Adults

Initial dose is 2 mg once daily, preferably in the morning. The dose may be increased to 4 mg and then to 6 mg, depending on individual response and blood pressure control. Dose adjustments should be made at intervals of 3-4 weeks.

Elderly

No special dose adjustment is required, but caution should be exercised due to potential for increased sensitivity.

Renal_impairment

No dose adjustment is usually necessary for patients with renal impairment.

Onset

Onset of action within 30-60 minutes.

Excretion

Less than 1% of the administered dose is excreted unchanged in the urine; the majority is excreted as metabolites, mainly via the faeces and urine.

Half life

Terminal elimination half-life is typically 13-19 hours, which supports once-daily dosing.

Absorption

Well absorbed after oral administration, but undergoes extensive first-pass metabolism, resulting in low systemic bioavailability (approximately 10%). Peak plasma concentrations are reached within 0.5-2 hours.

Metabolism

Extensively metabolized in the liver, primarily by the cytochrome P450 enzyme CYP3A4, to inactive metabolites.

Cimetidine

May increase lacidipine plasma levels.

Other Antihypertensives

Concurrent administration with other blood pressure lowering agents (e.g., beta-blockers, diuretics) may result in additive hypotensive effects.

CYP3A4 Inducers (e.g., rifampicin, phenytoin, carbamazepine)

May decrease plasma concentrations of lacidipine, reducing its efficacy. Blood pressure should be monitored.

CYP3A4 Inhibitors (e.g., ketoconazole, erythromycin, ritonavir)

May increase plasma concentrations of lacidipine, enhancing its hypotensive effect. Caution and dose reduction may be necessary.