Plandil - General Information:

A dihydropyridine calcium antagonist with positive inotropic effects. It lowers blood pressure by reducing peripheral vascular resistance through a highly selective action on smooth muscle in arteriolar resistance vessels. [PubChem]

Pharmacology:

Plandil, a dihydropyridine calcium-channel blocker, is used alone or with an angiotensin-converting enzyme inhibitor, to treat hypertension, chronic stable angina pectoris, and Prinzmetal's variant angina. Plandil is similar to other peripheral vasodilators. Plandil inhibits the influx of extra cellular calcium across the myocardial and vascular smooth muscle cell membranes blocking the calcium channels. The decrease in intracellular calcium inhibits the contractile processes of the myocardial smooth muscle cells, causing dilation of the coronary and systemic arteries, increased oxygen delivery to the myocardial tissue, decreased total peripheral resistance, decreased systemic blood pressure, and decreased afterload.

Plandil for patients

Information for the Patient

Patients should be instructed to take felodipine whole and not to crush or chew the
tablets. They should be told that mild gingival hyperplasia (gum swelling) has been
reported. Good dental hygiene decreases its incidence and severity.

Note: As with many other drugs, certain advice to patients being treated with felodipine
is warranted. This information is intended to aid in the safe and effective use of this
medication. It is not a disclosure of all possible adverse or intended effects.

Plandil Interactions

CYP3A4 Inhibitors—Felodipine is metabolized by CYP3A4. Co-administration of CYP3A4 inhibitors (eg, ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine) with felodipine may lead to several- fold increases in the plasma levels of felodipine, either due to an increase in bioavailability or due to a decrease in metabolism. These increases in concentration may lead to increased effects, (lower blood pressure and increased heart rate). These effects have been observed with co-administration of itraconazole (a potent CYP3A4 inhibitor). Caution should be used when CYP3A4 inhibitors are co-administered with felodipine. A conservative approach to dosing felodipine should be taken. The following specific interactions have been reported:

Itraconazole—Co-administration of another extended release formulation of felodipine with itraconazole resulted in approximately 8-fold increase in the AUC, more than 6- fold increase in the Cmax, and 2-fold prolongation in the half- life of felodipine.

Erythromycin—Co-administration of felodipine (PLENDIL) with erythromycin resulted in approximately 2.5- fold increase in the AUC and Cmax, and about 2- fold prolongation in the half- life of felodipine.

Grapefruit juice—Co-administration of felodipine with grapefruit juice resulted in more than 2-fold increase in the AUC and Cmax, but no prolongation in the half- life of felodipine.

Cimetidine—Co-administration of felodipine with cimetidine (a non-specific CYP-450 inhibitor) resulted in an increase of approximately 50% in the AUC and the Cmax, of felodipine.

Beta-Blocking Agents— A pharmacokinetic study of felodipine in conjunction with metoprolol demonstrated no significant effects on the pharmacokinetics of felodipine. The AUC and Cmax of metoprolol, however, were increased approximately 31 and 38%, respectively. In controlled clinical trials, however, beta blockers including metoprolol were concurrently administered with felodipine and were well tolerated.

Digoxin— When given concomitantly with PLENDIL the pharmacokinetics of digoxin in patients with heart failure were not significantly altered.

Anticonvulsants— In a pharmacokinetic study, maximum plasma concentrations of felodipine were considerably lower in epileptic patients on long-term anticonvulsant therapy (eg, phenytoin, carbamazepine, or phenobarbital) than in healthy volunteers. In such patients, the mean area under the felodipine plasma concentration-time curve was also reduced to approximately 6% of that observed in healthy volunteers. Since a clinically significant interaction may be anticipated, alternative antihypertensive therapy should be considered in these patients.

Tacrolimus— Felodipine may increase the blood concentration of tacrolimus. When given concomitantly with felodipine, the tacrolimus blood concentration should be followed and the tacrolimus dose may need to be adjusted.

Other Concomitant Therapy— In healthy subjects there were no clinically significant interactions when felodipine was given concomitantly with indomethacin or spironolactone.

Interaction with Food— See CLINICAL PHARMACOLOGY, Pharmacokinetics and Metabolism.

Plandil Contraindications

PLENDIL is contraindicated in patients who are hypersensitive to this product.

Plandil more info

Indication, Mechanism Of Action, Drug Interactions, Food Interactions, etc..