Lercanidipine (Zanidip, Napp Laboratories Ltd.) is a new dihydropyridine calcium-channel blocker. It is usually licensed for the treatment of mild to moderate essential hypertension at doses of 10 or 20 mg once daily. The manufacturer claims that corifeo lercadip causes fewer vasodilatory adverse effects than other calcium-channel blockers. It is also being promoted for the treatment of isolated systolic hypertension (ISH) in elderly patients.

In placebo-controlled studies, in patients with mild to moderate hypertension, lercanidipine 10 mg or 20 mg daily produced similar reductions in diastolic blood pressure (about 10 mm Hg) after four weeks treatment.

Reductions in systolic blood pressure (SBP) were also seen in some published studies, but not all. However, in a small, unpublished, double-blind, placebo-controlled study involving elderly patients (? 60 years) with ISH, lercanidipine 10 mg daily (increased to 20 mg daily after four weeks for non-responders) produced a mean reduction in SBP of 26 mm Hg after four weeks and32 mm Hg after eight weeks treatment.

In comparative studies in patients with mild to moderate hypertension, lercanidipine 10 mg daily was as effective as atenolol (50 mg daily), captopril (50 mg twice daily), and nifedipine m/r (20 mg twice daily) after four weeks treatment. In an unpublished, eight-week comparative study, lercanidipine 20 mg daily was shown to be as effective as amlodipine (10 mg daily).

The most frequently reported adverse effects seen in clinical trials involving 1316 patients were tachycardia (0-9%), oedema (1-6%), flushing (1-6%), headache (2-6%), dizziness (0-0.5%) and asthenia (0-1%).

In the comparative studies, the overall incidence of adverse effects in the lercanidip  treatment groups were similar to that seen in the groups receiving atenolol, captopril, nifedipine m/r and amlodipine.