The bioavailability of felodipine was increased approximately two-fold when taken with grapefruit juice. Orange juice does not appear to modify the kinetics of Plendil. A similar finding has been seen with other dihydropyridine calcium antagonists, but to a lesser extent than that seen with felodipine. There are no adequate and well-controlled studies in pregnant women. If felodipine is used during pregnancy, or if the patient becomes pregnant while taking this drug, she should be apprised of the potential hazard to the fetus, possible digital anomalies of the infant, and the potential effects of felodipine on labor and delivery and on the mammary glands of pregnant females.
Hematologic side effects have included anemia. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. Br J Clin Pharmacol. Felodipine is a slightly yellowish, crystalline powder with a molecular weight of 384. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Felodipine was not when fed to mice at doses up to 138. Felodipine produces dose-related decreases in systolic and diastolic blood pressure as demonstrated in six placebo-controlled, dose response studies using either immediate-release or extended-release dosage forms. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?
Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.
Have your blood pressure checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure. Calcium channel blockers CCBs may have varying degrees of negative inotropic effect. Congestive heart failure CHF worsening of CHF, and pulmonary edema have occurred in some patients treated with a CCB, primarily verapamil. Some CCBs have also caused mild to moderate peripheral edema due to localized vasodilation of dependent arterioles and small blood vessels, which can be confused with the effects of increasing left ventricular dysfunction. The increase is inhibited by beta-blocking agents. If you have any further questions, ask your doctor. RxList is part of the WebMD Health Network. The opinions expressed in the WebMD User Reviews are solely those of the User, who may or may not have medical or scientific training, and do not represent the opinions of WebMD. These member reviews have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other purpose except for compliance with our Terms and Conditions. Product Information. Plendil felodipine. What other drugs will affect felodipine Plendil? These adjustments should occur generally at intervals of not less than 2 weeks. Fagan TC, Haggert BE, Liss C "Efficacy and tolerability of extended-release felodipine and extended-release nifedipine in patients with mild-to-moderate essential hypertension. What is felodipine Plendil? This leaflet was last revised in August 2016. In a pharmacokinetic study, maximum plasma concentrations of felodipine were considerably lower in epileptic patients on long-term anticonvulsant therapy eg, phenytoin, carbamazepine, or phenobarbital than in healthy volunteers. In such patients, the mean area under the felodipine plasma concentration-time curve was also reduced to approximately 6% of that observed in healthy volunteers. Since a clinically significant interaction may be anticipated, alternative antihypertensive therapy should be considered in these patients. Psychiatric system side effects have included depression, anxiety disorders, irritability, nervousness, and decreased libido.
When given concomitantly with Plendil the pharmacokinetics of digoxin in patients with heart failure were not significantly altered. Although this medication is effective in preventing chest pain angina some people who already have severe heart disease may rarely develop worsening chest pain or a heart attack after starting this medication or increasing the dose. This list is not complete and other drugs may interact with felodipine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Dear healthcare professional letter regarding calcium-channel blockers and increased risk of heart attack. The enlargement can be avoided or reversed by careful oral hygiene. Gingival hyperplasia has been avoided or has regressed with good dental hygiene. Similar fetal anomalies were not observed in rats given felodipine. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Your pharmacist can provide more information about felodipine. Dizziness, lightheadedness, headache, flushing, or stomach upset may occur as your body adjusts to the medication. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Rudd says, but encourage a patient to try it before dismissing it because of potential effects. If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class. Bailey DG, Arnold JMO, Spence JD. Grapefruit juice and drugs: how significant is the interaction? Bayer, West Haven, CT: Personal communication. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Swallow extended-release tablets intact; do not chew or crush. ceclor
What is the most important information I should know about felodipine Plendil? Carbatrol, Tegretol phenobarbital Solfoton or phenytoin Dilantin. American Heart Association Task Force on Practice Guidelines. Circulation. Felodipine is metabolized by CYP3A4. After carefully screening participants including tests for the nine women enrolled in the study the researchers asked participants to avoid products containing grapefruit. Spence JD. Drugs and grapefruit juice. Clin Pharmacol Ther. These patients should have their blood pressure monitored closely during dosage adjustment of Plendil. If severe hypotension occurs, symptomatic treatment should be instituted. The patient should be placed supine with the legs elevated. The administration of intravenous fluids may be useful to treat hypotension due to overdosage with calcium antagonists. If adequate BP response not achieved with a single antihypertensive agent, add a second drug with demonstrated benefit; if goal BP still not achieved with optimal dosages of 2 antihypertensive agents, add a third drug. 501 May maximize dosage of the first drug before adding a second drug, or add a second drug before maximizing dosage of the initial drug. Importance of taking felodipine exactly as prescribed. Both peak plasma concentration and the area under the plasma concentration time curve AUC increase linearly with doses up to 20 mg. Felodipine is greater than 99% bound to plasma proteins. afec.info anafranil
Felodipine is metabolized by CYP3A4. Co-administration of CYP3A4 inhibitors eg, ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine with felodipine may lead to several-fold increases in the plasma levels of felodipine, either due to an increase in bioavailability or due to a decrease in metabolism. These increases in concentration may lead to increased effects, lower blood pressure and increased heart rate. These effects have been observed with co-administration of itraconazole a potent CYP3A4 inhibitor. Caution should be used when CYP3A4 inhibitors are co-administered with felodipine. A conservative approach to dosing felodipine should be taken. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Vanderkrogt KP, Brand R, Dawson EC "Amlodipine versus extended-release felodipine in general practice: a randomized, parallel-group study in patients with mild-to-moderate hypertension. Felodipine may increase the blood concentration of tacrolimus. When given concomitantly with felodipine, the tacrolimus blood concentration should be followed and the tacrolimus dose may need to be adjusted. 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 . Modification of the recommended dosage is usually not required in patients with renal impairment. The optimum BP threshold for initiating antihypertensive drug therapy is controversial. What other drugs will affect felodipine? It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Plendil is indicated for the treatment of hypertension, to lower blood pressure. Lowering blood pressure lowers the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including felodipine. Geriatric Use. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. You can also report side effects directly via the Yellow Card Scheme. This medicine has been prescribed for you only. Do not pass it on to others. It is not known whether this drug is secreted in human milk and because of the potential for serious adverse reactions from felodipine in the infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. The following undesirable effects have been identified. Goudie AW, Gupta OP, Gray PL, Ross JRM, Goves JR, Mckenna BJ, Blomfield IA, Bramley KW, Sharp RW, Jones DF, Hadley RJ "A comparison of felodipine and nifedipine as monotherapy in patients with mild-to-moderate hypertension. azelastine generic buy
Do not stop taking any medications without consulting your healthcare provider. Hypotensive effect is principally a consequence of a dose-related reduction in peripheral vascular resistance, with a modest reflex increase in heart rate. Byington RP, Craven TE, Furberg CD et al. Isradipine, raised glycosylated haemoglobin, and risk of cardiovascular events. Lancet. Renal vascular resistance is decreased by felodipine while glomerular filtration rate remains unchanged. Mild diuresis, natriuresis, and kaliuresis have been observed during the first week of therapy. No significant effects on serum electrolytes were observed during short- and long-term therapy. Although unlikely, felodipine may cause mild swelling of the gums. Massage your gums and brush and floss your teeth regularly to minimize this problem. See your dentist regularly. In a teratology study in cynomolgus monkeys, no reduction in the size of the terminal phalanges was observed, but an abnormal position of the distal phalanges was noted in about 40% of the fetuses. Tell your doctor right away if this rare but very serious side effect occurs: fainting. Clinical studies of felodipine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. Waters D. Proischemic complications of dihydropyridine calcium channel blockers. Circulation. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first. Plendil extended release tablets should be taken in the morning and be swallowed with water. Hasselgren B, Edgar B, Johnsson G, Ronn O "The acute haemodynamic and renal effects of oral felodipine and ramipril in healthy subjects. The JNC VII report recommends either a thiazide or beta-blocker as the initial treatment for uncomplicated hypertension. Lorimer AR, Pringle SD "The safety of felodipine.
Peripheral edema was generally mild, but it was age and dose related and resulted in discontinuation of therapy in about 3% of the enrolled patients. Discontinuation of therapy due to any clinical adverse event occurred in about 6% of the patients receiving Plendil, principally for peripheral edema, headache, or flushing. Physicians who treat hypertension and depression say they don't rule out the use of Viagra for all patients on blood pressure-lowering or antidepressant drugs. But they do select these patients very carefully and rule out certain patients. It is not known whether felodipine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Anon. NHLBI panel stands by JNC V in response to Circulation CCB article; AIM report supports use of beta blockers for prevention of sudden cardiac death. F-D-C Rep. BS. I feel sorry for nay senior who has taken these generics. Furberg CD, Psaty BM, Meyer JV. Nifedipine: dose-related increase in mortality in patients with coronary heart disease. Circulation. Plendil and the risk of side effects. Musculoskeletal side effects have included arthralgia, back pain, leg pain, foot pain, muscle cramps, myalgia, arm pain, knee pain, and hip pain. Always take this medicine exactly as your doctor has told you. Wagenknecht LE, Furberg CD, Hammon JW et al. Surgical bleeding: unexpected effect of a calcium antagonist. BMJ. The effect of felodipine on blood pressure is principally a consequence of a dose-related decrease of peripheral vascular resistance in man, with a modest reflex increase in heart rate see . With the exception of a mild diuretic effect seen in several animal species and man, the effects of felodipine are accounted for by its effects on peripheral vascular resistance. In controlled studies in the United States and overseas, approximately 3000 patients were treated with felodipine as either the extended-release or the immediate-release formulation. Achilli F, Buono G, Difraia S, Dolara A, Raffo M, Montereggi A, Ravera E, Valagussa F "Acute and chronic effects of felodipine extended release and amlodipine in patients with exertional angina: a double-masked, clinical comparison. Welin L, Elvelin L, Niklasson A, Olsson G, Elmfeldt D "Overview of the safety of felodipine based on clinical trials in patients with hypertension. Keep this medicine out of the sight and reach of children. Schaefer RM, Aldons PM, Burgess ED, Tilvis R, Singh GP, Rehn L, Morgan TO "Improved tolerability of felodipine compared with amlodipine in elderly hypertensives: A randomised, double-blind study in 535 patients, focusing on vasodilatory adverse events. generic perindopril buy now visa
Neaton JD, Kuller LH. Diuretics are color blind. JAMA. The antihypertensive effect is dose dependent and correlates with the plasma concentration of felodipine. Caution is recommended especially at the start of treatment. The frequency and severity of the changes appeared dose related and were noted even at the lowest dose. These changes have been shown to occur with other members of the dihydropyridine class and are possibly a result of compromised uterine blood flow. Similar fetal anomalies were not observed in rats given felodipine. Roller L. Drugs and grapefruit juice. Clin Pharmacol Ther. Pratt Pharmaceuticals. Procardia nifedipine capsules prescribing information dated 1993 Feb. Plendil can have minor or moderate influence on your ability to drive and use machines. propranolol tablets order online visa
To obtain up-to-date information about the treatment of overdose, consult your Regional Poison-Control Center. Keep this leaflet. You may need to read it again. What should I avoid while taking felodipine Plendil? Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Like all medicines, this medicine can cause side effects, although not everybody gets them. INDEPENDENT of their effect on blood pressure. Felodipine--another calcium-channel blocker for hypertension. Carruthers SG, Vintreed C "Antihypertensive effect and tolerability of felodipine extended release er tablets in comparison with felodipine plain tablets pt and placebo in hypertensives on a diuretic. Pfizer, not to take Viagra. Others are cautioned to tell their physician about other drugs they are taking. Plendil and should therefore be avoided. What are the possible side effects of felodipine Plendil? Genitourinary side effects have included gynecomastia, impotence, urinary frequency, urinary urgency, dysuria, and polyuria. tecta
Side Effects List Plendil Tablet, Extended Release 24 Hr side effects by likelihood and severity. Check with your doctor about potential interactions between grapefruit and any drugs you take. It lowers blood pressure by dilating small blood vessels. Do not use this medicine if you notice the packaging is torn or damaged. Sympathomimetic drugs may also be given if the physician feels they are warranted. Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Al-Niaimi F, Lyon C "Felodipine-induced eruptive telangiectasia following mastectomy and radiotherapy. They tried to tell me when I was younger I was out of shape. It has not been established whether felodipine can be removed from the circulation by hemodialysis. If you have any further questions on the use of this medicine, ask your doctor. Numerous antihypertensive drugs, from a variety of pharmacologic classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality, and it can be concluded that it is blood pressure reduction, and not some other pharmacologic property of the drugs, that is largely responsible for those benefits. The largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke, but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice version 2012. The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice constituted by representatives of nine societies and by invited experts. Plasma concentrations of felodipine, after a single dose and at steady state, increase with age. Mean clearance of felodipine in elderly hypertensives mean age 74 was only 45% of that of young volunteers mean age 26. At steady state mean AUC for young patients was 39% of that for the elderly. Data for intermediate age ranges suggest that the AUCs fall between the extremes of the young and the elderly. Alderman M, Madhavan S, Cohen H. Calcium antagonists and cardiovascular events in patients with hypertension and diabetes. Lancet. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. The researchers made the furanocoumarin-free grapefruit juice in their lab. They checked to make sure it was free of furanocoumarins. The drink was "sweeter and less bitter" than the regular grapefruit juice, write Paine and colleagues. Following administration of Plendil, a reduction in blood pressure generally occurs within 2 to 5 hours. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. Tenormin which made me gain wieght and caused angina. In patients with hepatic disease, the clearance of felodipine was reduced to about 60% of that seen in normal young volunteers. iressa does order matter
Following an oral or intravenous dose of 14C-labeled felodipine in man, about 70% of the dose of radioactivity was recovered in urine and 10% in the feces. The use of Plendil is not recommended in children. Studies have yielded mixed results about which antihypertensive drugs to avoid if you want to keep some in your life. Several have shown, for instance that diuretics and beta-blockers are associated with more sexual side effects, according to Rudd. EFFERENT vasoconstriction which is mediated by Ang II. Increased efferent pressure due to efferent vasoconstriction impedes blood flow out of the glomerulus, so GFR is maintained. When such patients are given an ACE inhibitor or ARB, the protective mechanism is blocked, and renal function can deteriorate rapidly, producing acute renal failure. In contrast, patients with hypertensive renal disease can improve their renal status after being treated with such drugs because they will lower AFFERENT pressure, which helps to protect the kidney. Safety and effectiveness in pediatric patients have not been established. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. High-fat or high-carbohydrate meal increases peak plasma concentrations but does not affect extent of absorption. The recommended starting dose is 5 mg once a day. Before having surgery, tell your doctor or dentist that you are taking this medication. Peripheral edema, headache, flushing. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. proscar
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At least a week later, participants reported to the research center after overnight. They took a 10-milligram tablet of Plendil with a glass of regular grapefruit juice, orange juice, or furanocoumarin-free grapefruit juice. See Geriatric Patients under Dosage and Administration. Your doctor may occasionally change your dose to make sure you get the best results.
What happens if I miss a dose Plendil? But sexual problems can also increase with age and as other diseases set in, so it's even more difficult to pinpoint exactly what percent of problems can be blamed on the drugs. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ.
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. PLENDIL should regularly be taken either without food or with a light meal see . PLENDIL should be swallowed whole and not crushed or chewed. Hropot et al, 1985. Loop diuretics compete for the chloride site on the three ion cotransporter, which inhibits its function. This increases the delivery of ions and fluid to the distal tubule, and reduces the osmolarity gradient from cortex to outer medulla. The P-R interval of the ECG is not affected by felodipine when administered alone or in combination with a beta-blocking agent. Felodipine alone or in combination with a beta-blocking agent has been shown, in clinical and electrophysiologic studies, to have no significant effect on cardiac conduction P-R, P-Q, and H-V intervals.
Therapy was discontinued due to adverse drug events in about 6% of patients, primarily for peripheral edema, headache or flushing. Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. These conditions can lead to severely low blood pressure. Similar changes in the mammary glands were not observed in rats or monkeys. Plendil, check with your doctor right away.