Felodipine

Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension

PBSCCBPlendil ER, Felodur ER2.5 mg tabletS4+1

Max Dose

20 mg/day

Half-life

11–16 h

Edema

COMMON

Renal Adj.

NOT REQ.

Rapid Summary

Overview

Highly vascular-selective dihydropyridine CCB. Potent peripheral vasodilator with no negative inotropic effects on the heart.

Maximum Dose

Max 20 mg/day

Clinical Focus

Must be swallowed whole (extended-release). Avoid grapefruit juice entirely as it dramatically spikes plasma levels.

Bottom Line

Felodipine is a potent vascular-selective CCB for resistant hypertension, but must be swallowed whole and grapefruit juice is absolutely contraindicated.

Formulation & Access

Brand Names

Plendil ER, Felodur ER

Oral Routes

Do not crush

Extended-release tablets (2.5 mg, 5 mg, 10 mg). Do not crush.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension.

Clinical Place

Second-line or add-on antihypertensive. Useful in isolated systolic hypertension in the elderly.

Quick reference

Class & Role

Calcium Channel Blocker — Highly vascular-selective dihydropyridine CCB.

Route / Formulation

Extended-release tablets (2.5 mg, 5 mg, 10 mg). Do not crush. (Plendil ER, Felodur ER)

Usual Dose & Max

PO 2.5–5 mg OD. May increase gradually to Max 20 mg/day.

Key Indication Doses

Hypertension: PO 2.5–5 mg OD. May increase gradually to Max 20 mg/day. Elderly / Hepatic Impaired: Start at PO 2.5 mg OD. Target 5-10 mg/day. Max 10 mg/day in severe hepatic impairment.

Best Uses

Felodipine is a potent vascular-selective CCB for resistant hypertension, but must be swallowed whole and grapefruit juice is absolutely contraindicated.

Avoid / Cautions

Uncompensated heart failure, acute MI (within 1 month), severe aortic stenosis. Pregnancy Category C. Do not use.

Key Risks

Cardiovascular: Peripheral oedema (non-hydrostatic, worse at high doses). MODERATE — Flushing, reflex tachycardia. Neurological: Headache (usually transient upon initiation). Gastrointestinal: Gingival hyperplasia.

Key Interactions

CYP3A4 inhibitors (macrolides, azoles, grapefruit juice) vastly increase felodipine levels causing severe hypotension. Inducers (carbamazepine, phenytoin) will drastically reduce efficacy.

Monitoring

Monitor BP and assess for peripheral oedema. Routine U&E monitoring not required.

Clinical Pearl

Grapefruit irreversibly blocks intestinal CYP3A4 for up to 72 hours. One glass can double felodipine bioavailability, leading to shock.

Access

Plendil ER, Felodur ER2.5 mg tablet

Brand: Plendil ER, Felodur ER
Formulation: Extended-release tablets (2

Felodipine

Calcium Channel Blocker·Cardiovascular - Antihypertensives

Hypertension

PBSCCBPlendil ER, Felodur ER2.5 mg tabletS4+1

Max Dose

20 mg/day

Half-life

11–16 h

Edema

COMMON

Renal Adj.

NOT REQ.

Rapid Summary

Overview

Highly vascular-selective dihydropyridine CCB. Potent peripheral vasodilator with no negative inotropic effects on the heart.

Maximum Dose

Max 20 mg/day

Clinical Focus

Must be swallowed whole (extended-release). Avoid grapefruit juice entirely as it dramatically spikes plasma levels.

Bottom Line

Felodipine is a potent vascular-selective CCB for resistant hypertension, but must be swallowed whole and grapefruit juice is absolutely contraindicated.

Formulation & Access

Brand Names

Plendil ER, Felodur ER

Oral Routes

Do not crush

Extended-release tablets (2.5 mg, 5 mg, 10 mg). Do not crush.

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Hypertension.

Clinical Place

Second-line or add-on antihypertensive. Useful in isolated systolic hypertension in the elderly.

Quick reference

Class & Role

Calcium Channel Blocker — Highly vascular-selective dihydropyridine CCB.

Route / Formulation

Extended-release tablets (2.5 mg, 5 mg, 10 mg). Do not crush. (Plendil ER, Felodur ER)

Usual Dose & Max

PO 2.5–5 mg OD. May increase gradually to Max 20 mg/day.

Key Indication Doses

Hypertension: PO 2.5–5 mg OD. May increase gradually to Max 20 mg/day. Elderly / Hepatic Impaired: Start at PO 2.5 mg OD. Target 5-10 mg/day. Max 10 mg/day in severe hepatic impairment.

Best Uses

Felodipine is a potent vascular-selective CCB for resistant hypertension, but must be swallowed whole and grapefruit juice is absolutely contraindicated.

Avoid / Cautions

Uncompensated heart failure, acute MI (within 1 month), severe aortic stenosis. Pregnancy Category C. Do not use.

Key Risks

Key Interactions

CYP3A4 inhibitors (macrolides, azoles, grapefruit juice) vastly increase felodipine levels causing severe hypotension. Inducers (carbamazepine, phenytoin) will drastically reduce efficacy.

Monitoring

Monitor BP and assess for peripheral oedema. Routine U&E monitoring not required.

Clinical Pearl

Grapefruit irreversibly blocks intestinal CYP3A4 for up to 72 hours. One glass can double felodipine bioavailability, leading to shock.

Access

Plendil ER, Felodur ER2.5 mg tablet

Brand: Plendil ER, Felodur ER
Formulation: Extended-release tablets (2