Formulary
Felodipine: Indications, Dosing, Side Effects and Interactions
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions...
MedNext Academy | 3 min read
Felodipine: Indications, Dosing, Side Effects and Interactions
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions...
Drug action
For all calcium-channel blockers Calcium-channel blockers (less correctly called 'calcium-antagonists') interfere with the inward displacement of calcium ions through the slow channels of active cell membranes. They influence the myocardial cells, the cells within the specialised conducting system of the heart, and the cells of vascular smooth muscle. Thus, myocardial contractility may be reduced, the formation and propagation of electrical impulses within the heart may be depressed, and coronary or systemic vascular tone may be diminished. Drug action For felodipine Felodipine is a dihydropyridine calcium-channel blocker.
Indications and dose
**Prophylaxis of angina**
- **Adult** (By Mouth): Initially 5 mg once daily, to be taken in the morning; increased if necessary to 10 mg once daily.
- **Elderly** (By Mouth): Initially 2.5 mg once daily, to be taken in the morning; increased if necessary up to 10 mg once daily.
**Hypertension**
- **Adult** (By Mouth): Initially 5 mg once daily, to be taken in the morning; usual maintenance 5-10 mg once daily, doses above 20 mg per day rarely needed.
- **Elderly** (By Mouth): Initially 2.5 mg once daily, to be taken in the morning; usual maintenance 5-10 mg once daily, doses above 20 mg per day rarely needed.
Cautions
For all calcium-channel blockers Elderly Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate with persistent postural hypotension i.e. recurrent drop in systolic blood pressure 20 mmHg (risk of syncope and falls). Cautions For felodipine Predisposition to tachycardia; severe left ventricular dysfunction Cautions, further information Manufacturer advises discontinue if ischaemic pain occurs or existing pain worsens shortly after initiating treatment.
Contraindications
Cardiac outflow obstruction; significant cardiac valvular obstruction (e.g. aortic stenosis); uncontrolled heart failure; unstable angina; within 1 month of myocardial infarction
Side effects
For all calcium-channel blockers Common or very common Abdominal pain; dizziness; drowsiness; fatigue; flushing; headache; hypotension; nausea; palpitations; peripheral oedema; skin reactions; tachycardia; vomiting Uncommon Angioedema; depression; erectile dysfunction; gingival hyperplasia; myalgia; paraesthesia; syncope Overdose Features of calcium-channel blocker poisoning include nausea, vomiting, dizziness, agitation, confusion, and coma in severe poisoning. Metabolic acidosis and hyperglycaemia may occur. In overdose, the dihydropyridine calcium-channel blockers cause severe hypotension secondary to profound peripheral vasodilatation. For details on the management of poisoning, see Calcium-channel blockers, under Emergency treatment of poisoning. Side-effects For felodipine Rare or very rare Arthralgia; gingivitis; hypersensitivity vasculitis; photosensitivity reaction; sexual dysfunction; urinary frequency increased
Interactions
**Other interactions (10):**
- Concomitant administration of substances which interfere with the cytochrome P450 system may affect plasma concentrations of felodipine.
- Enzyme inhibitors such as cimetidine, erythromycin, itraconazole, ketoconazole and ritonavir impair the elimination of felodipine, and Cardioplen XL 2.5 mg Prolonged Release Tablets dosage may need...
- Conversely, powerful enzyme inducing agents such as some anticonvulsants (phenytoin, carbamazepine, phenobarbitone) can increase felodipine elimination and higher than normal Cardioplen XL 2.5 mg...
- No dosage adjustment is required when Cardioplen XL 2.5 mg Prolonged Release Tablets are given concomitantly with digoxin.
- Felodipine does not appear to affect the unbound fraction of other extensively plasma protein bound drugs such as warfarin.
- Felodipine may increase the concentration of tacrolimus.
Pregnancy
Avoid; toxicity in animal studies; may inhibit labour.
Breast feeding
Present in milk but amount probably too small to be harmful.
Hepatic impairment
For all calcium-channel blockers In general, manufacturers advise caution (risk of increased exposure). Hepatic impairment For felodipine Dose adjustments Manufacturer advises consider dose reduction.
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Felodipine in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

