Curr Med Res Opin. 2015 Jan;31(1):163-70.

Effects of lercanidipine versus amlodipine in hypertensive patients with cerebral ischemic stroke.

Cao Thuc Sinh1, Huynh Van Minh2, Tran Van Huy3

  1. Vinh Medical University, Vinh city, Nghe An, Vietnam
  2. Hue University of Medicine and Pharmacy, Hue, Vietnam
  3. Khanh Hoa Hospital, Nha Trang, Viet Nam

 

Abstract

Objectives: The aim of this study was to compare the efficacy and safety of lercanidipne and amlodipine in the treatment of hypertensive patients with cerebral ischemic stroke.

Reseach design and methods: An open label, control, randomized, parallel-group study was on 104 hypertensive patients (mean 24h ambulatory blood presure [BP] >130/80 mmHg) diagnosed with ischemic stroke. Enrolled subjects were randomly assigned to a 4 week treatment with lercanidipine 20 mg/day or amlodipine 10 mg/day. The treatment was administered during the acute phase of the stroke, either immediately after the diagnosis or during an observation period of maximum 6 days

Results:

Both lercanidipine and amlodipine were able to significantly reduce mean clinical systolic BP (SBP)/diasystolic BP (DBP), mean 24h ambulatory and day-time and nigh-time BP, in particular, mean clinical SBP/DBP was 168.9 ± 21.6/96.2 ± 13,6 mmHg to 147.1 ± 22.0/87.1 ± 14.0 in lercanidipine group (p<0,001 for SBP and <0,01 for DBP) and from 167.1 ± 19.9/97.8 ± 14.5 mmHg to 143.3 ± 21/82.8 ± 14.1 mmHg in amlodipine-treated group (p<0.001 for both SBP and DBP). No statistical difference was observed between the twoo treatment in the reduction of clinical BP. The response and normalization rates registered in the twoo group of patients were also similar, with no significant difference between the two drugs. In addition, both treatment reported comparable results in terms of early morning BP surge reduction BP stabilization, measured through trough-peak ratio and smoothness index. However lercanidipine showed a better tolerability profile than amlodipine, with fewer adverse events and a lower percentage of patients suffering from side effects.

Conclusions

Lercanidipine is as effective as amlodipine in the reduction and stabilization of BP in hypertensive patients after a stroke, and presents some advantages in terms of safety. Larger studies are necessary to further evaluate these preliminary findings.

Keywords: ABPM (ambulatory blood pressure monitoring), hypertension, morning surge, cerebral ischemic stroke, Trough/ peak ratios, Smoothness index, normalized and response rate. SBP (Systolic blood pressure); DBP (diasystolic blood pressure)

PMID: 25425058

 

 

Lercanidipine Hydrochlorid

  1. Chemistry formular: Bis phenyl

       SC fig1

C36H41N3O6.HCl

 

  1. Half time of plasma and tissue

SC fig2

T1/2 plasma = 2-5 h

T1/2 tissu is long

 

  1. Action mechanism

SC fig3

 

4. Some featured effects: Lercacnidipin is a new generation drugs of the calcium channel inhibition with high fat affinity, its circulation time in plasma is short, the ability to bind to receptors in the smooth muscle of the artery is long therefore blood pressure reducts long and smoothly.

Lercanidipine has the ability to reduce the atherosclerosis, to protect nerve cells in ischemic, it was tolerated and responded well in the elderly. The side effect rate is lower than the same drug group. There is also a protective effect on target organs such as reduction of left ventricular hypertrophy and reduction of cardiovascular risk factors in hypertensive patients.

 

 

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