Lercaril Tablet

Angiotensin Converting Enzyme Inhibitor

Lercaril belongs to the Angiotensin Converting Enzyme Inhibitor class of medicines. Angiotensin-converting enzyme (ACE) inhibitors treat a variety of conditions, such as high blood pressure, migraines, and scleroderma. It helps in relaxing the blood vessels.

How to use

• Follow directions on the product label, information guide, and provided by your doctor before using Lercaril. Use this medicine as per your doctor's instructions.
• Lercaril is used with or without food. The absorption of Lercaril is not interfered by the presence of food. 
• The typical adult dose of Lercaril is 40 mg daily. The typical dose for children is 5 mg once a day. The maximum dose for adults of Lercaril is 40 mg per day. Lercaril is typically used at the same time every day. It takes 1 hour for this medicine to start its action.

This medicine should be used on an as-needed basis. Typically used for long-term in case of high blood pressure. You should continue to use this medicine as directed by the doctor even if you feel well.

• Tell your doctor if you develop new symptoms. Talk to your doctor if dizziness, lightheadedness, difficulty in breathing, swelling of the face, swelling of the lips, tongue or throat, swelling of the hands, feet or ankles, rash, peeling skin, sore throat or fever, ringing in the ears, reduction in blood cell count, yellowing of the skin, lower hemoglobin, lowering of blood platelets, temporary loss of consciousness, vomiting, diarrhea, excessive sweating, and dehydration. If you have any kidney disease, For patients with kidney damage, the treatment with Lercaril should be started at a low dose. Also, the dosage interval between taking the next dose of Lercaril should be extended and dosage should be reduced. If you have issues with the health of your liver, The patients who are on treatment with Lercaril and develop yellow discoloration of skin or an increase in liver enzymes should discontinue the use of Lercaril and begin appropriate treatment. Consult with your doctor before stopping the use of Lercaril Coated Tablet.
• To see the impact of Lercaril Coated Tablet on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully. A lower dose of Lercaril Coated Tablet may be recommended to reduce the risk of side-effects. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.

Limit drinking alcohol with Lercaril.

• Your doctor may require that certain tests be performed before using Lercaril Coated Tablet. The doctor may ask you to have Blood Pressure test. Blood pressure should be monitored both before and after the treatment with Lercaril since cases of low blood pressure have been reported. Your doctor may request Kidney Function Panel test. Test for the functioning of kidneys should be performed both before and after the treatment with Lercaril since cases of kidney failure have been reported.
• Medicines may be given for uses other than those listed in the medicine guide. Do not use Lercaril Coated Tablet for symptoms for which it was not prescribed. Do not give Lercaril Coated Tablet to others who may have similar symptoms as you. Self-medication can cause harm.
• Store Lercaril Coated Tablet 15°C-30°C (59°F-86°F), and away from moisture. Keep this medicine away from children and pets.

Lercaril Dosage

Dosage for high blood pressure: Adult

• Recommended: 20mg in a day
• Initial: 5 mg once per day
• Maximum: 40 mg once per day or in two divided doses

Children (children more than 1 month of age)

• Initial: 0.08 mg/kg (0.036 mg/lb) once in a day
• Maximum: 5 mg in a day

Dosage for symptomatic heart failure: Adult

• Initial: 2.5 mg twice a day
• Maximum: 20 mg twice a day

Dosage for heart failure in patients with asymptomatic left ventricular dysfunction in the left part of the heart: Adult

• Initial: 2.5 mg twice a day
• Maximum: 10 mg twice a day

Minimum Age

• infants more than 1 month

Special Instructions

• Use with diuretics
• Lercaril may use with a low dose of diuretic if further lowering of blood pressure is required and suggested dose in a patient taking diuretics is 2.5 mg daily.

Patients with a low sodium level in the blood

• The recommended initial dose is 2.5 mg once daily in the patients with sodium levels in the blood less than 130 mEq/L or blood creatinine greater than 1.6 mg/dL.

Missed Dose

• A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Lercaril Side-effects

The following side-effects may commonly occur when using Lercaril Coated Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:

• abnormally low levels of potassium in the blood
• blurred vision
• change in sense of smell (anosmia)
• chest pain
• chest pain due to reduced supply of blood to the heart
• cough
• depression
• diarrhea
• dizziness
• increased heartbeat
• increased level of creatinine in the blood
• low blood pressure
• nausea
• rash
• rhythm disturbances
• shortness of breath (dyspnea)
• stomach pain
• swelling under lower layer of skin
• taste alteration
• tiredness
• weakness

Interactions with Lercaril

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.

• Lercaril Coated Tablet may interact with Non-Steroidal Anti-Inflammatory Agents (NSAIDs), which are used as pain relievers and in a condition such as arthritis. It may result in deterioration of the functioning of kidneys, including potential acute kidney failure which usually is reversible. NSAIDs may also reduce the antihypertensive effect of Lercaril. Monitor functioning of kidneys regularly in patients taking Lercaril and NSAID therapy.
• There may be an interaction of Lercaril with Renin-angiotensin inhibitors, which are used to reduce high blood pressure. Increased risks of low blood pressure, high potassium level, and changes in the functioning of kidneys (including acute kidney failure) are associated with dual blockade of the renin-angiotensin system with Lercaril. Combined usage of RAS inhibitors should be avoided. Close monitoring of blood pressure, the functioning of kidneys, and electrolytes in patients on Lercaril and other agents that affect the renin-angiotensin system. The use of aliskiren with Lercaril in patients with kidney abnormality and diabetes should be avoided.
• Lercaril Coated Tablet interacts with Agents increasing blood potassium levels such as spironolactone, triamterene, or amiloride, which are used to treat low potassium levels and heart failure. Lercaril reduces potassium loss caused by thiazide-type diuretics. Potassium supplements, or potassium-containing salt substitutes, potassium-sparing diuretics may lead to a notable increase in blood potassium level.
• Special instructions need to be followed while taking this medicine along with Lithium which is used to treat mental illnesses, eating disorders, and blood disorders. Lithium poisoning has been notified in patients taking Lercaril and lithium together which was usually reversible. Blood lithium levels should be monitored frequently if Lercaril is taken in combination with lithium.
• Your doctor's guidelines may need to be followed while taking this medicine along with Gold (sodium-aurothiomalate) which is used for its anti-inflammatory action in the treatment of rheumatoid arthritis. Symptoms such as nausea, facial flushing, vomiting, and low blood pressure have been notified rarely in patients on treatment with sodium aurothiomalate (injectable gold) and Lercaril therapy together.
• Lercaril Coated Tablet may interact with mTOR inhibitors, which are used in the treatment of kidney cancer. Patients taking Lercaril and mTOR inhibitor (e.g., sirolimus, temsirolimus, everolimus) treatment may be at an increased risk for swelling of the lower layer of the skin.
• There may be an interaction of Lercaril with Alcohol, which is used as an antiseptic, disinfectant, and an antidote. Alcohol enhances the blood pressure lowering effect of Lercaril.
• Lercaril Coated Tablet interacts with Sympathomimetics, which are used to treat low blood pressure. Sympathomimetics may decrease the blood pressure lowering effects of Lercaril.
• Special instructions need to be followed while taking this medicine along with Co-trimoxazole, which is used to treat certain bacterial infections. Patients taking Lercaril and trimethoprim/sulfamethoxazole (co-trimoxazole) together may be at an increased risk for high potassium level.
• Your doctor's guidelines may need to be followed while taking this medicine along with Other antihypertensives, which are used to treat high blood pressure. The use of antihypertensive agents and Lercaril together may increase the blood pressure lowering effects of Lercaril. The use of nitroglycerine and other nitrates or vasodilators with Lercaril may further decrease the blood pressure.
• Lercaril Coated Tablet may interact with Tricyclic antidepressants, which are used to treat depression, anxiety, and certain kinds of pain. The combined use of tricyclic antidepressants with Lercaril may result in further lowering of blood pressure.
• There may be an interaction of Lercaril with Diuretics (thiazide or loop diuretics), which are used to treat high blood pressure. History of high dose diuretics use may result in volume depletion and a risk of low blood pressure when starting therapy with Lercaril. The blood pressure lowering effect can be decreased by the discontinuation of the diuretic, by salt intake, or increasing volume or by starting therapy with a low dose of Lercaril.

This information page does not contain all the possible interactions of Lercaril Coated Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

References:

https://www.hpra.ie/img/uploaded/swedocuments/2184672.PPA1097_003_001.90d66b6f-0520-4da6-930d-1762807b6976.000001Product%20Leaflet%20Approved.170302.pdf

https://www.medicines.ie/medicines/lercaril-20-mg-10-mg-film-coated-tablets-32676/patient-info

https://www.mims.ie/news/lercaril-new-20mg-20mg-strength-01-03-2019/

https://www.drugs.com/international/lercaril.html

https://www.tabletwise.com/estonia/lercaril-coated-tablet