Felodipine

What is Felodipine?

Felodipine is a type of medication used to treat high blood pressure. It also works to manage angina and reduces your risk of a future heart attack or stroke.

How does Felodipine work?

Felodipine is a calcium channel blocker which relaxes the muscles of the heart and the blood vessels. This in turn allows the blood to flow more freely around the body, lowering the blood pressure. 

How long does Felodipine take to work?

Felodipine will start to work on the first day when you begin treatment. It can take a few weeks for the medication to have its full effect on your blood pressure however. It's likely that you won't feel different while taking Felodipine. This is because high blood pressure doesn't usually produce symptoms so you should continue taking the medication even if you don't notice a difference. For angina, Felodipine will take a few weeks to start working and you can expect chest pains to decrease after this.   

Active ingredients

Felodipine is the active ingredient in the medication. 

Inactive ingredients

The inactive ingredients are: microcrystalline cellulose, hypromellose, lactose monohydrate, povidone K25, propylene glycol, propyl gallate (Ph.Eur.), magnesium stearate (Ph.Eur.), colloidal anhydrous silica, talcum, iron oxide red (E172), iron oxide yellow (E172), titanium dioxide (E171).

Can Felodipine be crushed/split?

Felodipine should not be crushed or split before taking it. The tablets should be taken whole otherwise you may not get the full effect of the medicine. 

Felodipine Dosage

The dose of Felodipine prescribed will depend on your condition, symptoms and medical history. 5mg once a day is the usual starting dose which can be increased up to 10mg if necessary. Elderly patients may be issued with a 2.5mg dose. 

How to start taking Felodipine

Always follow the instructions given by your doctor on how to take Felodipine. The medicine should be taken once a day in the morning, preferably on an empty stomach or after a light meal. The tablets should always be swallowed whole with a glass of water.

Felodipine food interactions

Grapefruit juice should be avoided while you are taking Felodipine as it interacts with the medicine, stopping it from working properly. It's fine to drink alcohol but it can cause your blood pressure to lower too much in combination with Felodipine. If you experience dizziness you may need to avoid alcohol.

Felodipine and pregnancy

Felodipine is not usually suitable to take during pregnancy. If you fall pregnant during your treatment, inform your doctor as soon as possible. 

Felodipine and driving

Avoid driving until you are sure of how Felodipine affects you. You may experience dizziness at first but this will usually disappear within the first few weeks of taking the medication. 

How to cope with Felodipine side effects

if you experience headaches then drink plenty of water, make sure you're getting enough rest and take a painkiller like paracetamol. If these last longer than a week then alert your doctor. Take it easy if you get dizzy spells, sit or lie down until they pass and avoid driving or any other potentially dangerous activities until you feel better. Avoiding alcohol, tea and coffee will help with facial flushing and lying down with your legs raised will soothe swollen ankles. 

Drug Interactions

The following medicines may interact with Felodipine and cause it to not work properly:

• Cimetidine
• Erythromycin
• Itraconazole 
• Ketoconazole 
• HIV medications 
• Phenytoin 
• Carbamazepine 
• Rifampicin 
• Barbiturates
• Tacrolimus
• St John's wort

Always inform your doctor of any existing medications you are taking, including over the counter or herbal remedies.   

Contradictions

Felodipine should not be taken if: 

• You are pregnant 
• You are allergic to any of the ingredients in the medicine 
• You have uncompensated heart failure 
• You have acute myocardial infarction 
• You have long lasting chest pain that's worse than usual 
• You have a diseased heart valve or heart muscle

You should inform your doctor if you have problems with your liver before taking Felodipine.  

Felodipine Side Effects

Common side effects you may experience when you first start Felodipine include: 

• Headaches
• Dizziness
• Flushing
• Racing heartbeat
• Swollen ankles 

Rare side effects may include: 

• Fainting 
• Vomiting
• Rash
• Joint and muscle pain
• Sexual problems 
• Gingivitis 
• Increased liver enzymes 
• increased sensitivity to sunlight 
• inflamed blood vessels 
• Hypersensitivity 
• Frequent urination 

Felodipine can also cause swelling in the gums. This can be managed by maintaining good oral health.  

Alternatives to Felodipine

Other types of calcium blockers include Amlodipine, Diltiazem, Isradipine, Nicardipine, Nifedipine, Nisoldipine and Verapamil. 

Felodipine vs other high blood pressure medication

Felodipine is a calcium blocker which treats high blood pressure. There are other types of high blood pressure medication available such as ACE inhibitors or angiotensin-2 receptor blockers (ARB). If you're under the age of 55 it's likely you will be prescribed with one of these. Calcium blockers will be more suitable for patients of an African or Caribbean origin or if you're over 55. Beta blockers and diuretics are also available if other treatments haven't worked. 

Lifestyle changes to make when taking Felodipine

There are several lifestyle changes you can make to contribute to a healthier heart and overall blood pressure. Quitting smoking and cutting down on alcohol and salt will make a positive difference as will eating a healthy diet and exercising regularly. Managing stress is also important as stress can often cause your heart to beat faster, leading to a spike in your blood pressure. 

Lifestyle changes to reduce blood pressure

Maintaining a healthy lifestyle is key to reducing your blood pressure to a healthy level. Eating a healthy diet that's low in salt and saturated fats, exercising regularly, stopping smoking, cutting down on alcohol and good stress management are all positive steps to take. 

Felodipine vs other calcium channel blockers

There are three different types of calcium channel blockers. Felodipine belongs to the dihydropyridine group. These types of medicines mainly have an effect on the blood vessels themselves to relax them and allow blood to flow easier. Phenylalkylamines affect the heart so that it doesn't have to work as hard and Benzothiazepines target both the heart and arteries. How well each one will work depends entirely on your condition, symptoms and what is suitable for you. 

Will I need to take Felodipine forever?

It's likely that you will need to take Felodipine for the rest of your life in order to manage your blood pressure. However, your doctor may reduce your dose once your blood pressure is at a stable level.   

Can Felodipine help anxiety?

Felodipine hasn't been shown to help with anxiety. Other types of high blood pressure medication such as beta blockers can help to soothe the physical symptoms of anxiety.  

Is Felodipine addictive?

Felodipine is not addictive.

Will Felodipine affect my fertility?

There is no evidence to suggest that Felodipine has an effect on your fertility. If this is something that worries you then speak to your doctor before taking the medication. 

Will Felodipine affect my contraception?

Felodipine won't have an affect on your contraception. However, the combined pill is not suitable for women with high blood pressure so it's recommended to ask your doctor for advice about alternative forms of contraception. 

Can Felodipine cause hair loss?

Some types of blood pressure medication can cause hair loss but Felodipine does not. 

Why does Felodipine cause oedema/swelling?

Swollen ankles, known as oedema, is a common side effect in taking Felodipine. This is because the medication can cause increased pressure on the capillaries which leads to leaking fluid. If you experience this while taking Felodipine, lying down with your legs up against the wall can help ease the swelling. If it becomes a problem then see your doctor for advice. 

Sources

• Patient Information Leaflet
• NHS > Felodipine
• NHS > High Blood Pressure
• NHS > How should ankle oedema caused by calcium channel blockers be treated?
• Mayo Clinic > Calcium Channel Blockers
• Everyday Health > Felodipine
• WebMD > Drug Induced Hair Loss

Is long term use of Felodipine safe?

Felodipine is designed for long term use so it's safe to use in this manner.