Lercanidipin – eine Bereicherung für die Behandlung der arteriellen Hypertonie?

Calcium-channel blockers (CCB) are one of the main therapeutic options for the treatment of hypertension. Within the CCBs, the subgroup of dihydropyridines (DHP) underwent a particularly rapid evolution. A member of the last generation with an improved pharmacokinetic profile and a higher vascular selectivity is lercanidipine. As a result of its long receptor half-life, once-daily dosing produces a sustained blood pressure lowering over 24 hours. The gradual onset of action prevents the occurrence of reflex tachycardia. The antihypertensive action is equivalent to other CCBs or agents from other antihypertensive drug classes. In several clinical trials, lercanidipine has been successfully used in combination with other antihypertensive drugs or as addon therapies. When coadministered with betaadrenoceptor blocking drugs, bioavailability of lercanidipine is decreased and therefore an adjustment in the dosage of the latter may be necessary. It is metabolically neutral and one of its major advantages is the lower incidence of ankle oedema. This has a positive impact on therapeutic compliance, a major topic in the treatment of hypertension. Lercanidipine showed in animal and some clinical studies renal and cardiovascular protective effects, unrelated to its antihypertensive activity. In summary, lercanidipine is characterised by a good efficacy and tolerability profile as well as by a large field of applications by reason of its beneficial pharmacodynamic properties.