lacidipine: clinical use

Prescribing considerations

• Licensed for adult hypertension as monotherapy or combined with other antihypertensives.
• Use cautiously in hepatic impairment because systemic exposure and hypotensive effects may increase.
• Exercise caution with poor cardiac reserve, sinoatrial or atrioventricular node abnormalities, or congenital or acquired QT prolongation.
• Safety and efficacy have not been established in people younger than 18.
• The selected product contains lactose.

Contraindications and cautions

• Hypersensitivity to lacidipine or another ingredient; consider possible cross-reactivity after reactions to other dihydropyridines.
• Aortic stenosis.
• Cardiogenic shock or unstable angina.
• Use during or within one month after myocardial infarction.
• Rare hereditary galactose intolerance, total lactase deficiency or glucose-galactose malabsorption.

Monitoring

• Blood pressure and symptoms of hypotension.
• Dizziness, flushing, palpitations and peripheral oedema.
• New or worsening angina, especially after treatment begins.
• Clinical response and tolerability in hepatic impairment.
• Cardiac status where conduction abnormalities, poor cardiac reserve or QT-prolonging factors are present.

Clinical pharmacology

Lacidipine is a lipophilic, vascular-selective dihydropyridine calcium antagonist. It undergoes extensive hepatic first-pass metabolism involving CYP3A4; its principal metabolites have little or no pharmacological activity, and elimination is mainly as metabolites in faeces.

Formulation and product differences

• The selected product is a white, round, biconvex film-coated tablet containing lactose.
• It is supplied in light-protective blister packaging and should remain in the foil until required.

Tablet

Route: Oral

Strengths: 2 mg, 4 mg