felodipine


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felodipine

 [fĕ-lo´dĭ-pēn]
a calcium channel blocking agent used as a vasodilator in treatment of hypertension.

felodipine

Cardioplen (UK), Felotens (UK), Keloc (UK), Neofel (UK), Plendil, Renedil (CA), Vascalpha (UK)

Pharmacologic class: Calcium channel blocker

Therapeutic class: Antihypertensive, antianginal

Pregnancy risk category C

Action

Impedes extracellular calcium ion movement across membranes of myocardial muscle cells, depressing myocardial contractility and impulse formation; slows impulse conduction velocity and dilates coronary arteries and peripheral arterioles. Net effect is reduced cardiac workload and lower blood pressure.

Availability

Tablets (extended-release): 2.5 mg, 5 mg, 10 mg

Indications and dosages

Hypertension

Adults: Initially, 5 mg P.O. daily. Depending on response, may decrease to 2.5 mg or increase to a maximum of 10 mg P.O. daily at 2-week intervals.

Dosage adjustment

• Hepatic impairment
• Elderly patients

Off-label uses

• Heart failure
• Angina pectoris or vasospastic (Prinzmetal's) angina

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• cardiac disease, arrhythmias, severe hepatic or renal impairment
• elderly patients
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give without regard to meals.
• Make sure patient swallows tablet whole without crushing or chewing.

Adverse reactions

CNS: headache, drowsiness, dizziness, syncope, nervousness, anxiety, psychiatric disturbances, paresthesia, insomnia, asthenia, confusion, irritability

CV: chest pain, peripheral edema, hypotension, palpitations, tachycardia, angina, arrhythmias, myocardial infarction, atrioventricular block

EENT: rhinorrhea, sneezing, pharyngitis

GI: nausea, vomiting, diarrhea, constipation, abdominal discomfort, dyspepsia, abdominal cramps, flatulence, dry mouth

Hematologic: anemia

Musculoskeletal: back pain

Respiratory: bronchitis

Skin: dermatitis, rash, pruritus, urticaria, erythema

Other: dysgeusia, gingival hyperplasia, facial edema, thirst, warm sensation

Interactions

Drug-drug.Antifungals, cimetidine, erythromycin, propranolol, ranitidine: increased felodipine blood level, increased risk of toxicity

Barbiturates, hydantoins: decreased felodipine blood level

Beta-adrenergic blockers, digoxin, disopyramide, phenytoin: bradycardia, conduction defects, heart failure

Fentanyl, nitrates, other antihypertensives, quinidine: additive hypotension

Nonsteroidal anti-inflammatory drugs: decreased antihypertensive effects

Drug-food.Grapefruit juice: increased felodipine blood level and effects

Drug-behaviors.Acute alcohol ingestion: additive hypotension

Patient monitoring

Don't give to patient with heart block unless he has a pacemaker.

Use extreme caution when administering to patients with pulmonary hypertension, renal insufficiency, heart failure, or compromised ventricular function (especially those receiving beta-adrenergic blockers concurrently).
• Monitor fluid intake and output, and weigh patient daily.
• Monitor ECG and vital signs. Assess for signs and symptoms of heart block.
• Assess for reflex tachycardia, angina, and sustained hypotension.
• Check hepatic profile and alkaline phosphatase level in patients with hepatic impairment.

Patient teaching

• Tell patient drug controls but doesn't cure high blood pressure, so he should keep taking it even if he feels well.
• Instruct patient to move slowly when rising, to avoid light-headedness or dizziness from sudden blood pressure decrease.
• Explain that exercise and hot weather may increase drug's hypotensive effects.
• Tell patient to report peripheral edema, persistent headache, or flushing.
• Advise patient to use hard candy or gum if dry mouth or thirst occurs.
• Tell female patient to inform prescriber if she is pregnant or breastfeeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and behaviors mentioned above.

felodipine

/fe·lo·di·pine/ (fĕ-lo´dĭ-pēn) a calcium channel blocker used as a vasodilator in the treatment of hypertension.

felodipine

(fə-lō′də-pēn′)
n.
A calcium channel blocker that acts as a vasodilator, used to treat hypertension and angina pectoris.

felodipine

Plendil® Cardiology A beta-blocking antihypertensive

felodipine

(fəlō´dəpēn´),
n brand names: Plendil, Renedil;
drug class: calcium channel blocker;
action: inhibits calcium ion influx across cell membrane during cardiac depolarization; produces relaxation of coronary vascular smooth muscle; dilates coronary arteries; decreases SA/AV node conduction;
uses: essential hypertension, alone or with other antihypertensives, chronic angina pectoris.
References in periodicals archive ?
She remained hospitalized for one month after the surgery; during this time her physical symptoms were treated with prednisolone, felodipine, metoprolol, and omeprazole, and her psychiatric symptoms and sleep disorder were treated with quetiapine and alprazolam.
The strongest effect was recorded for vitamin E, followed by felodipine, 2-Cl analogue of nifedipine, nifedipine, amlodipine, nitrendipine, verapamil, and diltiazem.
Rapidly absorbed orodispersible tablet containing molecularly dispersed felodipine for management of hypertensive crisis: development, optimization and in vitro/in vivo studies.
06 mg/kg/d up Consider use in ([dagger]) to 5 mg (qd) hyperlipid/ ([double emia, asthma, dagger]) renal disease, diabetes Felodipine 2.
Received final approval from the USFDA to manufacture and market Felodipine Extended-Release tablets USP, 2.
Larsson, "Does prophylactic treatment with felodipine, a calcium antagonist, prevent low-osmolar contrast-induced renal dysfunction in hydrated diabetic and nondiabetic patients with normal or moderately reduced renal function?
For example, according to the US SmPC, the co-administration of digoxin and calcium channel blockers may lead to blocking atrio-ventricular (AV) of conduction, while according to the UK SmPC there are reports for digoxin and each calcium channel blockers individually (diltiazem, nifedipine, nisoldipin, amlodipine, felodipine, isradipin, lercandipin, nicardipine, nimodipine, nitrendipine and verapamil), with noticed differences in the clinical significance of interactions.
4) Amlodipine (33), (n=80 (a)) blocker nifedipine (10), Felodipine (4) Angiotension 39 (11.
Some commonly prescribed drugs in this class include nifedipine (Adalat, Procardia and others), nicardipine (Cardene), isradipine (DynaCirc), amlodipine (Norvasc) and felodipine (Plendil).
Drug Interactions: Co-administration of cisapride, pimozide, quinidine, dofetilide, levacetylmethadol (levomethadyl), felodipine, oral midazolam, nisoldipine, triazolam, lovastatin, simvastatin, ergot alkaloids such as dihydroergotamine, ergometrine (ergonovine), ergotamine and methylergometrine (methylergonovine) or methadone with ONMEL[TM] is contraindicated.
As the researchers explained, a single glass of grapefruit juice consumed 4 hours before taking the blood pressure medication felodipine (Plendil) caused blood levels of the drug to triple.
Up to 85 different drugs, including some statins, some blood pressure drugs (including felodipine and nifedipine), psychiatric drugs such as carbamazepine, Viagra and methadone.