Lerka 20Mg Tablets

• Mild to moderate essential hypertension (high blood pressure) in adults, used alone or in combination with other blood pressure medicines such as a beta-blocker, a water tablet (diuretic), or an ACE inhibitor

• If you are allergic to lercanidipine or any other ingredient in this medicine, as a serious allergic reaction may occur
• If you have a blockage in the outflow pathway of the left side of your heart (left ventricular outflow tract obstruction)
• If you have untreated heart failure (congestive cardiac failure)
• If you have unstable chest pain (unstable angina) or have had a heart attack within the last month
• If you have severe liver disease
• If you have severe kidney disease (GFR below 30 ml/min), including patients on dialysis
• If you are taking strong CYP3A4 inhibiting medicines such as ketoconazole, itraconazole, clarithromycin, ritonavir, or erythromycin, as these cause a dangerous rise in lercanidipine blood levels
• If you are taking ciclosporin (an immune-suppressing medicine), as this leads to dangerously high blood levels of both medicines
• If you are taking grapefruit or grapefruit juice, as this raises lercanidipine blood levels to unsafe amounts
• If you cannot tolerate lactose, speak to your doctor before taking this medicine, as each tablet contains lactose monohydrate

• Headache
• Fast heartbeat (tachycardia) and palpitations
• Flushing (a feeling of warmth or redness in the face and neck)
• Swelling of the feet, ankles, or legs (peripheral oedema)
• Dizziness
• Low blood pressure (hypotension)
• Indigestion (dyspepsia) and nausea
• Upper abdominal pain
• Skin rash and itching (pruritus)
• Muscle pain (myalgia)
• Passing more urine than usual (polyuria)
• Weakness (asthenia) and fatigue

Other General Warnings

• You develop swelling of the lips, face, tongue, or throat, as this may be a sign of a serious allergic reaction (angioedema) that requires immediate medical attention and permanent stopping of this medicine
• You experience new, worsening, or more frequent chest pain (angina), as Lerka tablet very rarely may worsen chest pain in patients with pre-existing heart disease; seek medical help right away if your chest pain changes in pattern or severity
• You have sick sinus syndrome (an irregular or slow heart rhythm) without a pacemaker, as Lerka tablet must be used with extra caution in this condition
• You have or develop problems with the left side of your heart not pumping effectively, as extra care is needed
• You have mild to moderate kidney problems, as a dose increase to 20 mg must be approached carefully; severe kidney disease (GFR below 30 ml/min) is a contraindication
• You have mild to moderate liver problems, as the blood pressure-lowering effect may be stronger than expected and a dose adjustment may be needed; severe liver disease is a contraindication
• You are on peritoneal dialysis and notice cloudy fluid in your dialysis bags, as Lerka tablet has been linked with this finding and may need to be stopped for it to resolve
• You are taking digoxin (a heart medicine), as Lerka tablet can raise peak digoxin levels; signs of digoxin toxicity such as nausea, vomiting, slow pulse, or visual disturbances should be watched for
• You are taking simvastatin, as this combination can raise simvastatin levels; take the medicines at different times of the day as your doctor advises
• You are planning to start a pregnancy or trying to conceive using assisted reproduction (IVF), as calcium channel blockers have been linked with reversible changes in sperm that could affect fertilisation; your doctor may review your treatment in this situation

• Swallow the tablet whole or divide it along the score line
• Never stop taking Lerka tablet without your doctor's advice, as stopping suddenly may cause blood pressure to rise sharply

• Store in the original packaging to protect from light.
• No special temperature conditions are required; store at room temperature.
• Keep out of reach of children and pets.

• Always take Lerka tablet before a meal, preferably before breakfast; taking it with or after food, especially a high-fat meal, significantly increases absorption and can cause blood pressure to drop too much
• Never take Lerka tablet with grapefruit or grapefruit juice, as this raises the medicine's level in the blood to unsafe amounts
• Avoid alcohol during treatment, as it can enhance the blood pressure-lowering effect and cause dizziness or fainting
• Never stop taking Lerka tablet suddenly without your doctor's advice, as blood pressure may rise sharply
• Swelling of the ankles or feet is a common side effect; tell your doctor if it is troublesome, as dose adjustments or adding a water tablet may help
• If you have pre-existing angina (chest pain), tell your doctor, as Lerka tablet very rarely can worsen chest pain; seek medical help right away if your chest pain changes in pattern or worsens
• Attend your regular blood pressure check-up appointments so your doctor can assess how well the medicine is working
• Tell your doctor if you are planning a pregnancy, as Lerka tablet is not recommended during pregnancy
• Inform all your doctors, dentists, and pharmacists that you are taking Lerka tablet, as it interacts with several commonly used medicines

Overdose

• In cases of overdose, Lerka tablet can cause excessive widening of blood vessels, leading to a marked drop in blood pressure and a fast heartbeat. At very high doses, a slowing of the heartbeat and reduced pumping strength of the heart have also been observed. Common overdose symptoms include very low blood pressure, dizziness, headache, and palpitations.
• If you think you or someone else has taken too much of this medicine, contact your doctor or go to the nearest emergency department right away. Heart and breathing function must be monitored for at least 24 hours. Dialysis is unlikely to be helpful as this medicine binds very strongly to proteins in the blood.

Missed a Dose

• If you miss a dose of Lerka tablet, skip the missed dose and take your next dose the following morning before breakfast as usual.
• Do not take double doses to make up for a missed one. If you are unsure what to do, contact your doctor or pharmacist for guidance.

Interactions with other medicines

• Never take Lerka tablet alongside strong CYP3A4 inhibiting medicines such as ketoconazole, itraconazole, clarithromycin, ritonavir, and erythromycin, as these can raise lercanidipine blood levels to dangerously high amounts; this combination is contraindicated
• Never take Lerka tablet alongside ciclosporin (an immune-suppressing medicine), as this leads to dangerously high levels of both medicines; this combination is contraindicated
• Avoid medicines that reduce CYP3A4 activity such as rifampicin, phenytoin, phenobarbital, and carbamazepine (used for tuberculosis or seizures), as these significantly reduce the blood pressure-lowering effect of Lerka tablet
• If you are taking digoxin (a heart medicine), your doctor will monitor you closely, as Lerka tablet can raise peak digoxin levels by about one third
• If you are taking simvastatin (a cholesterol medicine), take Lerka tablet in the morning and simvastatin in the evening as usual to reduce a potential interaction
• If you are taking alpha-blockers for urinary or blood pressure problems, tricyclic antidepressants, or antipsychotic medicines, your blood pressure may fall further than expected and your doctor will monitor you
• Corticosteroids (used for inflammation) may reduce the blood pressure-lowering effect of Lerka tablet
• Lerka tablet can be safely taken with ACE inhibitors and water tablets (diuretics); combinations with these are commonly used when one medicine is not enough
• Always tell your doctor and pharmacist about all medicines, supplements, vitamins, and herbal products you take before starting treatment

Interactions with food items

• Lerka tablet must be taken before a meal; taking it up to 2 hours after a high-fat meal increases the amount absorbed into the body approximately 4-fold, which can cause the blood pressure to drop too much; always take it before breakfast as instructed
• Never take Lerka tablet with grapefruit or grapefruit juice, as this raises the medicine's level in the blood to potentially unsafe amounts and is contraindicated
• Avoid alcohol during treatment, as it can strengthen the blood pressure-lowering effect and increase the risk of dizziness and fainting
• Maintain a low-salt diet as recommended by your doctor to support blood pressure control alongside the medicine