Plendil (felodipine) is a calcium channel blocker medication prescribed for the management of hypertension. It functions by relaxing the blood vessels, allowing blood to flow more easily and thereby reducing high blood pressure. Consistent use under medical supervision can significantly lower the risk of heart attack, stroke, and kidney problems. This medication is part of a comprehensive treatment plan that often includes diet, exercise, and other lifestyle changes. It is available in extended-release tablet form, designed to provide 24-hour control with a single daily dose.

Features

• Active ingredient: Felodipine
• Drug class: Dihydropyridine calcium channel blocker
• Available formulations: Extended-release tablets (2.5 mg, 5 mg, 10 mg)
• Administration: Oral, once daily
• Mechanism: Selective inhibition of calcium influx into vascular smooth muscle and cardiac muscle
• Bioavailability: Approximately 20% (subject to first-pass metabolism)
• Protein binding: >99%
• Metabolism: Hepatic, via cytochrome P450 3A4
• Elimination half-life: 11–16 hours
• Excretion: Primarily renal (70%) with remainder fecal

Benefits

• Provides consistent 24-hour blood pressure control with a single daily dose
• Reduces peripheral vascular resistance, easing strain on the heart
• Lowers the risk of major cardiovascular events including stroke and myocardial infarction
• Demonstrates selectivity for vascular smooth muscle over cardiac muscle
• May be used as monotherapy or in combination with other antihypertensive agents
• Extended-release formulation maintains stable plasma concentrations

Common use

Plendil is primarily indicated for the treatment of hypertension, either as monotherapy or in combination with other antihypertensive medications. It may be prescribed when first-line treatments are not suitable or when specific hemodynamic effects are desired. Some clinicians may use it off-label for certain cases of angina pectoris, though this is not its primary indication. It is particularly useful in patients who require vasodilation without significant negative inotropic effects. The medication is typically incorporated into long-term management plans for chronic hypertension.

Dosage and direction

The recommended starting dose for most adults is 5 mg once daily. Dosage may be adjusted based on therapeutic response and tolerability, typically at intervals not shorter than 2 weeks. The maintenance dose usually ranges from 2.5 mg to 10 mg daily. Doses exceeding 10 mg daily are not recommended. Tablets should be swallowed whole with a glass of water and not crushed, chewed, or divided. Administration should occur at approximately the same time each day, with or without food, though high-fat meals may increase absorption. For elderly patients or those with hepatic impairment, the recommended starting dose is 2.5 mg daily.

Precautions

Patients should be monitored regularly for blood pressure response and potential adverse effects. Use with caution in patients with heart failure, severe aortic stenosis, or hepatic impairment. Peripheral edema is a common side effect that is dose-dependent and more frequent in elderly patients. May cause hypotension, particularly in volume-depleted patients. Patients should avoid grapefruit juice as it may significantly increase felodipine plasma concentrations. Abrupt withdrawal may lead to rebound hypertension. Use during pregnancy only if potential benefit justifies potential risk to fetus. Not recommended for use while breastfeeding.

Contraindications

Hypersensitivity to felodipine or any component of the formulation. Patients with known hypersensitivity to other calcium channel blockers. Severe hypotension. Cardiogenic shock. Acute myocardial infarction with complicating tachycardia. Unstable angina pectoris (except when used in combination with beta-blockers). The safety and effectiveness in children have not been established.

Possible side effect

Common side effects include peripheral edema (dose-dependent), headache, dizziness, flushing, and palpitations. Less frequently, patients may experience fatigue, nausea, dyspepsia, muscle cramps, paresthesia, and gingival hyperplasia. Rare but serious side effects include significant hypotension, syncope, tachycardia, chest pain, and allergic reactions including rash and pruritus. Some patients may experience gastrointestinal disturbances such as constipation or diarrhea. Elevations in liver enzymes have been reported in some cases.

Drug interaction

Strong inhibitors of CYP3A4 (e.g., ketoconazole, itraconazole, clarithromycin) may significantly increase felodipine concentrations. Inducers of CYP3A4 (e.g., carbamazepine, phenytoin, St. John’s wort) may decrease felodipine concentrations. Concomitant use with beta-blockers may increase risk of hypotension and heart failure. May potentiate effects of other antihypertensive agents. Use with digoxin may increase digoxin concentrations. Grapefruit juice may increase bioavailability by inhibiting intestinal CYP3A4. Cimetidine may increase felodipine plasma concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is nearly time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Maintaining a consistent dosing schedule is important for optimal blood pressure control. Setting daily reminders or using pill organizers can help prevent missed doses.

Overdose

Symptoms of overdose may include severe hypotension, bradycardia or tachycardia, and shock. Management should include cardiovascular monitoring and supportive measures. Gastric lavage may be considered if ingestion was recent. Activated charcoal may be administered. Intravenous calcium gluconate may help reverse effects of calcium channel blockade. Vasopressors such as dopamine or norepinephrine may be required for hypotension unresponsive to fluid replacement. Bradycardia may require atropine or cardiac pacing. Patients should be monitored for at least 24 hours due to the extended-release formulation.

Storage

Store at controlled room temperature (20°C to 25°C/68°F to 77°F) with excursions permitted between 15°C and 30°C (59°F and 86°F). Keep in the original container with the lid tightly closed. Protect from light and moisture. Do not store in bathroom or other humid areas. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication that is no longer needed.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual responses to medication may vary. The prescribing physician should be consulted regarding specific medical questions or concerns. This information is not exhaustive and does not include all possible uses, directions, precautions, or interactions.

Reviews

Clinical studies have demonstrated Plendil’s efficacy in reducing both systolic and diastolic blood pressure. In randomized controlled trials, felodipine showed significant blood pressure reduction compared to placebo. Many patients report satisfactory blood pressure control with once-daily dosing. Some users note peripheral edema as a bothersome side effect, though this often diminishes with dose adjustment. Physicians appreciate its vascular selectivity and predictable pharmacokinetics. Long-term studies support its role in cardiovascular risk reduction when used as part of a comprehensive hypertension management plan.