What is felodipine?
Felodipine is a calcium channel blocker of the dihydropyridine type with particularly high vascular selectivity. It acts preferably on the smooth muscle cells of the arteries and has comparatively little influence on the heart.
Felodipine is taken as a retard tablet which releases the active substance uniformly over 24 hours. It is approved for the treatment of high blood pressure and stable angina pectoris. Known preparations are Felodipine-ratiopharm® and Plendil®.
The high vascular selectivity means that felodipine greatly expands the blood vessels, but the heart function hardly affects them. This is advantageous, but can lead to a reflection of the heart rate increase.
Active Ingredients & Mechanism of Action
Active ingredient: Felodipin
Felodipin blocks L-type calcium channels with high vascular selectivity:
Active mechanism:
- Selective blockage of calcium channels in vascular muscle
- Very high vascular/heart selectivity (approx. 100:1)
- Arterial vasodilatation and blood pressure reduction
- Reducing peripheral vascular resistance
Special features:
- Highest vascular selectivity of all dihydropyridines
- Hardly negative inotropy (no reduction in heartbeat power)
- As a retard form uniform 24-hour action
- Less reflective tachycardia than with short-acting calcium channel blockers
Additional effect:
- Natriuretic effect (promotes salt precipitation)
- Improves kidney perfusion
- Can increase renal sodium precipitation
Initiation of action: Retardform: Effect after 2-5 hours. Uniform action over 24 hours.
Who is it suitable for?
Felodipine is suitable for:
- Adults with high blood pressure
- Chronic stable angina pectoris
Especially suitable for:
- High blood pressure with normal heart rate
- Older patients with isolated systolic hypertension
- In combination with beta blockers (complementary mechanism)
- Patients with slight kidney failure
Not suitable:
- Decompensated heart failure
- unstable angina pectoris
- Heavy aortic stenosis
- Pregnancy and breastfeeding
- Within 4 weeks of acute heart attack
Available Dosages
High blood pressure:
- start dose: 5 mg once a day
- usual dose: 5-10 mg once a day
- Maximum dose: 10 mg daily
Angina pectoris:
- 5-10 mg once a day
Older patients / liver failure:
- start dose: 2.5 mg once a day
Available starches:
- 2.5 mg, 5 mg, 10 mg retard tablets
How to Take
Intake:
- Once a day, preferably morning
- swallow retard tablets unzerkaut – do not divide, chew or crush
- Regardless of light meals
- Do NOT take grapefruit juice
Important notes:
- Do not disassemble retard tablets (retard mechanism is destroyed)
- Grapefruit juice can increase the mirror by 2-3 times
- Regular blood pressure control
- With flush and headache at the beginning: often improvement after 1-2 weeks
Contraindications
**Felodipine must not be taken at:* *
- hypersensitivity to felodipine or other dihydropyridines
- Decompensated heart failure
- Heavy aortic stenosis
- unstable angina pectoris
- Acute heart attack (first 4 weeks)
- Pregnancy and breastfeeding
Preview at:
- liver failure (delayed degradation – lower dose)
- Tachycardia (reflective heart rate increase possible)
- Heavy kidney failure
pregnant: Contraindicated. Animal experiments indicate fruit damage.
Possible Side Effects
Acid (1-10%):
- Headaches
- Face redness (Flush)
- Ankle edema (dose dependent)
- Squeeze
** Occasionally (0,1-1%):* *
- Heart palpitations, tachycardia
- fatigue
- Gastrointestinal complaints
- Skin rash
- Gum growth (Gingivahyperplasia)
Selten:
- joint pain
- muscle pain
- Paresthesia (cribing)
- liver value increases
- Skin sensitivity
** Flush and headaches occur especially at the beginning of therapy and usually improve after 1-2 weeks. The retard form reduces these side effects compared to fast-releasing calcium channel blockers.
Interactions
Start interaction with Grapefruit:
- Grapefruit juice inhibits CYP3A4 in the gut
- Can increase the Felodipin mirror by 2-3 times
- Grapefruit juice and grapefruit strictly avoid!
Preview at:
- CYP3A4-Hemmer (Erythromycin, Itraconazole, Ketoconazole) → raised mirror
- CYP3A4 inductors (rifampicin, phenytoin, carbamazepine, currant) → reduced action
- Other blood pressure counter → increased hypotension
- Cimetidine → increased Felodipine mirror
- Tacrolimus → increased Tacrolimus levels
Combinable with:
- Beta-blockers (complementary mechanism, reflextachycardia is prevented)
- ACE inhibitors and sartans
Frequently Asked Questions
Similar Medications
Is felodipine right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.