Zanidip tablets contain the active ingredient lercanidipine hydrochloride, which is a type of medicine called a calcium channel blocker.

What is it used for?

  • High blood pressure (hypertension).

How does it work?

  • Zanidip tablets contain the active ingredient lercanidipine hydrochloride, which is a type of medicine called a calcium channel blocker. Lercanidipine is also available without a brand name, ie as the generic medicine.
  • Lercanidipine works by slowing the movement of calcium through the muscle cells that are found in the walls of blood vessels. It does this by blocking 'calcium channels' in these muscle cells. Calcium is needed by muscle cells so that they can contract. Lercanidipine reduces the amount of calcium available to muscle cells and so makes them relax.
  • Lercanidipine acts specifically on the muscle cells in the walls of arteries, causing them to relax.
This allows the arteries in the body to widen.
  • The relaxing and widening of the small arteries in the body decreases the resistance that the heart has to push against in order to pump the blood around the body. This reduces the pressure within the blood vessels. Lercanidipine can therefore be used to lower high blood pressure.
  • Lercanidipine can also have a widening effect on the small arteries in the heart, which improves the supply of blood, and therefore the oxygen to the heart. This reduces the effort the heart has to make to pump blood around the body.
  • Use with caution in

    • Elderly people.
    • Chronic heart failure.
    • Sick sinus syndrome, a problem common in the elderly, that affects the heart.
    • Decreased kidney function.
    • Decreased liver function.
    • Narrowing of the main artery coming from the heart (aortic stenosis).

    Not to be used in

    • Allergy to other related calcium channel blockers (dihydropyridines), eg nifedipine, amlodipine.
    • Children or adolescents under 18 years of age.
    • Heart failure
    • Angina that is increasing in severity, duration or frequency (unstable angina).
    • People who are having a heart attack or who have had a heart attack in the last month.
    • Failure of the heart to maintain adequate circulation of blood (cardiogenic shock).
    • Pregnancy.
    • Breastfeeding.
    • Hereditary blood disorders called porphyrias.
    • Zanidip tablets contain lactose and are not suitable for people with rare hereditary problems of galactose intolerance, Lapp lactose deficiency or glucose-galactose malabsorption.

    This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

    • This medicine should not be used during pregnancy as it may be harmful to the unborn baby. Seek further medical advice from your doctor.
    • This medicine may pass into breast milk in small amounts. The effect on a nursing infant is not known. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek further medical advice from your doctor.

    Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

    Uncommon (affect between 1 in 100 and 1 in 1000 people)

    • Dizziness.
    • Headache.
    • Flushing.
    • Swollen ankles, wrists, arms or legs.
    • Faster than normal heart beat (tachycardia).
    • Awareness of your heart beat (heart palpitations).

    Rare (affect between 1 in 1000 and 1 in 10,000 people)

    • Skin rash.
    • Fatigue.
    • Drowsiness.
    • Increased need to pass urine (polyuria).
    • Disturbances of the gut, such as nausea, vomiting, diarrhoea, abdominal pain and indigestion.
    • Difficulty in breathing (dyspnoea).
    • A general feeling of being unwell (malaise).
    • Chest pain.

    Very rare (affect less than 1 in 10,000 people)

    • Alteration in results of liver function tests.
    • Mild swelling of the gums (gingival hyperplasia).
    • Increased urinary frequency.
    • Hypotension.

    The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

    For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

    Lercanidipine may have an additive effect with other medicines that decrease blood pressure, particularly other medicines used to treat high blood pressure (antihypertensives). If the combination of medicines lowers your blood pressure too much it could make you feel dizzy. If this happens to you, you should sit or lie down until the symptoms pass. If you frequently feel dizzy when taking lercanidipine in combination with other medicines that can lower blood pressure you should let your doctor know, as your doses may need adjusting. Other medicines that can decrease blood pressure include the following:

    • ACE inhibitors, eg enalapril
    • alpha-blockers such as prazosin
    • alprostadil
    • angiotensin II receptor antagonists such as losartan
    • antipsychotics
    • benzodiazepines, eg temazepam, diazepam
    • baclofen
    • beta-blockers such as propranolol , metoprolol
    • other calcium-channel blockers, eg verapamil, nifedipine
    • clonidine
    • diazoxide
    • diuretics, eg furosemide, bendroflumethiazide
    • dopamine agonists, eg bromocriptine, apomorphine
    • hydralazine
    • levodopa
    • MAOI antidepressants, eg phenelzine
    • methyldopa
    • minoxidil
    • moxisylyte
    • moxonidine
    • nicorandil
    • nitrates, eg glyceryl trinitrate (GTN)
    • tizanidine.

    The following medicines may increase the breakdown of lercanidipine by the liver, which could make it less effective:

    • carbamazepine
    • phenobarbital
    • phenytoin
    • primidone
    • rifampicin
    • the herbal remedy St John's wort (Hypericum perforatum).

    These medicines should be avoided whilst taking lercanidipine.

    The following medicines may decrease the breakdown of lercanidipine by the liver, which could increase the risk of its side effects:

    • clarithromycin
    • erythromycin
    • itraconazole
    • ketoconazole
    • protease inhibitors for HIV infection, eg ritonavir, nelfinavir, saquinavir
    • telithromycin.

    Cimetidine may increase the blood level of lercanidipine and therefore increases the risk of its side effects. It is important that your blood pressure is closely montiored if you are taking this medicine together with cimetidine.

    Lercanidipine may increase the blood level of the immunosuppressant medicine ciclosporin. The use of these medicines together should be avoided.



    Health Reference: Hypertension