Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercandipine

Refer Verapramil-

 Lercanidipine is metabolised by the cytochrome P450 system. Hence it carries a potential for drug interactions.

However no notable drug interactions have been observed during interaction studies.

Cytochrome P-450 inhibitor such as itraconazole may alter the pharmacokinetics of lercanidipine.

Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercanidipine

Refer verapramil-

Flushing , peripheral edema, palpitations, tachycardia,

Headache, dizziness, asthenia. Gastrointestinal disturbances

Hypotention,

Drowsiness. Myalgia, polyuria, rash.

Aortic stenosis, unstable angina, uncontrolled hearfailure, within 1 month of myocardial infarction

Pregnancy and breast feeding

Special Precautions:

Hepatic and renal impairment, left ventricular dysfunction, sick sinus syndrome (if pacemaker is not fitted)

Avoid grape juice (may affect metabolism)

Indications:

Mild to moderate hypertension

Dosage:

Initially 10mg once daily, increased if necessary after at least 2 weeks to 20mg daily

Avoid grape juice (may affect metabolism)

Pharmacology:

Lercanidipine is a new long-acting dihydropyridine CCB used for treating hypertension. It selectively inhibits the influx of extracellular calcium through voltage-gated calcium channels.

It has a slow onset of action and a through-to-peak ratio that allows for consistent 24 hour blood pressure control. Lercanidipine reduces blood pressure to a similar degree as various other antihypertensives including other CCBs, ACE inhibitors and betablockers.

Pharmacokinetics:

Absorption occurs 2 hours after oral ingestion and consumption of a high-fat meal triples the bioavailability. The volume of distribution is approximately 2l/kg and protein binding is extensive.

When doses greater than 20mg are administered, a nonlinear relationship exists between dose and maximum plasma concentration and area under curve.

It is extensively metabolised in the liver and appears to be a substrate of the cytochrome P450 3A4 enzyme.

No drug is recoverd unchanged in the urine and approximately 44% and 50% of the metabolites are recovered in the urine and feces, respy.

Bioavailbility is nearly tripled 2 hours after consumption of high-fat meal.

Use during pregnancy and breast feeding contraindicated.