Felodipine

A to Z Drug Facts

Felodipine

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(feh-LOW-dih-peen)

Plendil, Renedil

Class: Calcium channel blocker

Action Inhibits movement of calcium ions across cell membrane in systemic and coronary vascular smooth muscle, altering contractile process.

Indications Treatment of hypertension.

Contraindications Sick sinus syndrome; second- or third-degree AV block except with functioning pacemaker; hypotension with systolic pressure < 90 mm Hg.

Route/Dosage

PO 2.5 to 10 mg once daily. Maximum 20 mg once daily. Elderly rarely require > 10 mg qd.

Interactions

Barbiturates: Effects of felodipine may be decreased. Carbamazepine: Plasma levels of felodipine may be decreased, reducing effect. Food: Effects of felodipine may increase if given with grapefruit juice. Histamine H2 antagonists: Cimetidine may increase effects of felodipine. Hydantoins: Serum felodipine levels may be decreased, reducing effects. Other antihypertensive agents: May have additive effects.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Peripheral edema; hypotension; syncope; AV block; MI; arrhythmias; angina; tachycardia. CNS: Headache; dizziness; lightheadedness; nervousness; psychiatric disturbances; paresthesias; somnolence; asthenia; insomnia; anxiety; irritability. GI: Nausea; diarrhea; constipation; abdominal discomfort; cramps; dyspepsia; vomiting; dry mouth; thirst; flatulence. GU: Micturition disorders; sexual difficulties. HEMA: Epistaxis. RESP: Nasal or chest congestion; sinusitis; rhinitis; pharyngitis; shortness of breath; wheezing; cough; sneezing; respiratory infections. OTHER: Muscle cramps, pain, or inflammation; gingival hyperplasia.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly patients: May have greater hypotensive effects and increased risk of peripheral edema when dosage exceeds 20 mg/day. Monitor closely; doses > 10 mg usually not needed. CHF: Use with caution. Hepatic impairment: Use with caution in patients with impaired hepatic function or reduced hepatic blood flow. Withdrawal syndrome: Abrupt withdrawal may cause increased frequency and duration of angina. Taper dose gradually.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Do not crush tablet or allow patient to chew it.
Give with food if patient experiences GI upset.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Monitor BP frequently during dosage adjustment, especially for patients > 65 yr and patients with liver dysfunction.

OVERDOSAGE: SIGNS & SYMPTOMS
	Hypotension, bradycardia, nausea, weakness, dizziness, slurred speech

Patient/Family Education

Instruct patient not to crush or chew tablets.
Teach patient and family member correct method of measuring BP.
Explain that mild peripheral edema may occur within 2 to 3 wk after beginning therapy.
Advise patient that drug may cause drowsiness and dizziness. Use caution while driving or performing other tasks requiring mental alertness.
Instruct patient to avoid sudden position changes to prevent postural hypotension.
Explain importance of proper oral hygiene and regular dental examinations to prevent gum disease.
Tell patient not to double up medication if dose is missed, but to wait and take next scheduled dose on time.
Instruct patient to report the following symptoms to physician: Irregular heart beat, increased frequency or severity of angina, shortness of breath, swelling of hands and feet, dizziness, constipation, nausea, unusual bleeding or bruising, and hypotension.