Names and pronunciation
(fe-loe′-di-peen) Plenedil , Renedil
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Individual generic drug information
Extracted information for felodipine only.
(fe-loe′-di-peen) Plenedil , Renedil
Source page 548
Func. class.: Antihypertensive, cal- cium channel blocker, antianginal
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Chem. class.: Dihydropyridine
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ACTION: Inhibits calcium ion influx across cell membrane, resulting in the inhibition of the excitation and contrac- tion of vascular smooth muscle
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USES: Essential hypertension alone or with other antihypertensives
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Unlabeled uses: Hypertension in ado- lescents and children, angina pectoris; Prinzmetal’s angina (vasospastic)
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Extracted information for felodipine only.
CONTRAINDICATIONS: Hyper- sensitivity to this product or dihydro pyridines, sick sinus syndrome, 2nd- or 3rd-degree heart block, hypotension <90 mm Hg systolic
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Black Box Warning: CV death Precautions: Pregnancy, breastfeeding, children, geriatric patients, HF, hepatic injury, renal disease, coronary artery disease Black Box Warning: CV status, fluid volume status, I&O, weight daily; weight gain, crackles, dyspnea, edema, jugular venous distention, adequacy of pulses, moist mucous membranes; bilateral lung sounds, peripheral pitting edema; dehy- dration symptoms of decreasing output, thirst, hypotension, dry mouth, and mu- cous membranes should be reported • Monitor ALT, AST, bilirubin often if F elevated • Cardiac status: B/P, pulse, respiration; ECG periodically during prolonged treatment • Angina pain: location, duration, inten- sity; ameliorating, aggravating factors • Hypertension: check for compliance, number of refills • Pregnancy/breastfeeding: no well- controlled studies; use only if benefits outweigh fetal risk, may cause fetal harm; discontinue breastfeeding or product, ex- cretion unknown Black Box Warning: To report dyspnea, palpitations, irregular heartbeat, swelling of extremities, nausea, vomiting, severe dizziness, severe headache • To change positions slowly to prevent orthostatic hypotension • To obtain correct pulse; to contact prescriber if pulse <50 bpm • To use good oral hygiene to prevent gingival hyperplasia • Not to stop abruptly • To avoid grapefruit juice
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SIDE EFFECTS CNS: Headache, fatigue, drowsiness, dizziness, anxiety, depression, nervous- ness, insomnia, light-headedness, par- esthesia, tinnitus, psychosis, somno- lence, flushing CV: Dysrhythmia, edema, HF, hypotension, palpitations, MI, pulmonary edema, tachy- cardia, syncope, AV block, angina GI: Nausea, vomiting, diarrhea, gastric upset, constipation, dry mouth GU: Nocturia, polyuria, sexual dysfunc- tion, decreased libido HEMA: Anemia INTEG: Rash, pruritus, peripheral edema MISC: Flushing, sexual difficulties, cough, nasal congestion, SOB, wheezing, epistaxis, respiratory infection, chest pain, angioedema, gingival hyperplasia, Stevens-Johnson syndrome
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INTERACTIONS Increase: bradycardia, HF—β-blockers, digoxin, phenytoin, disopyramide Increase: toxicity, hypotension—nitrates, alcohol, quiNIDine, zileuton, miconazole, diltiazem, delavirdine, quinupristin- dalfopristin, conivaptan, cycloSPORINE, cimetidine, clarithromycin, antiretroviral protease inhibitors, other antihyperten- sives, MAOIs, ketoconazole, erythromycin, itraconazole, propranolol Decrease: antihypertensive effects— NSAIDs, carBAMazepine, barbiturates, phenytoin Drug/Herb Increase: antihypertensive effect—gin- seng, ginkgo, hawthorn Decrease: antihypertensive effect— ephedra, St. John’s wort Drug/Food Increase: felodipine level—grapefruit juice
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TREATMENT OF OVERDOSE: Atropine for AV block, vasopressor for hypotension
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Extracted information for felodipine only.
DOSAGE AND ROUTES • Adult: PO 5 mg/day initially; usual range 2.5-10 mg/day; max 10 mg/day; do not adjust dosage at intervals of <2 wk • Geriatric: PO 2.5 mg/day, max 10 mg/ day Hepatic disease • Adult: PO 2.5-5 mg, max 10 mg/day Hypertension in adolescent/child (unlabeled) • Adolescent/child: PO 2.5 mg initially, titrate upward, max 10 mg/day
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Available forms: Ext rel tabs 2.5, 5, 10 mg
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Administer: PO route • Swallow whole; do not break, crush, or chew ext rel products • Once daily with light meal; avoid grape- fruit juice
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Extracted information for felodipine only.
Assess:
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Evaluate: • Therapeutic response: B/P, WNL, de- creased anginal attacks, increased activ- ity tolerance
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To avoid hazardous activities until sta- bilized on product, dizziness no longer a problem • To avoid OTC products, alcohol unless directed by prescriber; to limit caffeine consumption • About the importance of complying with all areas of medical regimen: diet, exer- cise, stress reduction, product therapy • That tablets may appear in stools but are insignificant
Source page 549
Extracted information for felodipine only.
PHARMACOKINETICS Onset 1 hr, peak 2.5-5 hr, highly protein bound >99%, metabolized in liver, 0.5% excreted unchanged in urine, elimination half-life 11-16 hr
Source page 549
Filter the extracted dose blocks for this individual drug.
• Adult: PO 5 mg/day initially; usual range 2.5-10 mg/day; max 10 mg/day; do not adjust dosage at intervals of <2 wk
Candidate age grouping · source page 548
• Geriatric: PO 2.5 mg/day, max 10 mg/ day Hepatic disease
Candidate age grouping · source page 548
• Adult: PO 2.5-5 mg, max 10 mg/day Hypertension in adolescent/child (unlabeled)
Candidate age grouping · source page 548
• Adolescent/child: PO 2.5 mg initially, titrate upward, max 10 mg/day
Candidate age grouping · source page 548