From the Guidelines
The highest recommended dose of lercanidipine for treating hypertension is 20 mg once daily. Treatment typically begins with 10 mg once daily, taken at least 15 minutes before meals, and can be increased to the maximum dose of 20 mg daily if needed for adequate blood pressure control. This maximum dose should not be exceeded. Lercanidipine is a third-generation dihydropyridine calcium channel blocker that works by blocking calcium entry into vascular smooth muscle cells, causing vasodilation and reducing peripheral resistance, thereby lowering blood pressure. The once-daily dosing is possible due to lercanidipine's lipophilic properties, which allow it to remain in cell membranes, providing a prolonged duration of action despite its relatively short plasma half-life. Patients with hepatic or renal impairment should start with a lower dose of 10 mg daily, and elderly patients may also require careful dose titration. If blood pressure remains uncontrolled at the maximum dose, adding a different class of antihypertensive medication rather than exceeding the 20 mg dose is recommended 1.
Key Considerations
- Lercanidipine's efficacy and safety profile make it a suitable option for hypertension management, as supported by recent guidelines 1.
- The choice of antihypertensive medication should be based on the individual patient's needs and medical history, with consideration of factors such as renal function and potential drug interactions.
- Regular monitoring of blood pressure and adjustment of medication as needed is crucial to achieve optimal blood pressure control and minimize the risk of cardiovascular complications.
Dosing and Administration
- Initial dose: 10 mg once daily
- Maximum dose: 20 mg once daily
- Dose titration: may be increased to 20 mg daily if needed for adequate blood pressure control
- Administration: taken at least 15 minutes before meals
Special Populations
- Hepatic or renal impairment: start with a lower dose of 10 mg daily
- Elderly patients: may require careful dose titration
- Patients with uncontrolled blood pressure at the maximum dose: consider adding a different class of antihypertensive medication rather than exceeding the 20 mg dose.
From the Research
Highest Recommended Dose of Lercanidipine
The highest recommended dose of lercanidipine for treating hypertension is discussed in several studies:
- Lercanidipine 10 or 20mg effectively reduced blood pressure in patients with mild to moderate hypertension 2.
- The usual and once a day dose to treat high blood pressure of any grade is 10 mg, which if needed could be increased to 20 mg once a day 3.
- Monotherapy with lercanidipine 20 or 40 mg/day has shown efficacy in patients with severe hypertension 2.
- Lercanidipine 5-30 mg/day effectively decreased BP in elderly patients with mild-to-moderate hypertension or isolated systolic hypertension 4.
- In clinical trials, lercanidipine was administered at a starting dose of 10 mg once daily, and increased to 20 mg once daily for nonresponders 5.
Key Points
- The maximum dose of lercanidipine mentioned in the studies is 40 mg/day for patients with severe hypertension 2.
- Lercanidipine 10-20 mg/day was as effective as other antihypertensive agents in reducing blood pressure in patients with mild-to-moderate hypertension 2, 4.
- The drug is well tolerated, with most treatment-emergent events related to vasodilation 2, 4, 5.