Zerotens
Generic Name
Lercanidipine Hydrochloride
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zerotens 3 mg tablet | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Zerotens 3 mg Tablet contains Lercanidipine Hydrochloride, a calcium channel blocker used to treat mild to moderate essential hypertension. It works by relaxing blood vessels, making it easier for the heart to pump blood throughout the body.
Uses & Indications
Dosage
Adults
Initial dose 3 mg once daily, may be increased to 6 mg, then to 10 mg after at least 2 weeks if blood pressure is not adequately controlled. Maximum daily dose 20 mg.
Elderly
No special dose adjustment required, but caution is advised. Start with the lowest effective dose.
Renal_impairment
No dose adjustment is usually required for mild to moderate impairment. For severe renal impairment (creatinine clearance < 30 mL/min), initial dose 3 mg once daily, with caution.
How to Take
Take one tablet orally once daily, preferably in the morning, at least 15 minutes before a meal. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Lercanidipine is a dihydropyridine calcium channel blocker. It inhibits the transmembrane influx of calcium ions into cardiac and vascular smooth muscle cells. This action leads to arterial vasodilation, reducing peripheral vascular resistance and consequently lowering blood pressure.
Pharmacokinetics
Onset
Gradual onset of antihypertensive action within 1-2 hours, reaching maximum effect within 24 hours.
Excretion
Primarily excreted in urine (approximately 50% as metabolites) and feces (approximately 50%).
Half life
Approximately 8-10 hours (terminal half-life).
Absorption
Well absorbed orally; peak plasma concentrations reached within 1.5-3 hours. First-pass metabolism significantly reduces bioavailability (approx. 10%).
Metabolism
Extensively metabolized by the liver, primarily via cytochrome P450 3A4 (CYP3A4).
Side Effects
Contraindications
- Known hypersensitivity to Lercanidipine or any dihydropyridine
- Pregnancy and lactation
- Severe hepatic impairment
- Severe renal impairment (CrCl < 30 mL/min)
- Patients with uncontrolled congestive heart failure
- Unstable angina pectoris
- Recent myocardial infarction (within 1 month)
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, grapefruit juice)
- Outflow tract obstruction (e.g., aortic stenosis)
Drug Interactions
Digoxin
No significant interaction, but caution advised.
Ciclosporin
Increased plasma levels of both Lercanidipine and Ciclosporin. Monitor closely.
Beta-blockers (e.g., Metoprolol)
Additive hypotensive effect. Caution and monitoring recommended.
CYP3A4 inducers (e.g., Rifampicin, Phenytoin, Carbamazepine)
Can decrease Lercanidipine plasma levels, potentially reducing its efficacy.
CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir, Erythromycin)
Can significantly increase Lercanidipine plasma levels, leading to increased hypotensive effect and risk of side effects. Concomitant use is contraindicated.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include pronounced vasodilation, marked hypotension, reflex tachycardia, and possibly loss of consciousness. Management involves supportive care, including gastric lavage, activated charcoal, and intravenous fluids to maintain blood pressure. Bradycardia may be treated with atropine, and in severe cases, a pacemaker may be necessary. Vasopressors may be used for persistent hypotension.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation due to insufficient data on safety and potential risks to the fetus/infant. Consult a doctor for alternative treatments.
Side Effects
Contraindications
- Known hypersensitivity to Lercanidipine or any dihydropyridine
- Pregnancy and lactation
- Severe hepatic impairment
- Severe renal impairment (CrCl < 30 mL/min)
- Patients with uncontrolled congestive heart failure
- Unstable angina pectoris
- Recent myocardial infarction (within 1 month)
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, grapefruit juice)
- Outflow tract obstruction (e.g., aortic stenosis)
Drug Interactions
Digoxin
No significant interaction, but caution advised.
Ciclosporin
Increased plasma levels of both Lercanidipine and Ciclosporin. Monitor closely.
Beta-blockers (e.g., Metoprolol)
Additive hypotensive effect. Caution and monitoring recommended.
CYP3A4 inducers (e.g., Rifampicin, Phenytoin, Carbamazepine)
Can decrease Lercanidipine plasma levels, potentially reducing its efficacy.
CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir, Erythromycin)
Can significantly increase Lercanidipine plasma levels, leading to increased hypotensive effect and risk of side effects. Concomitant use is contraindicated.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include pronounced vasodilation, marked hypotension, reflex tachycardia, and possibly loss of consciousness. Management involves supportive care, including gastric lavage, activated charcoal, and intravenous fluids to maintain blood pressure. Bradycardia may be treated with atropine, and in severe cases, a pacemaker may be necessary. Vasopressors may be used for persistent hypotension.
Pregnancy & Lactation
Contraindicated during pregnancy and lactation due to insufficient data on safety and potential risks to the fetus/infant. Consult a doctor for alternative treatments.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Available in pharmacies, hospitals, and licensed drug stores
Approval Status
Approved by regulatory authorities worldwide, including FDA and DGDA (Bangladesh)
Patent Status
Generic available (original patent expired)
Clinical Trials
Lercanidipine has undergone extensive clinical trials demonstrating its efficacy and safety in the treatment of essential hypertension. Studies have shown its comparable efficacy to other calcium channel blockers with a favorable tolerability profile, particularly regarding ankle edema.
Lab Monitoring
- Blood pressure monitoring regularly
- Renal function tests (creatinine, BUN) periodically
- Liver function tests (ALT, AST) periodically (especially in patients with hepatic impairment)
Doctor Notes
- Advise patients to take Lercanidipine consistently at the same time each day, preferably before breakfast.
- Emphasize avoiding grapefruit juice due to significant interaction.
- Monitor blood pressure regularly and assess for peripheral edema.
- Consider initiating with 3 mg in elderly or renally impaired patients, titrating slowly.
- Counsel on lifestyle modifications (diet, exercise, smoking cessation) for optimal blood pressure control.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Do not stop taking this medicine suddenly without consulting your doctor.
- Avoid grapefruit juice and grapefruit during treatment.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any unusual side effects or worsening of symptoms to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Zerotens may cause dizziness, drowsiness, or fatigue, especially at the beginning of treatment or when the dose is increased. If you experience these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Adopt a healthy diet low in sodium and saturated fats.
- Engage in regular physical activity as recommended by your doctor.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Quit smoking to improve cardiovascular health.
- Manage stress through relaxation techniques.
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