The optimum BP threshold for initiating antihypertensive drug therapy is controversial. Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.
It's difficult to predict who will and won't notice an effect on sexual functioning after beginning pressure-lowering drugs, Rudd says. Manufacturer recommends lower initial dosage in patients with hepatic impairment. 1 See Hepatic Impairment under Dosage and Administration. Waters D. Proischemic complications of dihydropyridine calcium channel blockers. Circulation. The patient should be placed with the legs elevated. Felodipine, like other calcium antagonists, may occasionally precipitate significant hypotension and, rarely, syncope. It may lead to reflex tachycardia which in susceptible individuals may precipitate angina pectoris.
Felodipine is in a group of drugs called calcium channel blockers. It works by relaxing the muscles of your heart and blood vessels. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. Felodipine was not when fed to mice at doses up to 138.
Hematologic side effects have included anemia. Nearly one in 10 suffers from a depressive illness. Luckily, an expanding array of is available to help treat and control both conditions. American Stroke Association. Stroke. 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 level of felodipine in your blood may be increased. Your doctor may lower the dose. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. In a suicide attempt, one patient took 150 mg felodipine together with 15 tablets each of atenolol and spironolactone and 20 tablets of nitrazepam. The patient's blood pressure and heart rate were normal on admission to hospital; he subsequently recovered without significant sequelae. Keep this medicine out of the sight and reach of children. Inhibits the transmembrane influx of extracellular calcium ions across the membranes of myocardial cells and vascular smooth muscle cells, without changing serum calcium concentrations. F. Keep container tightly closed. Protect from light. If you get any side effects, talk to your doctor. Silvestre JF, Albares MP, Carnero L, Botella R "Photodistributed felodipine-induced facial telangiectasia. Yedinak KC, Lopez LM "Felodipine: a new dihydropyridine calcium-channel antagonist. Wright JT, Bakris G, Greene T et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. Monotherapy without Regard to Causality Incidence of discontinuations shown in parentheses Patients in titration studies may have been exposed to more than one dose level of Plendil.
The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Our Plendil Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Tatti P, Pahor M, Byington RP et al. Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events randomized Trial FACET in patients with hypertension and NIDDM. Diabetes Care. Messerli FH, Staessen JA. Amlodipine better than lisinopril: how one randomized clinical trial ended fallacies from observational studies? Cleve Clin J Med. Dermatologic side effects have included rash up to 2% angioedema, contusion, erythema, and urticaria. These adjustments should occur generally at intervals of not less than 2 weeks. Similar fetal anomalies were not observed in rats given felodipine. Lorimer AR, Pringle SD "The safety of felodipine. What other drugs will affect felodipine Plendil? Six metabolites, which account for 23% of the oral dose, have been identified; none has significant vasodilating activity. Together, you can choose one that will keep you as healthy as possible while doing the least damage -- or perhaps none at all -- to your life.
P-R, P-Q, and H-V intervals. 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. Plendil is now only available as generic Felodipine the new version is casuing me the same side effects I got from Procardia. How should I take felodipine Plendil? Hypotensive effect is principally a consequence of a dose-related reduction in peripheral vascular resistance, with a modest reflex increase in heart rate.
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. 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. Plendil contains the active substance felodipine. Messerli FH. Case-control study, meta-analysis, and bouillabaisse: putting the calcium antagonist scare into context. Ann Intern Med. Take this medication by mouth usually once a day on an empty stomach, or as directed by your doctor. If stomach upset occurs, felodipine may be taken with a light meal. Dosage is based on your medical condition and response to therapy. American Heart Association Task Force on Practice Guidelines. Circulation. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure JNC VI. Bethesda, MD: National Institutes of Health; 1997 Nov. NIH publication No. 98-4080. Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly bradycardia. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Astra Merck, Wayne, PA: Personal communication. Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially dizziness. 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. And despite that smorgasbord of drugs, Rudd tells WebMD, the truth is there is much yet to be learned about the effects of blood pressure-lowering drugs on sexual functioning.
Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee JNC 8 hypertension guidelines. J Clin Hypertens Greenwich. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ. 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. 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. Do not stop taking any medications without consulting your healthcare provider. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Some antihypertensive drugs have smaller blood pressure effects as monotherapy in black patients, and many antihypertensive drugs have additional approved indications and effects eg, on angina, heart failure, or diabetic kidney disease. These considerations may guide selection of therapy. 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. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA. The bioavailability of PLENDIL is influenced by the presence of food. 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. The JNC VII report recommends either a thiazide or beta-blocker as the initial treatment for uncomplicated hypertension. What happens if I overdose Plendil? You make felodipine without food or a light meal, but take it the same way each time.
If you have any further questions on the use of this medicine, ask your doctor. Closely monitor BP response with each dosage adjustment. If so, it might be possible to isolate furanocoumarins from grapefruit juice, the researchers write. 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. Alderman M, Madhavan S, Cohen H. Calcium antagonists and cardiovascular events in patients with hypertension and diabetes. Lancet. Walton T, Symes LR "Felodipine and isradipine: new calcium-channel-blocking agents for the treatment of hypertension.
Marrs, 2009. NSAIDs can also adversely affect renal function in patients with renal dysfunction by blocking the production of autoregulatory prostaglandins which help to maintain normal renal blood flow. Do not take a double dose to make up for a forgotten dose. Almost completely absorbed following oral administration but undergoes extensive first-pass metabolism. Velussi M, Brocco E, Frigato F et al. Effects of cilazapril and amlodipine on kidney function in hypertensive NIDDM patients. Diabetes. BS. I feel sorry for nay senior who has taken these generics. Following administration of Plendil to hypertensive patients, mean peak plasma concentrations at steady state are about 20% higher than after a single dose. Blood pressure response is correlated with plasma concentrations of felodipine. PLENDIL should regularly be taken either without food or with a light meal see . PLENDIL should be swallowed whole and not crushed or chewed. OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
Overdose symptoms may include severe dizziness, slow heart rate, redness or tingling in your arms and legs, and feeling like you might pass out. If you forget to take a tablet, leave out that dose completely. Habib GB. Are calcium antagonists harmful in hypertensive patients? These considerations may guide selection of therapy. Genitourinary side effects have included gynecomastia, impotence, urinary frequency, urinary urgency, dysuria, and polyuria.
Plendil and should therefore be avoided. Hepatic impairment: Clearance is decreased to about 60% of that observed in young healthy individuals. Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed. Plendil contains castor oil, which may cause stomach upset and diarrhoea. The search for what doctors call "high-yield, low-risk" treatment of has been going on for decades, writes Peter Rudd, MD, a professor of medicine and chief of the division of general internal medicine at Stanford California University Medical Center, in an editorial published in the April 1, 2000, issue of the American Journal of Medicine. Co-administration of another extended release formulation of felodipine with itraconazole resulted in approximately 8-fold increase in the AUC, more than 6-fold increase in the C max, and 2-fold prolongation in the half-life of felodipine. Ocular system side effects have included visual disturbances.
Brush and floss your teeth regularly while taking this medication. Felodipine can cause mild swelling of your gums, which may be avoided with good dental hygiene. This condition may be avoided or may regress with improved dental hygiene. Negative inotropic effects observed in vitro but not in intact animals. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ALLHAT. JAMA. 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. Plendil can have minor or moderate influence on your ability to drive and use machines. Not all of the studies paint a bleak picture of the old standby drugs, however. For instance, a study published in the same issue of American Journal of Medicine that carried Rudd's editorial found no difference in sexual function between 312 men and women randomly placed on either the beta-blocker or an inactive drug. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Tenormin which made me gain wieght and caused angina. Safety and efficacy remain to be fully established in children; 1 however, some experts have recommended dosages for hypertension based on current limited clinical experience. FDA pregnancy category C. It is not known whether felodipine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is possible that some side effects of Plendil may not have been reported. Importance of taking felodipine exactly as prescribed. Following administration of Plendil, a reduction in blood pressure generally occurs within 2 to 5 hours. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.
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Cutler SA, Hammond JJ "A multicenter comparison of isradipine and felodipine in the treatment of mild-to-moderate hypertension. The Physician's Study Group. Loop diuretics are effective in many patients who have significant degrees of renal insufficiency. Pratt Pharmaceuticals. Procardia nifedipine capsules prescribing information dated 1993 Feb. Where can I get more information?
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. Felodipine is a member of the dihydropyridine class of calcium channel antagonists calcium channel blockers. Sympathomimetic drugs may also be given if the physician feels they are warranted.
SpecialSenses: Visual disturbances; Urogenital: Impotence, urinary frequency, urinary urgency, dysuria, polyuria. The enlargement can be avoided or reversed by careful oral hygiene. 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. You can also report side effects directly via the Yellow Card Scheme. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day as directed. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.
Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. Store the Canadian product at room temperature between 59 and 86 degrees F 15-30 degrees C away from light and moisture. Do not store in the bathroom. Gradman AH, Cutler NR, Davis PJ et al. Combined enalapril and felodipine extended release ER for systemic hypertension. Am J Cardiol.