach. Fatty food can increase the amount of lercanidipine your body takes in and make you more likely to have side effects.
Do not eat grapefruit or drink grapefruit juice while you're taking lercanidipine. It can make side effects worse.
Lercanidipine is also called by the brand name Zanidip.

3. Who can and can't take lercanidipine

Lercanidipine can be taken by adults aged 18 and over.

Lercanidipine isn't suitable for some people.

Tell your doctor before starting lercanidipine if you:

have had an allergic reaction to lercanidipine or any other medicine in the past
are trying to get pregnant, are pregnant or you're breastfeeding
have liver or kidney disease
have heart disease or have had a recent heart attack

4. How and when to take it

Always take lercanidipine exactly as your doctor has told you, and follow the directions on the label. If you're not sure, check with your doctor or pharmacist.

It's usual to take lercanidipine once a day. You can take lercanidipine at any time of day, but try to make sure it's around the same time every day. Most people take it in the morning.

How much to take

Lercanidipine comes as 10mg and 20mg tablets.

The usual starting dose of lercanidipine is 10mg once a day.

If this dose isn't working well enough (your blood pressure stays too high), you may need to increase your dose to 20mg once a day. Your doctor will tell you if you need to do this.

How to take it

Take lercanidipine on an empty stomach, at least 15 minutes before a meal. This is because fatty food can increase the amount of lercanidipine your body takes in and make you more likely to have side effects.

Swallow lercanidipine tablets whole with a drink of water.

Some brands have a score line to help you break the tablet to make it easier to swallow. Check the information leaflet for your brand to see if you can do this.

Do not eat or drink lots of grapefruit or grapefruit juice while you're taking this medicine. Grapefruit can increase the concentration of lercanidipine in your body and worsen side effects.

Important

Take lercanidipine even if you feel well, as you'll still be getting the benefits of the medicine.

What if I forget to take it?

If you forget to take lercanidipine, take it 15 minutes before your next meal.

If you don't remember until the next day, leave out the missed dose and carry on as normal.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too much lercanidipine by accident, contact your doctor or nearest hospital straight away.

An overdose of lercanidipine can cause dizziness and sleepiness.

The amount of lercanidipine that can lead to an overdose varies from person to person.

Urgent advice: Call your doctor or go to A&E straight away if you take too much lercanidipine

If you need to go to a A&E, do not drive yourself - get someone else to drive you or call for an ambulance.

Take the lercanidipine packet or leaflet inside it, plus any remaining medicine, with you.

5. Side effects

Like all medicines, lercanidipine can cause side effects, although not everyone gets them.

Side effects often improve as your body gets used to the medicine.

Common side effects

Common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.

Talk to your doctor or pharmacist if the side effects bother you or last for more than a few days.

The most common side effects of lercanidipine are:

headaches
dizziness
flushing
a pounding heartbeat
swollen ankles

Serious side effects

Serious side effects of lercanidipine are rare and happen in less than 1 in 1,000 people.

Call a doctor straight away if you get chest pain that's new or worse.

This side effect needs to be checked out as chest pain is a possible symptom of a heart attack.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to lercanidipine.

Immediate action required: Call 999 or go to A&E if:

you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
you're wheezing
you get tightness in the chest or throat
you have trouble breathing or talking
your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These aren't all the side effects of lercanidipine.

For a full list, see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

6. How to cope with side effects

What to do about:

headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if headaches last longer than a week or are severe.
feeling dizzy - if lercanidipine makes you feel dizzy, stop what you're doing and sit or lie down until you feel better.
flushing - try cutting down on coffee, tea and alcohol. It might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks. The flushing should go away after a few days. If it doesn't go away, or if it's causing you problems, contact your doctor.
a pounding heartbeat - if this happens regularly after you take lercanidipine, try taking it somewhere you can sit or lie down when the symptoms are worse. It may also help to cut down on alcohol, smoking, caffeine and big meals as these can make the effect worse. Speak to your doctor if it lasts more than a week as they may need to change you to a different type of medicine.
swollen ankles - raise your legs when you're sitting down

These side effects should go away after the first week of taking lercanidipine.

Tell your doctor if they last longer than this or get worse.

7. Pregnancy and breastfeeding

Lercanidipine is not normally recommended in pregnancy or when breastfeeding.

If you're trying to get pregnant or already pregnant, talk to your doctor about the benefits and possible harms of taking lercanidipine.

There may be other blood pressure-lowering medicines that are safer for you.

For more information about how lercanidipine can affect you and your baby during pregnancy, read the lercanidipine leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

Lercanidipine and breastfeeding

Small amounts of lercanidipine may get into breast milk, but it's not known if this is harmful to the baby.

Talk to your doctor, as other blood pressure-lowering medicines might be better while you're breastfeeding.

Non-urgent advice: Tell your doctor if you're:

trying to get pregnant
pregnant
breastfeeding

8. Cautions with other medicines

If you take other medicines that lower blood pressure, such as ramipril or lisinopril, at the same time as lercanidipine, the combination can sometimes lower your blood pressure too much.

This may make you feel dizzy or faint. If this keeps happening to you, tell your doctor as your doses may need to be changed.

Some medicines can interfere with the way lercanidipine works. Lercanidipine can also interfere with the way some other medicines work.

Tell your doctor before taking lercanidipine if you're taking any of these medicines:

aminophylline or theophylline (medicines to ease breathing)
the antifungal itraconazole
the antibiotic erythromycin
digoxin, a heart medicine
medicines to treat HIV
the epilepsy medicines carbamazepine, phenytoin, phenobarbital (phenobarbitone) or primidone
ciclosporin, a medicine to stop your immune system overreacting

Mixing lercanidipine with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with lercanidipine.

To be safe, speak to your pharmacist or doctor before taking any herbal or alternative remedies with it.

Important

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

9. Common questions

How does lercanidipine work?

Lercanidipine is a type of medicine called a calcium channel blocker.

Like other calcium channel blockers, lercanidipine works by blocking calcium going into muscles in the heart and blood vessels.

Muscles need calcium to contract, so when you block the calcium, it makes the muscle cells relax.

This lowers your blood pressure and makes it easier for your heart to pump blood around your body.

How long does lercanidipine take to work?

How long will I take it for?

Is lercanidipine safe to take for a long time?

What will happen if I stop taking it?

Can I come off lercanidipine now my blood pressure is lower?

Even if lercanidipine lowers your blood pressure successfully, it's best to carry on taking it.

If you stop taking lercanidipine, your blood pressure could rise back up again.

If you need blood pressure-lowering medicines, you'll probably need to take them for the rest of your life.

Remember, by keeping your blood pressure low, you're protecting yourself against having a heart attack or stroke in the future.

Can I drink alcohol with it?

Is there any food or drink I need to avoid?

Are there similar medicines to lercanidipine?

There are several other calcium channel blockers that work in the same way as lercanidipine.

They include nifedipine, felodipine, lacidipine and amlodipine.

There are also lots of other types of medicines to lower your blood pressure.

These medicines work in different ways from calcium channel blockers and include:

ACE inhibitors - for example, ramipril and lisinopril
angiotensin receptor blockers - for example, candesartan
beta blockers - for example, bisoprolol
tablets that make you pee more (diuretics) - for example, bendroflumethiazide

If you can't take lercanidipine or other calcium channel blockers because of side effects, you may be able to switch to another blood pressure-lowering medicine.

Your doctor will advise which one is best for you depending on your age, ethnicity and medical history.

Is lercanidipine addictive?

Will it affect my contraception?

Will it affect my fertility?

Can I drive or ride a bike?

Can lifestyle changes help?

You can boost the health of your heart by making some key lifestyle changes.

These will also help if you have high blood pressure or angina.

quit smoking - smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
cut down on alcohol - drinking too much alcohol raises blood pressure over time and also makes heart failure worse. Men and women should not drink more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
exercise - regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It doesn't need to be too energetic - walking every day is enough.
eat well - aim to eat a diet that includes plenty of fruit and veg, wholegrains, fat-free or low-fat dairy products, and lean proteins. It's a good idea to cut down on salt, too. Eating too much salt is the biggest cause of high blood pressure - the more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
deal with stress - when you're anxious or upset, your heart beats faster, you breathe more heavily, and your blood pressure often goes up. This can make heart failure worse, too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
vaccinations - if you have heart failure, it's recommended that you have a flu jab every year and a pneumonia vaccination (also called the pneumococcal vaccine) every 5 years. Ask your doctor about these vaccinations. You can have them free on the NHS.