felodipine

felodipine

 [fĕ-lo´dĭ-pēn]

a calcium channel blocking agent used as a vasodilator in treatment of hypertension.

Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

felodipine

(fə-lō′də-pēn′)

n.

A calcium channel blocker that acts as a vasodilator, used to treat hypertension and angina pectoris.

The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

felodipine

Plendil^® Cardiology A beta-blocking antihypertensive

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.