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 that 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, however it can take a few weeks for the medication to have its full effect on your blood pressure. 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 this medication.

Inactive ingredients

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

Please note: inactive ingredients may vary between different brands of generic felodipine.

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, swallowed whole with water. They can be taken without food, or after a light meal. Avoid taking these tablets after a large meal or a meal rich in fat or carbohydrate.

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 may be increased up to 10mg if necessary. Elderly patients may be issued with a starting dose of 2.5mg.

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 side effects

Common side effects (occurring in between 1/10 and 1/100 people) include: 

• Headaches
• Dizziness
• Numbness
• Flushing
• Swollen ankles

Uncommon side effects  (occurring in between 1/100 and 1/1,000 people) include: 

• Tachycardia (fast heartbeat)
• Palpitations
• Hypotension (low blood pressure)
• Nausea
• Abdominal pain
• Rash
• Itching
• Fatigue

Rare side effects (occurring in between 1/1,000 and 1/10,000 people) include:

• Fainting 
• Vomiting
• Hives or wheals
• Muscle pain
• Joint pain
• Sexual problems

Very rare side effects (occurring in less than 1/10,000 people) include:

• Swelling or inflammation of the gums 
• Increased liver enzymes
• Sensitivity of the skin to sunlight
• Vasculitis (inflammation of the small vessels, leading to rash)
• Inflammation of the urinary system, which may lead to an increased need to pass urine
• Allergic reaction
• Fever

If you experience any of the following, stop taking this medication immediately and consult a doctor:

• Hypersensitivity or allergic reaction, which may include swelling of the face, lips, mouth, tongue or throat, difficulty breathing or a sudden-onset rash

Contraindications

Felodipine should not be taken if you: 

• Are pregnant 
• Are allergic to any of the ingredients in the medicine
• Have unstable heart failure 
• Have recently had an acute myocardial infarction (heart attack)
• Experience chest pain with exertion that is getting worse
• Have certain heart valve problems

Have a hereditary problem related to of galactose or glucose-galactose absorption

• You should inform your doctor if any of the following apply to you:
• You have liver problems
• You have any problems with the heart, including heart failure or valve problems
• You are over the age of 65
• You are diabetic
• You are taking any other medications
• You are on a low-salt diet
• You are dehydrated or prone to dehydration for any reason
• You have primary aldosteronism 
• You have high cholesterol
• You have peripheral vascular disease
• You have high cholesterol

Drug interactions

Always tell your doctor of any other medications you are taking. This includes medicines you can buy without a prescription and herbal remedies.

The following medicines, in particular, are likely to interact with felodipine:

• Other medications designed to lower your blood pressure
• Antibiotics such as erythromycin, clarithromycin and rifampicin
• Antifungals such as Itraconazole or ketoconazole
• Medications used to treat HIV or hepatitis C
• Medicines to treat epilepsy such as carbamazepine or phenytoin
• Immune suppressors such as tacrolimus or ciclosporin
• Simvastatin to lower the cholesterol
• St John’s Wort (a herbal remedy)
• Cimetidine (used to treat increased stomach acid)

How to cope with felodipine side effects?

Many of the common side effects of felodipine diminish with time and can be self-managed. Headaches can be managed with simple painkillers such as paracetamol, along with plenty of water and rest. 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. If you experience troublesome side effects for more than a few weeks, speak to your doctor.

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. If you do feel dizzy, you should not drive or operate heavy machinery.

Alternatives to felodipine

Other types of calcium channel blockers include amlodipine, diltiazem, isradipine, nicardipine, nifedipine, nisoldipine and verapamil. Other types of antihypertensives include ACE inhibitors, angiotensin receptor blockers, beta-blockers and diuretics. 

Felodipine vs other calcium channel blockers

There are two broad groups 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. Non-dihydropyridine calcium channel blockers include diltiazem and verapamil and have an additional effect on the heart to also control heart rate. How well each one will work depends on your condition, symptoms and medical background.

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 receptor blockers (ARB). If you're under the age of 55 it's likely you will be prescribed an ACE inhibitor or ARB as a first-line medication. Calcium blockers will be more suitable for patients of African or Caribbean origin or those 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.

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 with the physical symptoms of anxiety.

Is long term use of Felodipine safe?

Felodipine is designed for long term use and is safe to use in this manner.

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 effect on your contraception. However, combined hormonal contraception is not suitable for women with high blood pressure so it's recommended to ask your doctor for advice about alternative forms of contraception if you’ve been diagnosed with high blood pressure.

Can felodipine cause hair loss?

Felodipine is not known to cause hair loss.

Why does felodipine cause oedema or 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 leakage of fluid into the tissues. If you experience this while taking felodipine, lying down with your legs raised can help ease the swelling. If it becomes a problem then see your doctor for advice.