Zanidip Drug Interactions

ZANIDIP has been safely administered with diuretics and ACE inhibitors. It may also be administered safely with beta-adrenoceptor blocking drugs which are renally eliminated such as atenolol. Co-administration of ZANIDIP in patients chronically treated with cardiac glycosides showed no evidence of pharmacokinetic interaction; patients on concomitant digoxin treatment should nevertheless be closely monitored clinically for sign of digoxin toxicity. Concomitant administration of cimetidine 800 mg daily dose not cause significant modifications in plasma levels of lercanidipine, but at higher dose caution is required. As for other dihydropyridines, the main metabolic pathway for lercanidipine involves the enzyme CYP3A4. Until further evidence is available, great caution is recommended when lercanidipine is co-prescribed with inhibitors, inducers and/or substrate of CYP3A4 such as amidarone, midazolam, diazepam, metoprolol, propranolol, quinidine, erythromycin, phenytoin, rifampicin, terfenadine and cyclosporin. Dihydropyridines appear to be particularly sensitive to inhibition of metabolism by grapefruit juice, with a consequent rise in their systematic availability. Alcohol should be avoided since it may potentiate the effect of vasodilating antihypertensive drugs. Caution is required if the patient is taking anticonvulsants.