Medical Hex

Felodipine

1. Overview

Brand name: Plendil

Felodipine is a calcium channel blocker that is used to treat high blood pressure in adults and elderly; It could be used alone or with other antihypertensive medications such as diuretics or ACE inhibitors.

Felodipine could also be used alone or with a beta blocker as a prophylaxis (prevention) for angina. The drug is available as extended-release tablets with the dosage strengths of 2.5 mg, 5 mg and 10 mg.

felodipine overview

2. Uses

Uses of felodipine:

  1. Management of high blood pressure: felodipine could be used alone or in combination with another hypertensive (e.g., diuretics or ACE inhibitors).
  2. Management of pediatric hypertension: this is an off-label use of felodipine.
  3. Prophylaxis of angina (chest pain): the drug could be used alone or in combination with a beta blocker for this purpose.

3. How and when to take Felodipine?

Felodipine could be taken with or without food.

You should avoid breaking, crushing, dissolving or dividing the extended-release tablets as they should be swallowed whole.

Can I stop taking felodipine if I feel better?

Do not stop taking felodipine without consultation with your doctor. If you stop taking felodipine abruptly you might worsen the underlying disease.

What should I do if I missed a dose?

Take the missed dose as soon as you remember. If the time of your next dose is close by the time you remember you should take the dose which comes after it according to the schedule; However, you should not take any extra doses to make up for the missed dose.

Who cannot take Felodipine?

Felodipine is not suitable for those individuals who have hypersensitivity to felodipine or other calcium channel blockers.

Felodipine is also not recommended for infants and children due to unestablished safety.

4. Special precautions

Make sure to tell your doctor if you have:

  • Liver problems or hepatic impairment
  • Heart problems, especially aortic stenosis
  • Had a recent heart attack (within 1 month)
  • Heart failure
  • Unstable angina
  • Lactose intolerance
  • Sensitivity to Felodipine

You should also inform your doctor if you are taking any other medication to avoid interactions or other undesired consequences.

Pregnancy and breastfeeding:

Avoid taking Felodipine during pregnancy. The toxicity of felodipine during pregnancy has been confirmed in animal studies and it might cause defects in the unborn baby. There’s also a possibility that the drug may inhibit labor.

Felodipine passes into breast milk in small amounts, probably too small to cause harm. However, breastfeeding is still not recommended in order to eliminate the small chance of adverse effects on the baby.

Can I drive and do hazardous work while I’m taking Felodipine?

Avoid such activities until you find out how felodipine affects you because the drug could make you dizzy and light-headed.

Can I drink alcohol while taking Felodipine?

It’s recommended to avoid drinking alcohol. Alcohol may cause dizziness by lowering blood pressure.

Alcohol might also increase the dizziness that may result from using the drug. In addition, alcohol might enhance the blood-pressure-decreasing effect of Felodipine, especially at the beginning of the treatment.

5. Side effects

The most common side effects of Felodipine are:

  • Light-headedness
  • Dizziness
  • Headache
  • Swelling of the ankles and lower leg
  • Flushing
  • Palpitations
  • Fatigue
  • Ringing in the ears (tinnitus)

On very rare occasions, you might have a severe allergic reaction to this medication; If this occurs, you should stop taking felodipine and seek medical attention immediately.

Rare side effects:

  • Gum inflammation or Gingivitis
  • Prickling sensation in the limbs
  • Chest pain
  • Joint pain
  • Anxiety
  • Sexual dysfunction
  • Increased urinary frequency
  • Diarrhea
  • Constipation
  • Abdominal discomfort

6. Interactions

Several drugs and other substances (such as food) can interact with Felodipine, resulting in undesired consequences.

Interaction can affect activity of Felodipine or increase the likelihood and severity of side effects, hence it’s recommended to avoid substances that interact with this medication.

Interactions with other drugs:

Felodipine can form drug-drug interactions with these drugs:

  • Other antihypertensive drugs: they might increase blood-pressure lowering effects of felodipine
  • All CYP3A4 inhibitors such as: ketoconazole, erythromycin, and cimetidine
  • Itraconazole, ritonavir, and atazanavir
  • Anti-epileptics
  • Ciclosporin
  • Tacrolimus
  • Theophylline/aminophylline

Interactions with Herbs:

  • St. John’s wort might decrease the concentration of the drug.
  • Ephedra, yohimbe and ginseng might worsen hypertension, thus influencing the effectiveness of felodipine.
  • Garlic might increase the antihypertensive effect of the drug.

Food interaction(s):

You should not take Felodipine with grapefruit juice or other grapefruit products. Grapefruit might increase the absorption of the drug, thus having a role in producing toxic effects of the drug. Grapefruit products might also decrease the breakdown of felodipine, hence increasing both its concentration and its effects.

References

1. Kizior, R.J. and Hodgson, B.B. (2018). Saunders nursing drug handbook 2019. Philadelphia: Saunders.

2. British Medical Association (2015). British Medical Association new guide to medicine & drugs. London: Dorling Kindersley.

3. Joint formulary committee, BNF 80 (The British National Formulary), 80th Revised edition, Pharmaceutical Press, London, United Kingdom, [2020]

4. Baker, E., Burrage, D., Hitchings, A. and Dagan Lonsdale (2019). The top 100 drugs: clinical pharmacology and practical prescribing. 2nd ed. Amsterdam: Elsevier

5. Carol Mattson Porth et al., Essentials of Pathophysiology Concepts of Altered Health States, Third edition, Philadelphia, Pennsylvania, United States, Wolters Kluwer Health, [2011]

6. Bertam G. Katzung et al., Katzung and Trevor's pharmacology, 12th edition, United States of AmericaMcGraw Hill Education, [2019]

7. Williams and Wolters Kluwer Health (2012). Nursing 2012 drug handbook. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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