Improved Tolerability of the Dihydropyridine Calcium-Channel Antagonist Lercanidipine: The Lercanidipine Challenge Trial

Borghi, Claudio; Prandin, Maria Grazia; Dormi, Ada; Ambrosioni, Ettore

doi:10.1080/08038020310000087

Cited by 32 publications

(23 citation statements)

References 16 publications

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“…However, when reported by patients as 'leg swelling', one of these thirdgeneration CCBs has been associated with an oedema incidence of 22%. 26 Thus, although differences among CCBs in oedema incidence rates have been reported in a number of studies, 10,[27][28][29][30] it is evident that dose-dependent peripheral oedema remains a common side effect in patients receiving both established and newer CCBs. 10,31 Factors that may influence oedema Several factors can predispose the patient to an increased risk of oedema.…”

Section: Mechanism Of Ccb-induced Oedemamentioning

confidence: 99%

Mitigation of calcium channel blocker-related oedema in hypertension by antagonists of the renin–angiotensin system

Sierra

2009

J Hum Hypertens

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This review is aimed at examining calcium channel blocker (CCB)-related oedema and how this can be attenuated through the use of agents that inhibit the renin-angiotensin system. CCBs are effective antihypertensive agents, but their propensity for causing oedema may reduce compliance. A review of the literature has indicated that the absolute incidence of this side effect is difficult to determine because reported rates vary widely, a factor that may stem from differences in the surveillance technique (active vs passive). In a recent trial incorporating active surveillance, 25% of patients who received amlodipine 10 mg per day experienced oedema. CCB-induced oedema is caused by increased capillary hydrostatic pressure that results from preferential dilation of pre-capillary vessels. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) cause postcapillary dilation and normalize hydrostatic pressure, and are thus ideally suited for prevention/reversal of CCB-induced oedema. The efficacy of this strategy was proven using both subjective and objective techniques. ARB/CCB and ACEI/CCB combination therapy is also more effective than CCB monotherapy in controlling blood pressure. These combinations represent an important advance in the management of hypertension.

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Section: Mechanism Of Ccb-induced Oedemamentioning

confidence: 99%

Mitigation of calcium channel blocker-related oedema in hypertension by antagonists of the renin–angiotensin system

Sierra

2009

J Hum Hypertens

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“…Therefore it was suggested that rapid removal of lercanidipine from plasma may be responsible for its favourable tolerability profile. 16 Though incidence of vasodilation related side effects other than pedal edema were less in lercanidipine treated group as compared to amlodipine group, the difference was statistically not significant. This observation was similar to the findings of the ELYPSE and the ELECTRA study.…”

mentioning

confidence: 85%

A randomized comparison between lercanidipine and amlodipine for efficacy and tolerability in patients with essential hypertension

Raparti

Choure

Patil

et al. 2016

Int J Basic Clin Pharmacol

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“…A study other than ours, tried to answer this question. One hundred twenty-five hypertensive subjects who experienced an adverse effect with amlodipine, nifedipine GITS, felodipine and nitrendipine received lercanidipine in the Lercanidipine Challenge Trial [4]. Lercanidipine reduced the overall incidence of edema by 46% in this 8-week, open-label study.…”

Section: Discussionmentioning

confidence: 99%

“…What about shifting to another dihydropyridine CCB when intolerant pedal edema develops? Only a few studies addressed this issue [4]. Therefore in our study we aimed to find out the incidence of pedal edema formation and the proportion of patients who maintain therapy after switching to a different dihydropyridine CCB in hypertensive patients who had already developed pedal edema on a dihydropyridine CCB therapy.…”

Section: Introductionmentioning

confidence: 99%

A different dihydropyridine calcium channel blocker in hypertensive patients who developed pedal edema on dihydropyridine calcium channel blocker therapy

et al. 2014

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Aim. Dihydropyridine calcium channel blockers (CCB) are widely preferred for the treatment of hypertension for their efficacy, metabolic neutrality and low side effect profile. However pedal edema formation limits their usage. The aim of the present study is to evaluate the incidence of pedal edema formation with a different dihydropyridine CCB in hypertensive patients who developed pedal edema during a dihydropyridine CCB therapy. Method. Fifty-eight hypertensive patients (34 female, 24 male, mean age: 65.3±10.5) in whom pedal edema developed during treatment with a dihydropyridine CCB (amlodipine 10mg/day in 40 patients, amlodipine 5mg/day in 14 patients, nifedipine GITS 30mg/day in 4 patients) were enrolled. CCB which caused pedal edema was withdrawn and a different CCB (felodipine or lacidipine) were initiated after the resolution of the pedal edema. CCB therapy was continued as long as the patient tolerated pedal edema. Results. At the end of one year, 44 out of 58 patients (36 [81.8%] free of pedal edema, 8 [19.2%] with pedal edema) continued CCB therapy. Eleven (37.9%) patients in the felodipine group and 9 (31.0%) patients in the lacidipine group developed pedal edema. In 7 patients in felodipine group and in 5 patients in the lacidipine group the study drug was withdrawn due to pedal edema. In two patients, study drug was withdrawn due to intractable headache (felodipine group) or due to flushing (lacidipine group). Conclusion. A different group of dihydropyridine CCB be used as an alternative therapy for hypertension whenever pedal edema develops during treatment with a dihydropyridine CCB.Keywords: Hypertension, dihydropyridine calcium channel blockers, edema Özet Amaç. Dihidropiridin kalsiyum kanal blokerleri (KKB) etkinlikleri, metabolik nötraliteleri ve düşük yan etki profilleri nedeniyle hipertansiyon tedavisinde yaygın olarak tercih edilirler. Ancak tedavi sırasında ayak bileği ödemi gelişimi kullanımlarını kısıtlar. Bu çalışmanın amacı dihidropiridin KKB tedavisi sırasında ayak bileği ödemi gelişen hipertansif hastalarda farklı bir dihidropiridin KKB' ne geçilmesiyle ayak bileği ödemi gelişim oranının araştırılmasıdır. Yöntem. Dihidropiridin KKB tedavisi sırasında ayak bileği ödemi gelişen 58 hipertansif hasta (34 kadın, 24 erkek, ortalama yaş 65,3±10,5) çalışmaya alındı. Bunlardan 40'ında ayak bileği ödemine yol açan KKB amlodipin 10mg/gün, 14'ünde amlodipin 5mg/gün ve 4'ünde nifedipine GITS 30mg/gün idi. Ayak bileği ödemi yapan KKB kesilerek ödem kaybolduktan sonra farklı bir dihidropiridin KKB (felodipin ya da lasidipin) başlandı. Yeni başlanan KKB tedavisine hasta ayak bileği ödemini tolere ettikçe devam edildi. Bulgular. grubunda 11 (%37,9) ve lasidipin grubunda 9 (%31,0) hastada ayak bileği ödemi gelişti. Felodipin grubunda 7, lasidipin grubunda 5 hastada ayak bileği ödemi geliştiği için tedavi kesildi. Felodipin grubunda bir hastada şiddetli başağrısı, lasidipin grubunda bir hastada ise flushing nedeniyle tedavi sonlandırıldı. Sonuç. Dihidropiridin KKB tedavisi sırasında ayak bile...

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Improved Tolerability of the Dihydropyridine Calcium-Channel Antagonist Lercanidipine: The Lercanidipine Challenge Trial

Cited by 32 publications

References 16 publications

Mitigation of calcium channel blocker-related oedema in hypertension by antagonists of the renin–angiotensin system

Mitigation of calcium channel blocker-related oedema in hypertension by antagonists of the renin–angiotensin system

A randomized comparison between lercanidipine and amlodipine for efficacy and tolerability in patients with essential hypertension

A different dihydropyridine calcium channel blocker in hypertensive patients who developed pedal edema on dihydropyridine calcium channel blocker therapy

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