Enalapril + Lercanidipine
Find more information about this combination medication at the webpages for Enalapril and Lercanidipine
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Advisory
- This medicine contains a combination of 2 drugs Enalapril and Lercanidipine.
- Enalapril and Lercanidipine are both used to treat the same disease or symptom but work in different ways in the body.
- Most doctors will advise making sure that each individual medicine is safe and effective before using a combination form.
Drug Status
Government Approvals
None
WHO Essential Medicine
NO
Known Teratogen
Definite
Pharmaceutical Class
Angiotensin Converting Enzyme Inhibitor
Controlled Drug Substance
NO
Summary
Enalapril is used to treat high blood pressure, heart failure, and kidney disease related to diabetes. Lercanidipine is used for managing mild to moderate high blood pressure. Both medications help reduce the risk of complications like heart attacks and strokes by controlling blood pressure.
Enalapril is an ACE inhibitor, which means it lowers blood pressure by reducing chemicals that tighten blood vessels. Lercanidipine is a calcium channel blocker, which means it relaxes blood vessels by preventing calcium from entering heart and vessel cells. Both aim to improve blood flow and reduce heart workload.
Enalapril is usually taken as a 5 mg tablet once daily, with adjustments up to 40 mg based on response. Lercanidipine is typically started at 10 mg once daily, increasing to 20 mg if needed. Both are taken orally, with Enalapril taken with or without food and Lercanidipine taken before meals.
Common side effects of Enalapril include cough, dizziness, and rash. Serious effects can include swelling of the face or throat. Lercanidipine may cause headaches, flushing, and palpitations. Both can lead to low blood pressure, causing dizziness or fainting. Monitoring for these effects is important.
Enalapril should not be used during pregnancy due to fetal harm risk and is contraindicated with aliskiren in diabetes. Lercanidipine should not be taken with grapefruit juice or in severe liver/kidney impairment. Both require caution in low blood pressure or heart conditions and need regular monitoring.
Indications and Purpose
How does combination of Enalapril and Lercanidipine work?
Enalapril works by inhibiting the angiotensin-converting enzyme (ACE), which decreases the production of angiotensin II, a substance that narrows blood vessels. This leads to relaxed blood vessels and lower blood pressure. Lercanidipine, a calcium channel blocker, prevents calcium from entering the cells of the heart and blood vessel walls, resulting in relaxed blood vessels and reduced blood pressure. Both medications aim to improve blood flow and reduce the workload on the heart, but they achieve these effects through different mechanisms.
How effective is combination of Enalapril and Lercanidipine?
Clinical trials have demonstrated the effectiveness of Enalapril in reducing blood pressure and improving heart function in patients with heart failure. It has been shown to decrease mortality and hospitalization rates in heart failure patients. Lercanidipine has been proven effective in lowering blood pressure in patients with mild to moderate hypertension, with studies showing significant reductions in systolic and diastolic blood pressure. Both medications have been evaluated in controlled clinical trials, confirming their efficacy in managing hypertension and reducing the risk of cardiovascular events. They work through different mechanisms but share the common goal of improving cardiovascular health.
Directions for Use
What is the usual dose of combination of Enalapril and Lercanidipine?
The usual adult daily dose for Enalapril is 5 mg once a day, which can be adjusted based on the patient's response, with a typical range of 10 mg to 40 mg per day. Lercanidipine is usually prescribed at a starting dose of 10 mg once daily, which can be increased to 20 mg depending on the patient's response. Both medications are used to treat high blood pressure, but they work through different mechanisms. Enalapril is an ACE inhibitor, while Lercanidipine is a calcium channel blocker. Both medications can be adjusted based on individual patient needs and responses.
How does one take combination of Enalapril and Lercanidipine?
Enalapril can be taken with or without food, but it should be taken at the same time each day to maintain consistent blood levels. Lercanidipine should be taken at least 15 minutes before meals, preferably in the morning, and should not be taken with grapefruit juice as it can increase the medication's effects. Both medications require adherence to prescribed dosages and schedules to ensure effectiveness. Patients should also follow any dietary recommendations provided by their healthcare provider, such as reducing salt intake, to enhance the medications' blood pressure-lowering effects.
For how long is combination of Enalapril and Lercanidipine taken?
Both Enalapril and Lercanidipine are typically used as long-term treatments for managing high blood pressure. Enalapril is often continued even if the patient feels well, as it controls but does not cure high blood pressure. Similarly, Lercanidipine is used for ongoing management of hypertension, with adjustments made based on patient response. Both medications require regular monitoring and adjustments to ensure effective blood pressure control over time.
How long does it take for combination of Enalapril and Lercanidipine to work?
Enalapril typically begins to work within an hour after oral administration, with peak effects occurring around four to six hours. Lercanidipine, on the other hand, reaches peak plasma levels approximately 1.5 to 3 hours after dosing. Both medications are used to manage high blood pressure, but they have different mechanisms of action. Enalapril is an ACE inhibitor that reduces blood pressure by decreasing certain chemicals that tighten blood vessels, while Lercanidipine is a calcium channel blocker that relaxes blood vessels. Despite their different mechanisms, both medications aim to improve blood flow and reduce blood pressure.
Warnings and Precautions
Are there harms and risks from taking combination of Enalapril and Lercanidipine?
Common side effects of Enalapril include cough, dizziness, and rash, while serious side effects can include swelling of the face or throat, difficulty breathing, and yellowing of the skin or eyes. Lercanidipine may cause peripheral edema, headache, flushing, and palpitations, with rare cases of angina or myocardial infarction. Both medications can cause hypotension, leading to dizziness or fainting. Patients should be monitored for these side effects, and any severe or persistent symptoms should be reported to a healthcare provider immediately.
Can I take combination of Enalapril and Lercanidipine with other prescription drugs?
Enalapril should not be taken with aliskiren in patients with diabetes, and caution is advised when used with NSAIDs, as they may reduce its effectiveness. Lercanidipine should not be taken with strong CYP3A4 inhibitors like ketoconazole or grapefruit juice, as these can increase its effects. Both medications can interact with other blood pressure medications, potentially leading to excessive hypotension. Patients should inform their healthcare provider of all medications they are taking to manage potential interactions effectively.
Can I take combination of Enalapril and Lercanidipine if I am pregnant?
Enalapril is contraindicated during pregnancy, especially in the second and third trimesters, due to the risk of fetal harm, including renal impairment and death. Lercanidipine is not recommended during pregnancy as there is insufficient data on its safety, and similar drugs have shown teratogenic effects. Both medications pose potential risks to the developing fetus, and alternative treatments should be considered for managing hypertension in pregnant women. Women of childbearing potential should use effective contraception while taking these medications.
Can I take combination of Enalapril and Lercanidipine while breastfeeding?
Enalapril and its active form, enalaprilat, are excreted in human breast milk, and due to the potential for serious adverse reactions in nursing infants, a decision should be made to either discontinue nursing or discontinue the drug. Lercanidipine's excretion in human milk is unknown, but it is not recommended during breastfeeding due to potential risks to the infant. Both medications require careful consideration of the benefits and risks when used by breastfeeding mothers, and alternative treatments should be discussed with a healthcare provider.
Who should avoid taking combination of Enalapril and Lercanidipine?
Enalapril is contraindicated in pregnancy due to the risk of fetal harm and should not be used with aliskiren in diabetic patients. It can cause angioedema, a serious allergic reaction. Lercanidipine is contraindicated in patients with severe liver or kidney impairment and should not be taken with grapefruit juice. Both medications require caution in patients with low blood pressure or heart conditions. Patients should be aware of these warnings and discuss any concerns with their healthcare provider to ensure safe use of these medications.
