Plendil: Effective Blood Pressure Control for Cardiovascular Health
Plendil
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Synonyms
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Plendil (felodipine) is a calcium channel blocker prescription medication specifically formulated for the management of hypertension, or high blood pressure. By selectively inhibiting calcium influx into vascular smooth muscle and cardiac muscle, it promotes peripheral arterial vasodilation, reducing systemic vascular resistance. This targeted mechanism of action allows for effective and sustained blood pressure lowering, a cornerstone in the long-term strategy to mitigate cardiovascular risk. Proper use under medical supervision can significantly contribute to achieving and maintaining therapeutic blood pressure goals.
Features
- Active Pharmaceutical Ingredient: Felodipine
- Pharmacologic Class: Dihydropyridine Calcium Channel Blocker
- Standard Tablet Strengths: 2.5 mg, 5 mg, 10 mg
- Formulation: Extended-Release (ER) Tablets
- Primary Indication: Treatment of Hypertension
- Administration: Oral, once-daily dosing
Benefits
- Provides consistent 24-hour blood pressure control from a single daily dose, supporting adherence to treatment regimens.
- Effectively lowers both systolic and diastolic blood pressure, reducing the long-term strain on the heart, kidneys, and other organs.
- Demonstrates a selective vasodilatory effect on peripheral arteries with minimal impact on cardiac contractility or conduction in most patients.
- Helps lower the overall risk of major cardiovascular events, such as heart attack and stroke, associated with uncontrolled hypertension.
- Can be used as monotherapy or effectively combined with other antihypertensive agents like beta-blockers or ACE inhibitors for synergistic effects.
Common use
Plendil is primarily indicated for the first-line treatment of essential hypertension in adults. It is not intended for the emergency lowering of blood pressure or for the treatment of hypertensive crises. Its use is part of a comprehensive therapeutic plan that should include lifestyle modifications, such as a heart-healthy diet (e.g., DASH or low-sodium diet), regular physical activity, weight management, and smoking cessation. Physicians may prescribe Plendil based on the patient’s individual blood pressure readings, overall cardiovascular risk profile, tolerance to other medications, and the presence of any comorbid conditions.
Dosage and direction
The dosage of Plendil must be individualized based on the patient’s therapeutic response and tolerability. The recommended starting dose for most adults is 5 mg once daily. Depending on the patient’s blood pressure response, the dose may be decreased to 2.5 mg or increased to 10 mg daily. Dosage adjustments should generally occur at intervals not shorter than 2 weeks to allow for full expression of the blood pressure effect at a given dose.
The tablet must be swallowed whole and must not be crushed, divided, or chewed, as this will alter the extended-release properties and could lead to an rapid increase in drug concentration. Administration should be consistent, preferably at the same time each day. Plendil may be taken with or without food; however, a low-fat meal is recommended as a high-fat, high-calorie meal can significantly increase the bioavailability of felodipine. It is crucial that patients do not discontinue therapy abruptly without consulting their physician.
Precautions
Before initiating therapy with Plendil, a thorough patient assessment is necessary. Use with caution in patients with heart failure or compromised ventricular function, as calcium channel blockers can potentially worsen this condition. Patients with severe hepatic impairment require a reduced starting dose (2.5 mg daily) and careful monitoring, as felodipine is extensively metabolized by the liver. Peripheral edema (swelling of the ankles and feet) is a common, dose-dependent side effect related to vasodilation. Gum hyperplasia (gingival overgrowth) has been associated with felodipine; maintaining good oral hygiene and regular dental check-ups can help mitigate this risk. As with any vasodilatory agent, patients may experience symptoms of hypotension, such as dizziness or lightheadedness, particularly upon initiation of therapy or after a dosage increase. Patients should be cautioned about engaging in activities requiring mental alertness, such as driving or operating machinery, until they know how Plendil affects them.
Contraindications
Plendil is contraindicated in patients with a known hypersensitivity to felodipine, any other calcium channel blockers, or any of the inactive ingredients in the tablet formulation. Its use is also contraindicated in patients experiencing cardiovascular collapse or shock.
Possible side effect
Like all medications, Plendil can cause side effects, although not everybody gets them. Most are mild to moderate and often diminish with continued treatment.
- Very Common (≥1/10): Peripheral edema (ankle and leg swelling), headache.
- Common (≥1/100 to <1/10): Flushing, dizziness, fatigue, nausea, abdominal pain, indigestion, palpitations, paresthesia (tingling sensation).
- Uncommon (≥1/1,000 to <1/100): Gum hyperplasia, rash, pruritus (itching), muscle cramps, syncope (fainting), impotence.
- Rare (<1/1,000): Increased frequency of urination, gynecomastia, hypersensitivity reactions, jaundice, and significantly low blood pressure.
Patients should report any persistent or severe side effects to their healthcare provider.
Drug interaction
Felodipine is a substrate of the CYP3A4 enzyme system. Concomitant use with drugs that inhibit or induce this pathway can significantly alter its plasma concentrations.
- Strong CYP3A4 Inhibitors (Increased Felodipine Levels): Concomitant use is not recommended. These include drugs like itraconazole, ketoconazole, ritonavir, clarithromycin, and erythromycin. Cimetidine also increases felodipine exposure.
- CYP3A4 Inducers (Decreased Felodipine Levels): Drugs like carbamazepine, phenytoin, phenobarbital, rifampicin, and St. John’s Wort can substantially decrease felodipine plasma levels, potentially reducing its efficacy. Dose adjustment of Plendil may be required.
- Other Antihypertensives: Concomitant use with other blood pressure-lowering agents (e.g., beta-blockers, ACE inhibitors, diuretics) may lead to an additive hypotensive effect.
- Grapefruit Juice: Should be avoided as it inhibits CYP3A4 and can increase felodipine bioavailability, raising the risk of adverse effects like hypotension and peripheral edema.
- Digoxin: Some calcium channel blockers can increase digoxin levels; monitoring of digoxin concentration is advised when initiating or discontinuing Plendil.
Patients must inform their doctor of all prescription, non-prescription, and herbal products they are taking.
Missed dose
If a dose is missed, it should be taken as soon as remembered on the same day. If it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. A double dose should never be taken to make up for a missed one.
Overdose
Overdose would be expected to cause pronounced peripheral vasodilation, leading to severe hypotension and possibly reflex tachycardia. Bradycardia, AV block, and metabolic acidosis have also been reported in severe cases. In the event of a suspected overdose, seek emergency medical attention immediately. Supportive measures should be instituted, including cardiovascular monitoring, elevation of extremities, and judicious administration of fluids. As felodipine is highly protein-bound, hemodialysis is not likely to be of benefit.
Storage
Store Plendil tablets at room temperature (15°C to 30°C or 59°F to 86°F) in their original container to protect from light and moisture. Keep all medications out of the reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any unused or expired medication as directed by a pharmacist; do not flush down the toilet or pour into a drain.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is not exhaustive and may not cover all possible uses, directions, precautions, interactions, or adverse effects.
Reviews
“After struggling to find a medication that controlled my hypertension without significant side effects, my cardiologist switched me to Plendil. The once-daily dosing is convenient, and my blood pressure has been consistently within target range for over a year. I experienced some mild ankle swelling initially, but it subsided.” – M.B., 58
“As a physician, I find Plendil to be a reliable and effective option in my antihypertensive arsenal. Its predictable pharmacokinetic profile and generally favorable side effect make it suitable for long-term management in many of my patients. The key is proper patient education on taking it correctly and managing common side effects like edema.” – Dr. A. Evans, Cardiologist
“The transition to Plendil was smooth. My readings improved within two weeks. The only notable effect was some flushing for the first few days, but it went away. I appreciate not having to remember multiple doses throughout the day.” – R.T., 64