====== Felodipine ======

Felodipine is a [[cardio:ccb:dhp|Dihydropyridine Calcium Channel Blocker]] (DHP CCB).

It primarily causes arterial vasodilation and reduces systemic vascular resistance.

Used in:

  * [[cardio:hypertension:start|Hypertension]]
  * [[cardio:angina:start|Stable Angina]]

→ [[cardio:ccb:start|Calcium Channel Blockers]]

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===== Mechanism of Action =====

Felodipine blocks L-type calcium channels in vascular smooth muscle.

This results in:

  * ↓ Intracellular calcium
  * Arterial vasodilation
  * ↓ Systemic Vascular Resistance (SVR)
  * ↓ Afterload

Minimal direct effect on:

  * SA node
  * AV node
  * Myocardial contractility

Primary action = vascular.

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===== Pharmacologic Profile =====

Formulation:

  * Extended-release (standard)

Half-life:

  * Intermediate (longer than nifedipine IR)
  * Once-daily dosing

Less reflex tachycardia than short-acting [[cardio:ccb:nifedipine|Nifedipine]].

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===== Clinical Use =====

Hypertension:

  * Alternative to [[cardio:ccb:amlodipine|Amlodipine]]
  * Often combined with:
      * [[cardio:raas:acei|ACE Inhibitors]]
      * [[cardio:raas:arb|ARBs]]
      * [[cardio:diuretics:thiazide:start|Thiazide Diuretics]]

Stable Angina:

  * Reduces afterload
  * Improves myocardial oxygen balance

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===== Adverse Effects =====

Common:

  * Peripheral edema
  * Headache
  * Flushing
  * Dizziness

Mechanism of edema:

  * Arteriolar dilation without venous dilation
  * Increased capillary hydrostatic pressure

Less AV nodal suppression than:

  * [[cardio:ccb:verapamil|Verapamil]]
  * [[cardio:ccb:diltiazem|Diltiazem]]

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===== Felodipine vs Other DHPs =====

[[cardio:ccb:amlodipine|Amlodipine]]:
  * Longer half-life
  * Very smooth BP control

[[cardio:ccb:nifedipine|Nifedipine]]:
  * Faster onset
  * Short-acting form associated with reflex tachycardia

Felodipine:
  * Extended-release
  * Reliable antihypertensive option
  * Pure vasodilator profile

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===== Clinical Pearls =====

  * DHP CCB
  * Arterial vasodilator
  * Once-daily dosing
  * Causes peripheral edema
  * No AV nodal slowing
  * Good alternative to amlodipine

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===== Related =====

  * [[cardio:ccb:start|Calcium Channel Blockers]]
  * [[cardio:ccb:dhp|Dihydropyridines]]
  * [[cardio:ccb:amlodipine|Amlodipine]]
  * [[cardio:ccb:nifedipine|Nifedipine]]
  * [[cardio:hypertension:start|Hypertension]]
  * [[cardio:angina:start|Anti-Anginal Therapy]]