General Information

• Lexxel contains 5 mg of felodipine, a calcium channel blocker, and 5 mg of enalapril, an angiotensin-converting enzyme (ACE) inhibitor. The 2 drugs in this combination belong to widely prescribed groups of hypertension medication.
• Lexxel is not meant for the initial treatment of hypertension.
• Most people taking this product have taken 1 of the ingredients as an individual pill and need more medication to control their blood pressure.
• Felodipine works by blocking the passage of calcium into heart and smooth-muscle tissue, especially the smooth muscle found in arteries. Since calcium is an essential factor in muscle contraction, any drug that affects calcium in this way will interfere with the contraction of these muscles. This causes the veins to dilate (widen), reducing blood pressure. Also, the amount of oxygen used by these muscles is reduced.
• ACE inhibitors such as enalapril work by preventing the conversion of a hormone called angiotensin Ito another hormone called angiotensin II, a potent blood-vessel constrictor. Preventing this conversion relaxes blood vessels and helps to reduce blood pressure and relieve the symptoms of heart failure.
• Enalapril’s effect on other hormones may also help to promote blood-vessel dilation. It begins working about 1 hour after you take it and continues to work for 24 hours.

How does the drug reacts ?

• The blood-pressure-lowering effect of Lexxel adds to that of diuretic (agent that increases urination) drugs or beta blockers.
• Any other drug that causes a rapid blood-pressure drop should be used with caution if you are taking Lexxel.
• When taken with Dyazide or other potassium-sparing diuretics, Lexxel may raise blood-potassium levels.
• Lexxel may increase the effects of lithium; this combination should be used with caution.
• Capsaicin may cause or aggravate the cough associated with Lexxel therapy.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) may interfere with the blood-pressure-lowering effect of Lexxel.
• Phenothiazine sedatives and antiemetics may increase the effects of Lexxel.
• Rifampin may reduce the effects of Lexxel.
• Combining allopurinol with Lexxel increases the risk of an adverse drug reaction.
• Cimetidine, indinavir, nelfinavir, ritonavir, saquinavir, clarithromycin, nefazodone, ketoconazole, itraconazole, erythromycin, telithromycin, aprepitant, fluconazole, and verapamil increase the amount of felodipine in the blood, causing a slight increase in the drug’s effect and possible side effects.
• Phenytoin and other hydantoin anti-seizure drugs, carbamazepine, and barbiturate sleeping pills and sedatives may decrease the amount of felodipine in the blood, reducing its effect.
• Felodipine may increase the effects of theophylline (a drug used to treat asthma and other respiratory problems) and oral anticoagulant (blood-thinning) drugs.
• Felodipine may increase blood levels of tacrolimus. Tacrolimus dose adjustment may be needed.
• Felodipine may interact with quinidine (an antiarrhythmic) to produce low blood pressure, very slow heart rate, abnormal heart rhythms, and swelling in the arms or legs.

Cautions

• Do not take Lexxel if you are allergic or sensitive to any of its ingredients. It could causes very low blood pressure, although rarely occurs.
• Lexxel should be used with caution by people with kidney disease, as it may also affect your kidneys, especially if you have congestive heart failure (CHF). Your doctor should check your urine for protein content during the first few months of treatment.
• Enalapril may affect white-blood-cell counts, possibly increasing your susceptibility to infection. Your doctor should monitor your blood counts periodically.
• ACE inhibitors can cause injury or death to a developing fetus in the last 2 trimesters. Pregnant women should not take Lexxel or any ACE inhibitor.
• People taking a beta-blocking drug who begin taking felodipine may develop heart failure or increased angina pain. Angina pain may also increase if your felodipine dosage is increased.
• People with severe liver disease break down felodipine much more slowly than those with less severe disease or normal livers.
• While taking any ACE inhibitor, sudden and painless swelling in the hands, face, feet, lips, tongue, or throat may develop. If this happens,  stop taking the medication at once , and contact your doctor. This condition usually goes away on its own, though antihistamines may also prove helpful.

Usual Dose and Intakes

• This drug is for adult only.
• 1 tablet a day. ( May be increased to 2 tablets if further blood pressure reduction is necessary after 1-2 weeks of treatment. )
• Overdose may cause low blood pressure. ( In case of overdose, contact your doctor or go to a hospital for emergency attention. ALWAYS bring the prescription bottle or container. )
• Lexxel may be taken without regard to food or meals ( you may take it with food if it upsets your stomach. )
• Avoid grapefruit juice while you are on Lexxel.
• Do not break, crush, or chew Lexxel tablets.
• Maintain good dental hygiene while taking Lexxel and use extra care when brushing or flossing teeth because of the increased risk of oral infection associated with Lexxel.
• Avoid over-the-counter diet pills, decongestants. and stimulants while taking Lexxel; they may raise blood pressure.

Possible Side Effects and Notes

*Side effects are more common with higher dosages and increasing age.
Most common side effects includes :-

• swelling in the ankles, feet, and legs;
• dizziness;
• lightheadedness;
• muscle weakness or cramps;
• facial flushing;
• headache;
• fatigue;
• nausea;
• chronic- (long-term) cough.  ( The cough usually goes away a few days after you stop taking the medication. )

Rare and Less common side effects ( Contact Your Doctor for advise )  :-

• respiratory infection,
• cough,
• tingling in the hands or feet,
• upset stomach,
• abdominal pain,
• chest pain,
• constipation,
• diarrhea,
• heart palpitations,
• sore throat,
• runny nose,
• back pain, rash,
• angina (condition characterized by brief attacks of chest pain),
• vomiting,
• bronchitis,
• urinary tract infection,
• breathing difficulties,
• Unusual condition affecting your heart, muscles and joints, stomach and intestines, sexual function, kidney or liver, and other body parts.

Hypertension may be present without symptoms, thus continue taking your medication and follow any instructions for diet restriction or other treatments to help maintain lower blood pressure, even if you feel well.

Do not take a double dose.

- If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule.

For those under Pregnancy/Breast-feeding period

Women who are or might be pregnant should not take Lexxel. ACE inhibitors have caused low blood pressure, kidney failure, slow skull formation, and death in the fetus when taken during the last 6 months of pregnancy.

Women of childbearing age who must take Lexxel must use an effective contraceptive method.

If you become pregnant, stop taking the medication and call your doctor immediately.
Nursing mothers who must take Lexxel should use infant formula, as small amounts of enalapril + felodipine are known to pass into breast milk.

Seniors citizen :-

• Especially those with liver disease, may be more sensitive to the drug’s effects. Take it with care., it is best to consult doctor before taking it.

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