Felodipine

About Felodipine

Felodipine relaxes the muscle in the walls of blood vessels, which lowers blood pressure. The current labels approve it for one use: the treatment of hypertension, to lower blood pressure, alone or with other blood pressure medicines; angina is not a labeled use. The usual starting dose is 5 mg once a day, within a range of 2.5 to 10 mg once a day, and the prescriber changes the dose no more often than every two weeks. Older adults and people with liver problems usually start at 2.5 mg with close blood pressure checks while the dose is adjusted; kidney problems usually do not call for a change. The label notes that doses above 10 mg lowered blood pressure further but brought a large increase in swelling and other side effects from widened blood vessels.

There is no boxed warning, and the only contraindication is an allergy to felodipine. It can occasionally lower blood pressure too far and, rarely, cause fainting; the faster heartbeat that follows a drop in pressure can bring on angina in people prone to it. Its safety in heart failure has not been established, so it is used with caution there, especially with a beta blocker. Swelling of the ankles and feet is the most common side effect; it rises with the dose and with age and usually appears in the first two to three weeks. Headache is also common, and flushing and dizziness occur more often than with placebo.

Mild swelling of the gums has been reported, and the label says good dental hygiene reduces how often it happens and how bad it gets. The tablets are extended release: they are swallowed whole and never crushed or chewed. Animal studies showed effects on the fetus and there are no adequate studies in pregnant women, so a pregnancy, a plan to become pregnant or breastfeeding is a conversation to have with the prescriber; the label says it is not known whether felodipine passes into breast milk.

Taking Felodipine

How to take it

Once a day, either without food or with a light meal, taken the same way each day. Swallow the tablet whole; do not crush, chew, break or dissolve it. Keep taking it even if you feel well, and only the prescriber changes the dose.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take two doses at once.

Storage

At room temperature, tightly closed and protected from light, away from heat and moisture, out of reach of children.

Interactions to know about

The label states that taking felodipine with grapefruit juice more than doubled the amount of felodipine in the blood, and the patient information advises talking to the prescriber before having grapefruit or grapefruit juice. Itraconazole and other strong CYP3A4 inhibitors, erythromycin and cimetidine also raise its levels; phenytoin, carbamazepine and phenobarbital sharply lower them; and felodipine can raise tacrolimus levels. Report worsening chest pain, a fast heartbeat, lightheadedness, or swelling with rapid weight gain or shortness of breath.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Felodipine differs from pharmacy to pharmacy

Felodipine is an old generic, but it may not be on every pharmacy’s flat-price generic list. A pharmacy that fills it rarely may order it in and price it as a slow-moving item, while one that stocks it routinely can quote much less for the same tablet. Because Plendil is no longer sold, every quote is for a generic, and the maker a pharmacy buys from affects what it charges.

For a once-daily generic tablet, much of a monthly quote can be the dispensing fee, which is charged per fill, so a ninety-day fill spreads it over more tablets. Compare quotes for the same strength and tablet count.

Ways to pay less for Felodipine without insurance

• Ask whether felodipine is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Ask for a ninety-day prescription once your dose and blood pressure are stable.
• Make sure the prescription is written for one tablet of your strength rather than several lower-strength tablets, and never break or crush a tablet to change the dose.
• If it is quoted high, ask the prescriber whether amlodipine, a related once-daily blood pressure medicine that more pharmacies keep on flat-price lists, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Felodipine

1. 1.Do any of my medicines, such as antifungals, erythromycin, seizure medicines or tacrolimus, interact with my felodipine?
2. 2.Should I avoid grapefruit and grapefruit juice completely while I take this?
3. 3.How much ankle swelling is expected, and when should I call my prescriber about it?
4. 4.My tablets look different this refill; is it the same strength from a different maker?

Related medications