Uses of Lercastad 20

Lercastad 20 is made in the form of tablets, with the main ingredient being Lercanidipine hydrochloride. It is used to treat primary (mild to moderate) hypertension.

What is Lercastad ? Each Lercastad 20 tablet contains 20mg of Lercanidipine hydrochloride and excipients just enough. Lercanidipine is a calcium channel blocker of the dihydropyridine family. The drug selectively blocks calcium channels that move across cell membranes to the myocardium and vascular smooth muscle. The antihypertensive effect of Lercanidipine is directly related to the vascular smooth muscle relaxant effect, which reduces peripheral resistance. Lercanidipine has long-lasting antihypertensive activity (possibly related to a high membrane division coefficient). Lercanidipine does not cause a decrease in myocardial contractility, only mild reflex tachycardia, because of its high vascular selectivity. The vasodilator effect of the Lercanidipine component is usually gradual. Cases of hypotension with reflex tachycardia are uncommon in hypertensive patients.
Indications for use of Lercastad:
Treatment of mild to moderate primary hypertension. Contraindications to the use of Lercastad:
People with hypersensitivity to Lercanidipine, dihydropyridine group or any other ingredients in the drug formula; Pregnant women, breastfeeding mothers; Women of childbearing potential (unless you are using effective birth control); People with left ventricular outflow tract obstruction; Patients with unstable angina ; People with untreated congestive heart failure; Patients with myocardial infarction within 1 month; Concomitant use with strong inhibitors of CYP3A4, grapefruit juice, cyclosporin; Patients with severe liver or kidney failure (GFR less than 30ml/min); Children under 18.

Usage: Orally. Patients should take Lercastad with a full glass of water, at least 15 minutes before meals.
Dosage:
Indicated dose: 10mg (1⁄2 tablets)/time/day. If necessary, the dose can be increased to 20mg (1 tablet)/time/day after at least 2 weeks; Elderly: Careful health monitoring is recommended when starting treatment; Patients with hepatic or renal dysfunction: Careful monitoring of health is recommended when initiating treatment in patients with mild to moderate hepatic or renal dysfunction. The usual indicated doses may be tolerated in this patient population. Caution should be exercised when increasing the dose to 20 mg/day. Because the antihypertensive effect is increased in patients with hepatic impairment, a dose adjustment should be considered. Overdose: When using Lercastad in overdose, the patient may experience excessive vasodilation with typical symptoms of marked hypotension and reflex tachycardia. In cases of severe hypotension, bradycardia and unconsciousness, cardiac support with intravenous atropine (useful for bradycardia) is recommended. Due to the prolonged pharmacological effects of lercanidipine, the cardiovascular status of patients with overdose should be monitored for at least 24 hours.
Missed dose: When forgetting a dose of Lercastad 20, the patient should take the medicine as soon as he remembers. If it is almost time for the next dose, skip the missed dose, take the next dose at the same time as originally planned, do not double the dose.

When using Lercastad, patients may experience some side effects as follows:
Uncommon: Dizziness, headache, heart palpitations, peripheral edema, nervousness, flushing; Rare: Drowsiness, nausea, dyspepsia, abdominal pain, diarrhea, vomiting, angina pectoris, myalgia, rash, asthenia, fatigue; Very rare: Hypotension, polyuria, gingival enlargement, chest pain, reversible increase in serum transaminase levels, increased sensitivity, syncope; Other side effects: Some dihydropyridines rarely cause chest pain in front of the heart or angina. Patients with pre-existing angina rarely experience increased frequency, duration, and severity of pain. Heart attack events can occur in some cases. If experiencing side effects of Lercastad 20, patients should immediately notify the treating doctor for instructions on the most appropriate treatment and response.

Some notes for patients to remember before and while taking Lercastad 20:
Should be carefully monitored when using Lercanidipine for patients with pathological sinus node syndrome (in case of not using a pacemaker), patients left ventricular dysfunction; Increased cardiovascular risk in ischemic patients with short-acting dihydropyridine. Therefore, long-acting lercanidipine should be used in this population; Lercastad 20 should not be used in patients with hereditary problems of galactose intolerance, glucose-galactose malabsorption or total lactase deficiency; There is no clinical experience with lercanidipine in pregnancy and lactation. However, other drugs of the dihydropyridine class are known to be teratogenic in animals. Therefore, Lercastad should not be used in pregnant women and women of childbearing potential, unless effective contraception is used; Due to its high lipophilicity, the component Lercanidipine can be excreted in milk. Therefore, Lercastad 20 should not be used in lactating women; Side effects of Lercastad 20 include dizziness, fatigue, weakness and drowsiness, which may affect the ability to drive or use machines. Therefore, caution should be exercised when lercanidipine is used in this population.

Some drug interactions of Lercastad 20 include:
Avoid co-administration of Lercastad with alcohol because alcohol can interfere with the effectiveness of antihypertensive drugs by vasodilating; Lercanidipine is metabolised by the enzyme CYP3A4. Therefore, concomitant administration of Lercastad 20 with drugs that inhibit and induce CYP3A4 enzymes may interfere with the metabolism and elimination of lercanidipine. Concomitant administration of lercanidipine with ketoconazole (a strong inhibitor of CYP3A4) may increase plasma concentrations of lercanidipine. Caution should be exercised when lercanidipine is co-administered with inducers of CYP3A4 such as anticonvulsants (carbamazepine, phenytoin) and rifampicin because of possible interference with the antihypertensive effect, requiring frequent blood pressure monitoring; Concomitant administration of lercanidipine at a dose of 20 mg and oral midazolam may increase the absorption of lercanidipine and decrease the rate of absorption. Meanwhile, midazolam concentrations were not changed. Caution should be exercised when lercanidipine and CYP3A4 substrates such as astemizol, terfenadine, class III antiarrhythmic drugs such as quinidine, amiodarone; When lercanidipine was co-administered with metoprolol (a beta-blocker eliminated primarily by the liver), the bioavailability of metoprolol was unchanged but lercanidipine was reduced by up to 50%. This effect also occurs with other drugs in this class, because beta-blockers reduce blood flow to the liver. Therefore, lercanidipine can be safely used when co-administered with beta-blockers, but dose adjustment is required; Caution should be exercised when cimetidine doses above 80 mg are used concomitantly with lercanidipine, as the bioavailability and antihypertensive effect of lercanidipine may be increased; Co-administration of digoxin and lercanidipine 20 mg may increase digoxin Cmax, while AUC and renal clearance have no significant changes. Patients treated concomitantly with lercanidipine and digoxin should be closely monitored clinically for signs of digoxin toxicity; Concomitant administration of lercanidipine with cyclosporin increases serum concentrations of both lercanidipine and cyclosporin; Lercanidipine is inhibited from metabolism by grapefruit juice, resulting in increased bioavailability and increased antihypertensive effect of the drug. When using Lercastad 20, patients should strictly follow the doctor's prescription and instructions above. At the same time, patients should follow a suitable diet and lifestyle, exercise moderately to better control hypertension.
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