Formulary
Lacidipine: Indications, Dosing, Side Effects and Interactions
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions...
MedNext Academy | 3 min read
Lacidipine: Indications, Dosing, Side Effects and Interactions
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions...
Drug action
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions through the slow channels of active cell membranes. They influence the myocardial cells, the cells within the specialised conducting system of the heart, and the cells of vascular smooth muscle. Thus, myocardial contractility may be reduced, the formation and propagation of electrical impulses within the heart may be depressed, and coronary or systemic vascular tone may be diminished. Drug action For lacidipine Lacidipine is a dihydropyridine calcium-channel blocker.
Indications and dose
**Hypertension**
- **Adult** (By Mouth): Initially 2 mg daily; increased if necessary to 4 mg daily, then increased if necessary to 6 mg daily, dose increases should occur at intervals of 3-4 weeks, to be taken preferably in the morning.
Cautions
For all calcium-channel blockers Elderly Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate with persistent postural hypotension i.e. recurrent drop in systolic blood pressure 20 mmHg (risk of syncope and falls). Cautions For lacidipine Cardiac conduction abnormalities; poor cardiac reserve
Contraindications
Acute porphyrias ; aortic stenosis; avoid within 1 month of myocardial infarction; cardiogenic shock; unstable angina
Side effects
For all calcium-channel blockers Common or very common Abdominal pain; dizziness; drowsiness; fatigue; flushing; headache; hypotension; nausea; palpitations; peripheral oedema; skin reactions; tachycardia; vomiting Uncommon Angioedema; depression; erectile dysfunction; gingival hyperplasia; myalgia; paraesthesia; syncope Overdose Features of calcium-channel blocker poisoning include nausea, vomiting, dizziness, agitation, confusion, and coma in severe poisoning. Metabolic acidosis and hyperglycaemia may occur. In overdose, the dihydropyridine calcium-channel blockers cause severe hypotension secondary to profound peripheral vasodilatation. For details on the management of poisoning, see Calcium-channel blockers, under Emergency treatment of poisoning. Side-effects For lacidipine Common or very common Abdominal discomfort; asthenia; polyuria Uncommon Ischaemic heart disease Rare or very rare Muscle cramps; tremor
Interactions
**Severe interactions:**
- Lacidipine is known to be metabolised by cytochrome CYP3A4 and, therefore, significant inhibitors and inducers of CYP3A4 (e.g.
**Other interactions (7):**
- Co-administration of lacidipine with other agents recognised to have a hypotensive effect, including anti-hypertensive agents, (e.g.
- However, no specific interaction problems have been identified in studies with common antihypertensive agents (e.g.
- The plasma level of lacidipine may be increased by simultaneous administration of cimetidine.
- Lacidipine is highly protein-bound (more than 95%) to albumin and alpha-1-glycoprotein.
- As with other dihydropyridines, lacidipine should not be taken with grapefruit juice as bioavailability may be altered.
- In clinical studies in patients with a renal transplant treated with cyclosporin, lacidipine reversed the decrease in renal plasma flow and glomerular filtration rate induced by cyclosporin.
Pregnancy
Manufacturer advises avoid; may inhibit labour.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
For all calcium-channel blockers In general, manufacturers advise caution (risk of increased exposure). Hepatic impairment For lacidipine Dose adjustments Manufacturer advises consider dose reduction if hypotension occurs.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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