From the Guidelines
Lercanidipine can cause several side effects, including peripheral edema, headache, and dizziness, but these can be managed with strategies such as dose adjustment, taking the medication with food, and avoiding grapefruit juice. When used for hypertension treatment, lercanidipine, a third-generation dihydropyridine calcium channel blocker, has several potential side effects. Common side effects include:
- Peripheral edema (swelling in the ankles and feet)
- Headache
- Flushing
- Dizziness
- Palpitations
- Fatigue These effects typically result from the medication's vasodilatory action. Less common side effects may include:
- Gingival hyperplasia (gum overgrowth)
- Rash
- Gastrointestinal disturbances
- Rarely, liver enzyme elevations According to the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1, combination therapy with different drug classes can have additive or synergistic effects and lead to greater BP reduction than increasing the dose of one drug, which may reduce side effects. To manage these side effects, several strategies can be employed, such as:
- Starting with a lower dose (10mg daily) and gradually increasing if needed
- Taking lercanidipine with food to reduce its bioavailability and decrease side effect intensity
- Avoiding grapefruit juice as it can increase drug levels and side effects
- Elevating the legs when sitting to reduce peripheral edema If side effects persist or are severe, dose reduction or switching to another antihypertensive medication may be necessary. Lercanidipine is generally better tolerated than older calcium channel blockers due to its high vascular selectivity and gradual onset of action, which explains its lower incidence of reflex tachycardia and edema 1. Patients should report persistent headaches, significant swelling, or any signs of allergic reactions to their healthcare provider promptly.
From the Research
Potential Side Effects of Lercanidipine
Management Strategies for Lercanidipine Side Effects
- Monitoring of blood pressure and adjustment of dosage as needed 2, 3
- Patient education on potential side effects and their management 2, 3
- Consideration of alternative antihypertensive agents if side effects are severe or intolerable 2, 3
- Combination therapy with other antihypertensive agents to minimize side effects 5, 6
Special Considerations for Lercanidipine Use
- Renal protection: Lercanidipine may provide renal protection in hypertensive patients, particularly those with diabetes and renal impairment 5, 6
- Elderly patients: Lercanidipine is effective and well-tolerated in elderly patients with mild to moderate hypertension 2, 3
- Patients with isolated systolic hypertension: Lercanidipine is effective in reducing blood pressure in patients with isolated systolic hypertension 2, 3