Felodipine: Uses, Interactions and Safety
Uses
Felodipine is a dihydropyridine calcium channel blocker that relaxes small arteries and lowers blood pressure. This page concerns extended-release tablets. The reviewed US label covers hypertension, while Turkish and European Plendil information also includes stable angina. It is not intended for immediate relief of a hypertensive emergency or an acute angina attack.
Administration
Swallow the extended-release tablet whole with water; do not divide, crush or chew it. Follow the product instructions for food, typically fasting or after a light meal. Avoid grapefruit and grapefruit juice. Liver impairment and older age can increase exposure, so the prescribed regimen may differ between patients.
Safety
Excessive blood-pressure reduction can cause fainting or worsen myocardial ischaemia in susceptible people. Chest pain or collapse needs urgent assessment. European restrictions include pregnancy, decompensated heart failure, acute myocardial infarction, unstable angina and significant outflow obstruction. Contraindication wording differs from the US label.
Interactions
Strong CYP3A inhibitors such as itraconazole or ritonavir can markedly increase felodipine exposure; alternatives are generally preferred. Strong inducers such as carbamazepine, phenytoin, rifampicin, enzalutamide and apalutamide may substantially reduce efficacy. The prescriber should review treatment instead of the patient changing doses. Felodipine can increase tacrolimus concentrations, so blood-level monitoring and a prescribed adjustment may be required.
Pregnancy and breastfeeding
Turkish and European information advise against use during pregnancy because developmental effects occurred in animals and adequate human evidence is lacking. Felodipine is detected in breast milk; treatment is not recommended during breastfeeding because infant-effect data are insufficient.
Adverse effects
Ankle swelling, headache and flushing are characteristic effects. Palpitations and dizziness can occur, particularly after starting or increasing treatment. Swelling reflects local changes in small-vessel pressure and does not automatically mean general fluid overload. Mild gum enlargement may occur; careful oral hygiene can help, and persistent changes should be assessed.
Sources
The linked Turkish profile contains the medicine record and its documented interaction list.