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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Dihydropyridine Calcium Channel Blocker [EPC]
Felodipine is a dihydropyridine calcium channel blocker used primarily to manage hypertension. It works by relaxing vascular smooth muscle to lower blood pressure and reduce cardiovascular risk.
Name
Felodipine
Raw Name
FELODIPINE
Category
Dihydropyridine Calcium Channel Blocker [EPC]
Drug Count
3
Variant Count
56
Last Verified
February 17, 2026
RxCUI
402695, 402696, 402698
UNII
OL961R6O2C
About Felodipine
Felodipine is a dihydropyridine calcium channel blocker used primarily to manage hypertension. It works by relaxing vascular smooth muscle to lower blood pressure and reduce cardiovascular risk.
Detailed information about Felodipine
References used for this content
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Felodipine.
Hypertension is a chronic medical condition where the force of the blood against the artery walls is high enough that it may eventually cause health problems, such as heart disease and stroke. Felodipine helps mitigate these risks by ensuring that the heart does not have to work as hard to pump blood throughout the body. Healthcare providers often select Felodipine for patients who require sustained blood pressure control, as its extended-release formulation provides a consistent therapeutic effect over a 24-hour period. It is important to note that Felodipine is not a cure for hypertension but a management tool that requires consistent adherence to prevent long-term complications.
At the molecular level, Felodipine functions as a calcium ion influx inhibitor, specifically targeting the 'L-type' voltage-gated calcium channels located on the sarcolemma (cell membrane) of vascular smooth muscle cells. In a healthy physiological state, the entry of calcium ions into these cells triggers a cascade of events leading to muscle contraction and vasoconstriction (narrowing of the blood vessels). By binding to these channels, Felodipine prevents the transmembrane influx of extracellular calcium. The result is a significant reduction in the contractile tone of the smooth muscle within the arterial walls.
This process leads to systemic vasodilation (widening of the blood vessels), which decreases peripheral vascular resistance—the primary driver of elevated blood pressure. Unlike some other antihypertensives, Felodipine’s mechanism is highly specific to the peripheral arteries, with minimal effect on the venous system or the electrical conduction system of the heart. While it can cause a mild, transient increase in heart rate (reflex tachycardia) due to the rapid drop in blood pressure, this effect is generally minimized by the drug's extended-release delivery system. By maintaining arterial dilation, Felodipine ensures improved blood flow and reduced afterload on the heart, ultimately lowering the systolic and diastolic blood pressure readings.
Understanding the pharmacokinetics of Felodipine is essential for optimizing therapy and avoiding adverse effects. Felodipine is characterized by high lipid solubility and complex metabolic pathways.
Felodipine is FDA-approved for the treatment of hypertension. In clinical practice, it is often utilized in the following scenarios:
Felodipine is primarily available in the following dosage forms:
> Important: Only your healthcare provider can determine if Felodipine is right for your specific condition. Regular monitoring of blood pressure is required to evaluate the effectiveness of the treatment.
For the treatment of hypertension, the standard starting dose for most adults is 5 mg once daily. Depending on the patient's individual response and blood pressure goals, the healthcare provider may adjust the dosage after a period of 2 weeks. The maintenance dose typically ranges from 2.5 mg to 10 mg once daily. Clinical trials have shown that doses above 10 mg do not significantly increase the antihypertensive effect but do significantly increase the risk of adverse reactions, such as peripheral edema (swelling).
Patients should be monitored closely during the titration phase. If a patient is switching from an immediate-release calcium channel blocker to Felodipine extended-release, the doctor will calculate the equivalent dose carefully. It is essential to take the medication at the same time every day to maintain a steady state of the drug in the bloodstream.
The safety and effectiveness of Felodipine in pediatric patients (children under the age of 18) have not been established. Consequently, Felodipine is generally not approved for pediatric use. Healthcare providers will typically explore other antihypertensive options that have more robust clinical data in children and adolescents.
Patients with impaired kidney function do not typically require a dose adjustment for Felodipine, as the drug is primarily metabolized by the liver and the inactive metabolites are cleared by the kidneys. However, as with any antihypertensive, cautious monitoring is advised in patients with severe renal failure.
Since Felodipine is extensively metabolized by the liver, patients with hepatic impairment (liver disease) may experience higher plasma concentrations of the drug. Healthcare providers typically recommend a lower starting dose of 2.5 mg once daily for these patients. Frequent monitoring of blood pressure and side effects is necessary for individuals with cirrhosis or other forms of liver dysfunction.
Patients over the age of 65 may clear Felodipine more slowly than younger patients. Clinical guidelines suggest a starting dose of 2.5 mg once daily for the elderly. Adjustments should be made slowly and with careful attention to the risk of hypotension (low blood pressure) and fainting.
Felodipine extended-release tablets must be swallowed whole. They should never be crushed, chewed, or split, as this destroys the extended-release mechanism and can lead to a rapid, dangerous release of the entire dose at once. The medication can be taken either on an empty stomach or with a light meal. However, it should not be taken with a high-fat or high-carbohydrate meal, as this can interfere with how the drug is absorbed.
Storage is also critical; the medication should be kept at room temperature (20°C to 25°C or 68°F to 77°F), away from excessive moisture, heat, and direct light. Always keep the tablets in their original container until it is time to take them.
If you miss a dose of Felodipine, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once to make up for a missed one. Doubling the dose can lead to a severe drop in blood pressure.
An overdose of Felodipine can lead to excessive peripheral vasodilation, resulting in marked hypotension and sometimes bradycardia (slow heart rate). Symptoms may include severe dizziness, confusion, fainting, or a feeling of extreme warmth (flushing). In the event of a suspected overdose, seek emergency medical attention immediately. Treatment usually involves supportive care, such as intravenous fluids to raise blood pressure and, in some cases, calcium gluconate or vasopressors.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop taking the medication without medical guidance, as stopping suddenly can cause a 'rebound' increase in blood pressure.
The most frequently reported side effect of Felodipine is peripheral edema (swelling of the ankles, feet, or lower legs). This occurs because the drug dilates the small arteries more than the veins, causing fluid to leak into the surrounding tissues. This effect is dose-dependent, meaning it is more likely to occur at 10 mg than at 2.5 mg. It usually appears within the first 2 to 3 weeks of starting therapy.
Other common side effects include:
Some patients may experience secondary effects that are less frequent but still notable:
Rarely, Felodipine can cause more unusual reactions, including:
While rare, some side effects require urgent intervention.
> Warning: Stop taking Felodipine and call your doctor immediately if you experience any of the following:
With prolonged use, the most significant long-term concern is gingival hyperplasia. Patients on Felodipine for several years should have regular dental checkups to monitor gum health. Additionally, because Felodipine is used for a chronic condition, patients must be monitored for changes in liver function over time, although hepatotoxicity is extremely rare with this specific agent. Long-term use does not typically lead to drug tolerance; the antihypertensive effect generally remains stable over years of therapy.
As of 2026, there are no FDA black box warnings for Felodipine. However, this does not mean the drug is without risk. The absence of a black box warning simply indicates that the drug does not carry the highest level of safety alert required by the FDA for specific life-threatening risks that cannot be managed through standard labeling precautions.
Report any unusual symptoms or persistent side effects to your healthcare provider. Your doctor may be able to adjust your dose or suggest ways to manage side effects, such as elevating your legs to reduce swelling.
Felodipine is a potent vasodilator, and its primary safety considerations revolve around its effect on blood pressure and its interaction with liver enzymes. Patients must be aware that while Felodipine is effective at lowering blood pressure, it can sometimes lower it too much, leading to hypotension. This is especially true when first starting the medication or when increasing the dose. It is also vital to understand that Felodipine interacts significantly with certain foods and other medications, which can lead to dangerous levels of the drug in the system.
There are currently no FDA black box warnings for Felodipine. It is considered a safe and well-tolerated medication when used as directed under the supervision of a healthcare professional.
Patients taking Felodipine require regular medical follow-up to ensure the medication is working correctly and safely. Monitoring typically includes:
Felodipine may cause dizziness, lightheadedness, or fatigue, especially during the first few days of treatment or after a dose increase. Patients should determine how they react to the medication before driving a car or operating heavy machinery. If you feel dizzy or faint, avoid these activities and consult your doctor.
Alcohol can enhance the blood-pressure-lowering effect of Felodipine, leading to an increased risk of dizziness, fainting, and falls. It is generally recommended to limit or avoid alcohol consumption while taking this medication, particularly during the initiation phase of therapy.
Do not stop taking Felodipine abruptly. Stopping the medication suddenly can cause a rapid increase in blood pressure, known as 'rebound hypertension,' which increases the risk of stroke or heart attack. If the medication needs to be stopped, your healthcare provider will provide a tapering schedule to slowly reduce the dose over several days or weeks.
> Important: Discuss all your medical conditions, especially any history of liver disease or heart problems, with your healthcare provider before starting Felodipine.
There are several substances that should never be combined with Felodipine due to the risk of severe adverse reactions:
Felodipine is not known to interfere significantly with most common laboratory tests. However, it may cause minor, transient elevations in liver enzymes in rare cases, which could be misinterpreted during routine blood panels.
For each major interaction, the mechanism involves the modulation of the CYP3A4 enzyme system. Inhibitors (like grapefruit) lead to increased toxicity, while inducers (like rifampin) lead to reduced efficacy. Management strategies always involve dose adjustment or choosing alternative therapies.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, as many substances can alter how Felodipine works in your body.
Felodipine must NEVER be used in the following situations:
In these conditions, the risks and benefits must be carefully weighed by a healthcare provider:
There is a high likelihood of cross-sensitivity among the dihydropyridine class of calcium channel blockers. If a patient has experienced angioedema or severe skin reactions to drugs like amlodipine or nifedipine, they are at a significantly higher risk of a similar reaction to Felodipine. Patients should always inform their doctor of any previous adverse reactions to blood pressure medications.
> Important: Your healthcare provider will evaluate your complete medical history, including any allergies or previous heart conditions, before prescribing Felodipine to ensure it is the safest option for you.
Felodipine is classified under the older FDA Pregnancy Category C. Animal studies have shown evidence of teratogenicity (birth defects) and embryotoxicity at doses much higher than those used in humans. There are no adequate and well-controlled studies in pregnant women. Felodipine should be used during pregnancy only if the potential benefit to the mother outweighs the potential risk to the fetus. If a patient becomes pregnant while taking Felodipine, they should contact their healthcare provider immediately to discuss alternative antihypertensive treatments, such as methyldopa or labetalol, which have better-established safety profiles in pregnancy.
It is not known whether Felodipine is excreted in human milk. However, because many drugs are excreted in breast milk and because of the potential for serious adverse reactions in nursing infants from Felodipine, 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. Most clinicians recommend caution and monitoring the infant for signs of low blood pressure or lethargy if breastfeeding is continued.
Felodipine is not approved for use in children. The pharmacokinetics and safety profile have not been studied in patients under 18 years of age. Hypertension in children is often secondary to other conditions (like kidney disease), and treatment should be managed by a pediatric specialist using medications with established pediatric data.
Elderly patients (65 years and older) are more likely to have decreased hepatic function and decreased clearance of Felodipine. This leads to higher blood levels of the drug compared to younger patients. Consequently, there is an increased risk of side effects like peripheral edema and dizziness, which can increase the risk of falls. The American Geriatrics Society (Beers Criteria) suggests caution with some CCBs, though Felodipine is often used if started at the low dose of 2.5 mg once daily.
For patients with renal impairment, no specific dose adjustment is typically required because the kidney is not the primary route of elimination for the active drug. However, the metabolites are cleared renally, and in cases of severe renal failure (GFR < 30 mL/min), patients should be monitored for any unexpected accumulation or side effects. Felodipine is not removed by hemodialysis due to its high protein binding.
This is the most critical special population for Felodipine. Because the drug is metabolized by the CYP3A4 enzyme in the liver, any degree of hepatic impairment can lead to significantly elevated drug levels. Patients with Child-Pugh Class A, B, or C cirrhosis should be started on the lowest possible dose (2.5 mg) and titrated very slowly with frequent blood pressure monitoring.
> Important: Special populations require individualized medical assessment. Always inform your doctor if you are pregnant, planning to become pregnant, or have any history of liver or kidney disease.
Felodipine is a member of the dihydropyridine class of calcium channel antagonists. Its primary molecular target is the L-type voltage-gated calcium channel. These channels are found in high density in the smooth muscle cells of the peripheral vasculature. By binding to the alpha-1 subunit of these channels, Felodipine inhibits the inward flow of calcium ions during depolarization. Since calcium is required for the activation of myosin light-chain kinase—the enzyme that triggers muscle contraction—the inhibition of calcium influx leads to relaxation of the vascular smooth muscle. This results in arterial vasodilation, a decrease in total peripheral resistance, and a subsequent fall in systemic blood pressure.
The blood-pressure-lowering effect of Felodipine is dose-related and is typically seen within 2 to 5 hours after oral administration of the extended-release tablet. The effect is sustained for at least 24 hours, allowing for once-daily dosing. Felodipine is highly vascular-selective; it has approximately 100 times greater affinity for vascular smooth muscle than for myocardial tissue. Therefore, at therapeutic doses, it does not significantly affect heart contractility or electrical conduction (the PR interval). A mild reflex increase in heart rate may occur due to the rapid onset of vasodilation, but this is usually transient.
| Parameter | Value |
|---|---|
| Bioavailability | 15% - 20% (due to high first-pass metabolism) |
| Protein Binding | >99% (primarily to albumin) |
| Half-life | 11 - 16 hours (Extended Release) |
| Tmax | 2.5 - 5 hours |
| Metabolism | Hepatic (Primary: CYP3A4) |
| Excretion | Renal 70% (as metabolites), Fecal 10% |
Felodipine is classified as a Dihydropyridine Calcium Channel Blocker. Other drugs in this same therapeutic class include Amlodipine (Norvasc), Nifedipine (Adalat, Procardia), and Isradipine (DynaCirc). It is distinct from non-dihydropyridines like Verapamil and Diltiazem, which have more pronounced effects on the heart's conduction system and are used for arrhythmias as well as hypertension.
Medications containing this ingredient
Common questions about Felodipine
Felodipine is primarily used to treat hypertension, also known as high blood pressure. By lowering blood pressure, it helps prevent serious long-term complications such as strokes, heart attacks, and kidney problems. It belongs to a class of drugs called dihydropyridine calcium channel blockers, which work by relaxing the blood vessels so blood can flow more easily. Your doctor may prescribe it alone or in combination with other medications. It is specifically designed as an extended-release tablet to provide consistent control over a 24-hour period.
The most common side effect of Felodipine is peripheral edema, which is swelling in the ankles or feet caused by fluid buildup. Many patients also experience headaches, flushing (redness and warmth in the face), and dizziness, especially when they first start the medication. These symptoms are usually mild and often improve as your body adjusts to the drug. However, if the swelling becomes uncomfortable or the headaches persist, you should consult your healthcare provider. Dose reduction often helps alleviate these common side effects.
It is generally advised to limit or avoid alcohol while taking Felodipine. Alcohol can have an additive effect with the medication, causing your blood pressure to drop too low, which may lead to severe dizziness, lightheadedness, or fainting. This risk is highest when you first start Felodipine or when your dose is increased. Additionally, alcohol can sometimes worsen the flushing associated with calcium channel blockers. If you choose to drink, do so in moderation and only after discussing it with your doctor.
Felodipine is generally not recommended during pregnancy unless the benefits clearly outweigh the potential risks to the fetus. It is classified as FDA Category C, meaning animal studies have shown potential harm, but there isn't enough data from human studies to be certain. If you are pregnant or planning to become pregnant, you must inform your doctor immediately. There are other blood pressure medications, such as labetalol, that have a more established safety record for use during pregnancy. Your healthcare provider will help you transition to a safer alternative.
Felodipine begins to lower blood pressure within 2 to 5 hours after the first dose. However, because it is an extended-release medication, it may take up to two weeks of consistent daily use to see the full antihypertensive effect. Your doctor will likely wait at least 14 days before deciding if your dose needs to be adjusted. It is important to continue taking the medication even if you feel well, as hypertension often has no outward symptoms. Consistent use is key to achieving the desired long-term health benefits.
No, you should never stop taking Felodipine suddenly without consulting your doctor. Abruptly discontinuing an antihypertensive medication can cause your blood pressure to spike rapidly, a condition known as rebound hypertension. This sudden increase can significantly raise your risk of experiencing a heart attack or stroke. If you need to stop the medication due to side effects or a change in treatment, your doctor will provide a plan to gradually decrease your dose. Always follow your medical professional's guidance for stopping any chronic medication.
If you miss a dose of Felodipine, take it as soon as you remember that same day. If you do not remember until the next day, skip the missed dose entirely and return to your normal schedule. Never take two doses at the same time to 'make up' for the one you missed, as this can cause your blood pressure to drop to a dangerously low level. To help prevent missed doses, try taking your medication at the same time every morning, perhaps after brushing your teeth or with breakfast.
Felodipine does not typically cause true weight gain in the form of increased body fat. However, it can cause peripheral edema, which is fluid retention in the legs and ankles. This fluid buildup can sometimes cause a slight increase in the number on the scale and make your shoes or pants feel tighter. If you notice rapid weight gain (several pounds in a few days) along with shortness of breath, contact your doctor, as this could be a sign of a more serious heart condition. Standard weight gain from fat is not a documented side effect of this drug.
Felodipine can interact with many other medications, so it is vital to share your full medication list with your doctor. It is particularly dangerous to take with strong CYP3A4 inhibitors like ketoconazole or certain antibiotics, as these can cause Felodipine levels to skyrocket. It is also frequently used safely alongside other blood pressure drugs like diuretics or ACE inhibitors for a synergistic effect. However, you should avoid taking it with grapefruit juice or St. John's Wort. Always check with a pharmacist before starting any new over-the-counter drugs or supplements.
Yes, Felodipine is widely available as a generic medication in the form of extended-release tablets. Generic versions are required by the FDA to have the same active ingredient, strength, dosage form, and route of administration as the brand-name version (Plendil). Generic Felodipine is typically much more affordable than the brand-name drug and is covered by most insurance plans. When switching to a generic, ensure that the tablets are still the extended-release version, as these cannot be crushed or chewed.