Lercanidipine in hypertension

Abstract

Lercanidipine is a lipophilic, dihydropyridine calcium antagonist with a long receptor half-life. Its slow onset of action helps to avoid reflex tachycardia associated with other dihydropyridines (DHPs). It produces even and sustained blood pressure lowering with once-daily dosing. It has equivalent antihypertensive efficacy to many other agents and is effective as initial monotherapy or in combination. Efficacy has been demonstrated in elderly as well as younger patients and also in the presence of other risk factors. Lercanidipine is well tolerated with DHP-associated adverse effects occurring early in treatment. The incidence of pedal edema and subsequent withdrawals has been found to be lower with lercanidipine than with amlodipine or nifedipine gastrointestinal transport system. Preclinical and preliminary clinical findings suggest lercanidipine may have beneficial effects on atherosclerosis and left ventricular hypertrophy. The efficacy and tolerability profiles of lercanidipine make it a suitable choice for treating hypertension in a wide range of affected patients.

Figure 1

Evolution of dihydropyridine calcium antagonists for improved clinical efficacy and tolerability. Abbreviations: GITS, gastrointestinal therapeutic system.

Figure 2

Amlodipine produces significantly more leg edema than lercanidipine after 2 weeks therapy in patients with mild to moderate hypertension (p = 0.006) (Pedrinelli et al 2003).

Figure 3

Clinical summary of lercanidipine in hypertension. All features and comments are derived from referenced information in the text. Abbreviations: ACE, angiotensin converting enzyme; AEs, adverse events; DHP, dihydropyridine; ISH, isolated systolic hypertension.