Drug Index

Felodipine

 
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Mechanism :

Inhibits calcium ions from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization, producing a relaxation of coronary vascular smooth muscle and coronary vasodilation.


Indication :

• Management of hypertension (off-label in children)


Contraindications :

Hypersensitivity to felodipine or other dihydropyridines; women of childbearing potential, in pregnancy, and during lactation.


Dosing :

Children ≥6 years and Adolescents (off-label use): Oral: Initial: 2.5 mg once daily; may increase as needed at no less than 2-week intervals to a maximum of 10 mg once daily


Adverse Effect :

Peripheral edema, headache, flushing, tachycardia.


Interaction :

Alpha1-Blockers: May enhance the hypotensive effect of Calcium Channel Blockers.
Calcium Channel Blockers (Nondihydropyridine): Calcium Channel Blockers (Dihydropyridine) may enhance the hypotensive effect of Calcium Channel Blockers (Nondihydropyridine).
CYP3A4 Inducers: May increase the metabolism of CYP3A4 Substrates.
CYP3A4 Inhibitors: May decrease the metabolism of CYP3A4 Substrates.
Fosphenytoin: Calcium Channel Blockers may increase the serum concentration of Fosphenytoin.
Hypotension-Associated Agents: Blood Pressure Lowering Agents may enhance the hypotensive effect of Hypotension-Associated Agents.
Ketoconazole (Systemic): May increase the serum concentration of Felodipine.
Phenytoin: Calcium Channel Blockers may increase the serum concentration of Phenytoin.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxNot dialysed. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

Patients with impaired hepatic function may have elevated plasma concentrations of felodipine and may respond to lower doses.
For adults: Reduce initial dosage to 2.5 mg PO once daily in hepatic impairment. Dosage may be increased cautiously based on clinical response. Maintenance dose can be adjusted to 2.5 to 10 mg orally once a day depending upon clinical benefits and drug toxicity.
For Pediatrics: No specific guidelines for dosing in pediatric population with hepatic impairment are given, however on the basis of adult drug studies with hepatic impairment and pharmacokinetics of the drug, dose adjustments in pediatric population with hepatic impairment is recommended
05/25/2020 01:54:48 Felodipine
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