What is the recommended dosage for Felodipine (a calcium channel blocker)?

From the Guidelines

The recommended dosage for Felodipine is 2.5-10 mg once daily, with a starting dose of 5 mg once daily for hypertension, which can be adjusted based on blood pressure response. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1, the usual dose range for Felodipine is 2.5-10 mg/day, with a daily frequency of once.

• The dose may be increased gradually at intervals of at least 2 weeks, with a maximum recommended daily dose of 10 mg.
• For elderly patients or those with hepatic impairment, a lower starting dose of 2.5 mg daily is recommended.
• Felodipine should be taken in the morning with food to reduce gastrointestinal irritation, and the extended-release tablets must be swallowed whole, not crushed or chewed.
• Patients should maintain consistent timing of doses and avoid grapefruit products, which can increase blood levels of the medication.
• Felodipine works as a calcium channel blocker by relaxing blood vessels, making it easier for the heart to pump blood.
• Common side effects include headache, flushing, dizziness, and ankle swelling.
• Blood pressure should be monitored regularly while taking this medication to ensure proper dosing and effectiveness. It's also worth noting that the 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction 1 provides information on the properties of calcium channel blockers, including Felodipine, but the most recent and highest quality study for dosage recommendations is the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline 1.

From the FDA Drug Label

The most common clinical adverse events reported with Felodipine administered as monotherapy at the recommended dosage range of 2.5 mg to 10 mg once a day were peripheral edema and headache. A dose of 20 mg once a day has been evaluated in some clinical studies. Although the antihypertensive effect of Felodipine is increased at 20 mg once a day, there is a disproportionate increase in adverse events, especially those associated with vasodilatory effects (see DOSAGE AND ADMINISTRATION) Patients with Impaired Liver Function—Patients with impaired liver function may have elevated plasma concentrations of felodipine and may respond to lower doses of Felodipine; therefore, a starting dose of 2.5 mg once a day is recommended.

The recommended dosage range for Felodipine is 2.5 mg to 10 mg once a day. A starting dose of 2.5 mg once a day is recommended for patients with impaired liver function. The maximum dose evaluated in clinical studies is 20 mg once a day, but this dose is associated with a disproportionate increase in adverse events. 2 2

From the Research

Dosage Information

• The initial dosage of felodipine for the treatment of hypertension is 5 mg once daily 3
• Felodipine can be administered once daily with an extended-release formulation, providing equivalent antihypertensive efficacy to the same amount of drug administered twice daily as standard tablets 4
• The dosage of felodipine can be increased as needed, with some studies using doses of 10 mg once daily 5

Administration and Efficacy

• Felodipine is effective in lowering blood pressure in patients with mild to moderate hypertension, and can be used as monotherapy or in combination with other antihypertensive agents 4, 3
• Felodipine has been shown to be as effective as other calcium channel blockers, such as amlodipine and nifedipine, in lowering blood pressure 5
• The efficacy of felodipine is maintained over a 24-hour period, with trough to peak ratios indicating a consistent antihypertensive effect throughout the day 5

Comparison to Other Agents

• Felodipine has been compared to other antihypertensive agents, including beta-blockers and diuretics, and has been shown to be effective in lowering blood pressure in patients with mild to moderate hypertension 4, 6
• Felodipine has been used in combination with other agents, such as beta-blockers and diuretics, to achieve greater reductions in blood pressure 4, 6