Meds and you

27 September 2013

The combination of Lercanidipine and Enalapril

The combination of Lercanidipine and Enalapril is a combination of a calcium channel-blocker and an ACE-inhibitor.

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The combination of lercanidipine and enalapril is the active ingredient of Zaneril tablets (Nappi code: 711444-001 & 71445-001).

 

General Information

The combination of Lercanidipine and Enalapril is a combination of a calcium channel-blocker and an ACE-inhibitor. Both calcium channel blockers and inhibitors are drugs prescribed, amongst others, for the treatment of high blood pressure. It causes blood vessels to relax and widen, thereby reducing high blood pressure.

 

In South Africa this combination is registered for the treatment of essential high blood pressure.

 

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective you must take it regularly - high blood pressure declines slowly and it may take a few weeks for the combination of lercanidipine and enalapril to reach its full effect. Keep taking this medicine during this period, even if you are feeling better, or fail to notice any improvement.

 

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised to be resting when starting treatment and to lie down for two hours afterwards.

 

This medication should be avoided during pregnancy. Speak to your doctor about the use of this drug if you are planning to get pregnant as it may cause harm to the unborn baby.

 

How does this combination work?

Enalapril prevents the conversion of angiotensin I, a chemical in your blood, to a more powerful version, angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production aldosterone, a hormone, which promotes salt (sodium) retention in the body, an action which increases blood pressure.

Lercanidipine is a calcium channel-blocker. Calcium plays an important role in the contraction of heart muscle, as well as smooth muscle in the walls of arteries. By blocking the channels through which calcium enters cells in these muscles, relaxation of these muscles is obtained. The result is a reduced workload of the heart, as well as widening of blood vessels, causing high blood pressure to return to normal and safe levels. 

 

Fast facts

Drug schedule: schedule 3

Available as: this combination is available as tablets.

What does it do? The combination of lercanidipine and enalapril lowers blood pressure.

Overdose risk: medium

Dependence risk: low

Is this combination available as a generic? no

Is this combination available on prescription only? yes

 

User information

Onset of effect: although an effect may be seen much sooner, the maximum effect of this combination is reached within 3 - 6 weeks.

Duration of action: up to 24 hours

Dietary advice: this medication should be taken 15 – 30 minutes prior to a meal. It is advised to avoid drinking grapefruit juice while taking this medication, as it may increase the level of lercanidipine in your blood, which may lead to additional side effects

Stopping this medicine: it may be dangerous to discontinue this drug abruptly as symptoms of the condition being treated may recur. Don't discontinue this drug without speaking to your doctor

Suddenly stopping the drug may cause your blood pressure to increase dangerously. Your dosage should be decreased gradually only as directed by your doctor.

 

Special precautions

Consult your doctor before using this drug if:

 

  • you have a liver or kidney disease
  • you have any heart disease
  • you suffer from angina pectoris
  • you had a recent heart attack
  • you are pregnant
  • you are taking other medication

 

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. This medication is passed through breastmilk and may affect your baby adversely. Consult your doctor before use.

Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: this medication is not intended for use in children under the age of 18.

The elderly: caution is advised in the elderly as side effects are more likely to occur.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: avoid concomitant use of alcohol with this medication.

 

Possible side effects:

 

 

 

       Side Effects                 Frequency                  Consult your doctor        
            Common Rare           Only if severe In all cases
flushing x   x  
dizziness x   x  
vertigo x   x  
cough x   x  
headache x   x  
swelling   x x  
eye pain   x   x
fast heart rate   x x  
constipation/ diarrhoea/ abdominal dicomfort    x x  
skin rash   x   x
low blood pressure   x x  
fainting   x   x

 

 

Interactions:

Drug interactions

 

 

 

 

Cyclosporine Increased effect of both agents
Drugs for epilepsy  Reduced effect of lercanidipine
Some anti-fungal drugs Increased risk of this combination's toxicity
Cimetidine Increased risk of this combination's side effects
Erythromycin Increased risk of this combination's toxicity
Digoxin Increased risk of digoxin toxicity
Ritonavir Increased risk of this combination's toxicity
Grapefruit juice Increased risk of this combination's toxicity

Food interactions

It is advised to avoid drinking grapefruit juice while taking this medication, as it may increase the level of lercanidipine in your blood which may lead to additional side effects.

 

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms may include dizziness and fainting.

 

Recommended dosage

Adults: not to exceed dose as for each individual agent

 

 

This material is not intended to substitute medical advice, but is for informational purposes only.   Please consult a physician for specific treatment and recommendations.

 

 

 
 

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