Cilnidipine is used for the management of hypertension with the aim of providing protection to vital organs. It is particularly beneficial in elderly patients, as well as in individuals with diabetes and albuminuria. It is also increasingly utilized in patients with chronic kidney disease.

Hypertension refers to persistently elevated blood pressure. Blood pressure is generated by the force exerted by circulating blood on the walls of blood vessels. When this pressure remains high over time, it can lead to damage of the blood vessels and associated organs.

Cilnidipine is a dihydropyridine calcium channel blocker. It acts by binding to specific sites on L-type voltage-gated calcium channels, thereby inhibiting the influx of calcium ions (Ca²⁺) into vascular smooth muscle cells. This results in relaxation of blood vessels and subsequent vasodilation. In addition, cilnidipine also blocks N-type voltage-gated calcium channels located in sympathetic nerve endings. This reduces calcium entry into these neurons, leading to decreased release of norepinephrine. As a result, sympathetic overactivity is suppressed, and the usual reflex increase in heart rate following blood pressure reduction is minimized.

Adults: 5–10 mg once daily after breakfast. Maximum dose: 20 mg once daily.

Pediatric use: The safety of Cilnidipine in pediatric patients has not been established.

Elderly use: Since the elderly may be more susceptible to hypotension, therapy should be initiated with the lowest possible dose (5 mg).

Cilnidipine may interact with other antihypertensive drugs, antipsychotic agents that can lower blood pressure, as well as medications such as quinidine, carbamazepine, phenytoin, rifampicin, cimetidine, and erythromycin.

Cilnidipine should not be used in patients with known hypersensitivity to cilnidipine or any of its components. It is also contraindicated in individuals with cardiogenic shock, recent myocardial infarction, acute unstable angina, or severe aortic stenosis.

Common adverse effects of cilnidipine include dizziness, flushing, headache, hypotension, peripheral edema, palpitations, gastrointestinal disturbances, increased frequency of urination, fatigue, eye pain, and depression.

Cilnidipine is not recommended during pregnancy or in women who may become pregnant. It should also be avoided during breastfeeding. If its use is considered essential, discontinuation of breastfeeding is advised.

Cilnidipine should be used cautiously in patients with severe liver impairment or those with a history of adverse reactions to calcium channel blockers. When discontinuing therapy, the dose should be tapered gradually under medical supervision.

Calcium-channel blockers

Store below 30°C, protected from light and moisture. Keep out of reach of children.