Felodipine

Indications
 Oral
Hypertension
Adult: As modified-release preparation: Initially, 5 mg once daily in the morning, adjust dose according to patient's response. Maintenance: 2.5-10 mg daily. Up to 20 mg daily may be used if needed.
Renal impairment: Dose reduction may be required.
Oral
Angina pectoris
Adult: Initially, 5 mg daily, increased to 10 mg daily if necessary.
Renal impairment: Dose reduction may be required.

Special Populations: Reduce dose in elderly and in those with renal failure.
Contraindications
 Hypersensitivity. Pregnancy.
Warnings / Precautions
 Impaired renal or hepatic function, CHF, sick-sinus syndrome, severe left ventricular dysfunction, hypertrophic cardiomyopathy. May cause hypotension with reflex tachycardia resulting in MI in susceptible patients; severe liver disease. Elderly, children. Lactation.
Adverse Reactions
 Flushing, headache, peripheral oedema, tachycardia, palpitation, dizziness, fatigue. Ankle swelling may occur. Hyperplasia, rash, pruritus. Gingival enlargement, angina, angioedema, decreased libido, insomnia, irritability in patients with pronounced gingivitis or periodontitis.
Overdose Reactions
 Overdosage may cause excessive peripheral vasodilation with marked hypotension and bradycardia. Treatment is symptomatic. Patient should be placed supine with the legs elevated. IV fluids may be given to treat hypotension due to overdosage with calcium antagonists. IV atropine (0.5-1 mg) should be given if there is bradycardia.
Drug Interactions
 Increased absorption with ethanol. Plasma levels increased by enzyme inhibitors e.g. cimetidine. Plasma levels reduced by enzyme inducers e.g. phenytoin, carbamazepine and barbiturates.
Potentially Fatal: Additive hypotensive effect with sildenafil and vardenafil. Increased conc with ciclosporin. Increases plasma digoxin concentrations by approximately 40%.
See Below for More felodipine Drug Interactions
Food Interactions
 Grapefruit juice significantly increase bioavailability. High fat and carbohydrate meals.
Mechanism of Actions
 Felodipine relaxes coronary vascular smooth muscles by inhibiting calcium ions from entering the 'slow channels' or voltage-sensitive areas of vascular smooth muscles and myocardium during depolarisation. It also increases myocardial O2 delivery in patients with vasospastic angina.
Absorption: Almost completely absorbed from the GI tract (oral).
Distribution: Protein-binding: 99%.
Metabolism: Gut and liver (extensive 1st pass effect).
Excretion: Via urine (70% as metabolites), via faeces (remaining dose); 11-16 hr (elimination half-life).
Administration
 May be taken with or without food. (Take w/o food or w/ a light meal. Avoid grapefruit juice. )
Storage Conditions
 Oral: Store below 30°C.
ATC Classification
 C08CA02 - felodipine ; Belongs to the class of dihydropyridine derivative selective calcium-channel blockers with mainly vascular effects. Used in the treatment of cardiovascular diseases.
Storage
 Oral: Store below 30°C.
Available As
  • Felodipine 10 mg
  • Felodipine 2.5 mg
  • Felodipine 5 mg

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