Felodipine (Oral)

Felodipine is one of a family of medicines called calcium channel blockers which are widely used in combination with other drugs to treat patients who have high blood pressure.

Overview

In the US, felodipine is sold under the brand name Plendil. The drug comes in extended-release tablet form and is only available via a prescription from your GP.

The drug felodipine is usually prescribed in combination with other medication to treat patients who are suffering from high blood pressure (hypertension). High blood pressure is a potentially very serious complaint that can cause damage to the blood vessels of the kidneys, heart, and brain. If left untreated for a long period of time, hypertension can increase the risk of heart attack and stroke.

It should be understood that this drug cannot provide a cure for your high blood pressure. However, when used with other hypertension medications it an be extremely effective in helping to control the problems that this condition can cause.

Felodipine is one of a group of drugs called calcium channel blockers. The medication works by disrupting and restricting the flow of calcium into the cells of the blood vessels and the heart. The drug also relaxes the blood vessels, widening them and therefore effectively increasing the free flow of blood to the patient's heart.

Conditions treated

  • High blood pressure

Type of medicine

  • Calcium channel blocker
  • Extended-release tablet

Side effects

In addition to the positive effects it is designed to have, some drugs can cause unwanted side effects. Not everyone taking felodipine will notice any odd effects, but if you are affected, you may need to seek medical attention.

Consult your treating physician if you notice any of the effects that are listed below:

  • Wheezing
  • Voice changes
  • Unexpected weight gain or loss
  • Unusual weakness or tiredness
  • Unusual bruising or bleeding
  • Breathing problems on exertion
  • Insomnia
  • Trouble swallowing
  • Tingling sensation in hands or feet
  • Swollen or tender neck glands
  • Swelling or puffiness of face
  • Sweating
  • Sore throat
  • Sneezing
  • Shortness of breath
  • Shivering
  • Runny nose
  • Rapid weight gain
  • Pale skin
  • Discomfort or pain in jaw, arms, back, or neck
  • Nausea
  • Nasal congestion
  • Muscular aches and pains
  • Loss of voice
  • Poor appetite
  • Hives or swellings on the face, lips, eyelids, throat, tongue, hands, legs, feet, or genitals
  • Joint pain
  • Hoarseness
  • Headache
  • General feeling of being unwell
  • Fever
  • Rapid, slow, or irregular heartbeat
  • Ear congestion
  • Feeling dizzy, faint, or lightheaded when rising suddenly from a lying or sitting position
  • Breathing difficulties
  • Diarrhea
  • Cough producing mucus
  • Cough
  • Congestion
  • Confusion
  • Chills
  • Chest tightness, pain, or heaviness
  • Body aches or pains
  • Blurred vision
  • Swelling or bloating of arms, hands, face, lower legs, or feet

If you accidentally take too much of this medication, you may experience the following symptoms, in which case you should call 911 immediately:

  • Reddening of the neck, face, upper chest, and arms
  • Feelings of warmth

Felodipine can cause some side effects that do not usually require medical intervention. These effects often disappear as your body acclimatizes to the new medicine, and your GP may be able to suggest ways in which you can prevent or manage the effects. However, if any of the following side effects do not go away within a week or so of starting to take felodipine, you should check with your treating physician.

  • Insomnia or disturbed sleep
  • Tunnel vision
  • Trouble concentrating
  • Tiredness
  • Swollen joints
  • Breast soreness or swelling in both men and women
  • Stomach pains, discomfort, or upset
  • Sores, welts, or blisters on the skin
  • Unusual sleepiness or drowsiness
  • Skin rashes
  • Redness of skin
  • Reddening and swelling of the gums
  • Increased frequency of urination
  • Passing gas more than usual
  • Tenderness or pain around eyes and cheekbones
  • Over-bright appearance of lights
  • Night blindness
  • Muscle stiffness or cramps
  • Loss of interest or pleasure
  • Loss of sexual ability, libido, or performance
  • Loss or lack of strength
  • Itching
  • Irritation in the mouth
  • Irritability
  • Indigestion
  • Increased volume of dilute or pale urine
  • Increased need to urinate
  • Inability to obtain or maintain an erection
  • Welts or hives
  • Heartburn
  • Seeing halos around lights
  • Frequent, strong, or increased urge to urinate
  • Feeling sad or empty
  • Fear or nervousness
  • Dry mouth
  • Double vision
  • Color blindness
  • Feelings of discouragement
  • Difficulty moving
  • Pain or difficulty when urinating
  • Constipation
  • Feelings of burning, tingling, crawling, numbness, itching, prickling, or "pins and needles"
  • Burning sensation while urinating
  • Nose bleeds
  • Feeling full or bloated
  • Bleeding gums
  • Belching
  • Acid or sour stomach

It should be noted that the side effects that are mentioned in this guide may not form an exhaustive list. If you notice any other odd effects, you should speak with your GP.

Dosage

As part of your treatment for high blood pressure, your GP may recommend a weight control and exercise program. You may also be told to reduce your consumption of foods that are high in salt. Felodipine and your other hypertension medicines will be more effective if you adhere to this holistic therapy regimen. Do not change your diet without first consulting your doctor.

High blood pressure may go undetected in some people, and you may feel completely normal. However, it is still very important that you take your medication exactly as you have been told to and that you also attend any check-up appointments that are scheduled with your GP.

Felodipine will not provide a cure for high blood pressure, although it will help to keep it under control. In order to maintain the beneficial effects of the drug you must continue to take it as prescribed. You may need to continue taking blood pressure medicines for the rest of your life. Remember, if your hypertension goes untreated, you could suffer serious health problems, including kidney disease, stroke, heart failure, or diseases of the blood vessels.

When you take your felodipine extended-release tablets, you should swallow them whole, without chewing, breaking, or crushing them. You may take your tablets just with a glass of water or with a light meal if you prefer.

The dose of felodipine that you are prescribed will not necessarily be the same for everyone. The amount of medicine that you are told to take, the number of daily doses, and the total duration of your treatment will all depend on the strength of the drug, your medical condition, and how your body responds to the effects of the medication.

The dosage levels shown below are only based on the recommended average for felodipine. You must take your dose exactly as prescribed by your GP or indicated on the dispensary label. Do not change the dose or stop taking the drug unless you are expressly told to do so by your GP.

Extended-release tablets for high blood pressure:

  • Adults: Initially, take 5 mg once daily. This dose may be adjusted by your GP if necessary.
  • Children: Your doctor will work out the correct dose and usage for your child.

In the event that you forget to take one of your doses, try to take it right away. However, if your due dose is scheduled imminently, miss out the one you forget and revert to your correct dosing regimen. Never take a double dose.

Do not give any of your prescription medication to anyone else.

Interactions

Some drugs should never be used with other medicines, as this could cause an interaction to occur. However, in some patients it may be safe and appropriate to use one or more different medications, even though an interaction may be caused. Before you start using felodipine, you must be sure to tell your doctor if you are taking any other prescription or over the counter medicines, including vitamin supplements, herbal remedies, and diet pills.

It is not recommended to use felodipine with any of the following medications. In this case, your doctor may decide not to give you this drug or may substitute some of your other medicines:

  • Ketoconazole
  • Itraconazole

It is not generally advisable to use felodipine with any of the following medications, although it may be appropriate in some patients. If you are told to use both drugs, your GP may change the dose or frequency of one or both:

  • Vincristine Sulfate Liposome
  • Vincristine
  • Topotecan
  • St John's Wort
  • Quinupristin
  • Pixantrone
  • Phenobarbital
  • Oxcarbazepine
  • Nilotinib
  • Nelfinavir
  • Morphine Sulfate Liposome
  • Morphine
  • Mibefradil
  • Magnesium
  • Lumacaftor
  • Lacosamide
  • Indinavir
  • Idelalisib
  • Fluconazole
  • Droperidol
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Digoxin
  • Dantrolene
  • Dalfopristin
  • Cyclosporine
  • Conivaptan
  • Clopidogrel
  • Clarithromycin
  • Ceritinib
  • Carbamazepine
  • Atazanavir
  • Amprenavir
  • Amiodarone
  • Afatinib

Other interactions

Some drugs should not be taken when you are eating food or with certain food groups, as this could cause an interaction. An interaction may also happen if you smoke tobacco or drink alcohol while using some medications. Talk to your GP about this aspect of your high blood pressure treatment before you begin using felodipine.

In the case of felodipine, drinking grapefruit juice should be avoided as this can increase the risk of certain side effects.

Medical interactions

Some existing or historical medical problems can affect the use of felodipine. Before you begin using the medicine, be sure to discuss your medical history fully with your treating physician.

If you have ever suffered heart failure, felodipine should be used with caution, as it could make the condition worse.

Extra care must be taken when using felodipine in patients who have liver disease, because the drug may be removed more slowly from the body, potentially increasing its effects and presenting a risk of overdose if the dose is not adjusted appropriately.

Warnings

When considering whether or not to take a certain drug, it is important that you weight the benefits of doing so against the risks. Talk with your doctor to fully understand the implications of using felodipine, before you begin your course.

If you are allergic to felodipine or to any other medicine, including over the counter products, you must tell your GP. You should also mention allergies to particular food groups, food colors or preservatives, and animal by-products.

Throughout your treatment with this medication you will be expected to see your doctor for regular progress checks. These appointments are important, as they allow your GP to check that your body is responding positively to the medicine. You will also be able to mention any side effects that you have noticed. Your doctor may ask you to periodically undergo routine blood tests.

Geriatric patients

Although there have been no specific studies performed to date on the effect of felodipine in the elderly, it should be borne in mind that this group of patients may be more likely to suffer from age-related heart, liver, or kidney problems. The dose of felodipine should therefore be adjusted to take this into consideration when it is prescribed for patients in this age range.

Pregnancy and breastfeeding

There is no evidence to suggest that felodipine has any adverse effect on the fetus. However, if you are pregnant or if you are considering trying to start a family in the immediate future, you should speak with your GP about the benefits and risk of using this medication.

Although felodipine can pass into breast milk in very small amounts, it is not thought to present a risk to a nursing infant. However, to err on the side of caution you may wish to discuss an alternative method of feeding your child with your GP or midwife for the duration of your course of treatment with felodipine.

Medical complications

Felodipine can cause the blood pressure to fall too low in some patients. If any of the symptoms listed below are experienced, you should mention them to your GP immediately:

  • Sweating
  • Feeling very dizzy
  • Feeling unusually tired or weak
  • Feeling lightheaded when rising from a seated or prone position
  • Fainting
  • Confusion
  • Blurred vision

In some patients, felodipine can cause edema (fluid retention). If you notice any of the symptoms in the list that follows, tell your doctor right away:

  • Swelling or bloating of the arms, face, lower limbs, hands, or feet
  • Tingling sensations in the feet or hands
  • Unexpectedly gaining or losing weight

Some patients who are being treated with felodipine report reddening, bleeding, or swelling of the gums. You can take steps to prevent this side effect by brushing and flossing carefully, and gently massaging your gums. If you find this effect especially problematic, ask your dentist or GP for more advice.

Storage

Your supply of felodipine should be kept in its original container, sealed, and at room temperature. Do not expose the medication to heat sources, moisture, and direct sunlight. Do not freeze or refrigerate the tablets.

Be sure to place your medicine well out of the reach of children and pets. If a pet does eat any of your felodipine tablets, you should contact your emergency vet as soon as possible.

Do not use or retain any tablets that have gone out-of-date or appear damaged. Do not use medicines whose packaging appears to have been opened or tampered with.

Always dispose of any unused felodipine tablets responsibly. Ask your pharmacist or GP to safely dispose of the medication. Do not flush tablets down the toilet or drain. Do not throw loose tablets into your trash where they could be picked up by children or pets.

Summary

Felodipine is a calcium channel blocker that is used to treat patients who are suffering from high blood pressure (hypertension). The drug is usually given together with other suitable medicines and is available in extended-release tablet form.

Although felodipine is very effective at controlling blood pressure, it cannot cure your condition. You may need to use this medication in combination with other hypertension drugs for the rest of your life in order to guard against serious medical conditions, including heart attack, stroke, kidney disease, and blood vessel problems.

Felodipine can cause a number of side effects, and there are a number of drugs and medical conditions that it can cause an interaction with. For these reasons, it is important that you attend your doctor on a regular basis for check-up appointments and to make sure the drug is working properly. You can use these review sessions to discuss any unwanted effects that the drug is causing and work out ways of preventing or managing them.

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