Dihydropyridine calcium-channel blocker Pregnancy: Contraindicated in pregnancy (should not be given). Detected in breast milk; harmful effects on the newborn unknown.

Felodipine

Brand names: Plendil

Felodipine is a dihydropyridine calcium-channel blocker used for hypertension and angina.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Hypertension: 5 mg once daily initially; usual maintenance 5–10 mg once daily.

Route: Oral (prolonged-release tablet — swallow whole with water; do not chew or crush)

Frequency: Once daily (in the morning, without food or with a light meal)

Max: Doses higher than 20 mg daily are not usually needed

Dose adjusted to individual requirements; may be increased or another antihypertensive added. Angina pectoris: start 5 mg once daily, increase if needed to 10 mg once daily. Elderly: consider initial 2.5 mg daily (a 2.5 mg tablet is available for titration). Impaired hepatic function: elevated plasma concentrations possible — may respond to lower doses. Can be combined with beta-blockers, ACE inhibitors or diuretics (additive BP effect). Paediatric: safety and efficacy not established.

Dose adjustments

Renal

Pharmacokinetics not significantly affected in patients with impaired renal function.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION The recommended starting dose is 5 mg once a day. Depending on the patient's response, the dosage can be decreased to 2.5 mg or increased to 10 mg once a day. These adjustments should occur generally at intervals of not less than 2 weeks. The recommended dosage range is 2.5 to 10 mg once daily. In clinical trials, doses above 10 mg daily showed an increased blood pressure response but a large increase in the rate of peripheral edema and other vasodilatory adverse events (see ADVERSE REACTIONS ). Modification of the recommended dosage is usually not required in patients with renal impairment. Felodipine extended-release tablets, USP should regularly be taken either …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-12-04. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

Hypersensitivity to the active substance or excipients
Unstable angina pectoris
Pregnancy
Previous allergic reaction to felodipine or other dihydropyridines (risk of cross-reactivity)
Clinically significant aortic stenosis
During or within one month of a myocardial infarction
Cardiogenic shock (discontinue if it develops)
Decompensated heart failure
Haemodynamically significant cardiac valvular obstruction
Dynamic cardiac outflow obstruction

Side effects

Flushing
Headache
Palpitations / tachycardia
Dizziness
Peripheral oedema / ankle swelling (dose-related)
Fatigue

Interactions

CYP3A4 inhibitors (cimetidine, erythromycin, itraconazole, ketoconazole, ritonavir) — impair elimination, raise felodipine levels; dose may need reducing
CYP3A4 inducers (phenytoin, carbamazepine, phenobarbitone) — increase elimination; higher doses may be needed
Grapefruit juice — increases peak plasma levels and bioavailability; avoid
Tacrolimus — felodipine may increase tacrolimus concentration; monitor levels
Other antihypertensives — antihypertensive effect may be enhanced

Clinical monograph

How it works

It is vascular-selective, blocking L-type calcium channels in arterial smooth muscle to produce vasodilatation and lower blood pressure.

Prescribing in practice

Grapefruit juice inhibits its CYP3A4 metabolism and raises plasma levels, so it should be avoided.
Common dose-related effects include ankle oedema, flushing and headache.
It is given as a modified-release tablet, which should be swallowed whole.

Monitoring

Monitor blood pressure and review for vasodilatory side effects such as ankle swelling.

Counselling the patient

Avoid grapefruit and grapefruit juice while taking this medicine.
Swallow the tablets whole, and report marked ankle swelling or flushing.

Evidence & guidelines

A guideline-recommended dihydropyridine option for hypertension in UK practice (NICE NG136).

Reference: NICE NG136; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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