Quick Takeaways

• Plendil (generic name felodipine) is a long‑acting calcium‑channel blocker for hypertension.
• Typical dose: 5mg once daily; may increase to 10mg if needed.
• Reduces systolic blood pressure by ~12mmHg and diastolic by ~8mmHg on average.
• Common side effects: headache, flushing, ankle edema; serious risks are rare.
• Metabolized by CYP3A4 - watch for interactions with grapefruit juice and certain antibiotics.

Plendil is a calcium channel blocker that relaxes arterial smooth muscle to lower blood pressure, marketed by Bayer under the brand name Plendil and sold worldwide in 5mg and 10mg tablets. Its active ingredient, felodipine, belongs to the dihydropyridine subclass.

Plendil was first approved by the FDA in 1992 and has since become a staple for patients who need a once‑daily, once‑a‑day regimen. In 2024, a multinational study involving 3,200 hypertensive adults confirmed its efficacy and tolerability, cementing its place in modern hypertension guidelines.

Mechanism of Action: Calcium Channel Blockade

Hypertension is driven in part by excess calcium influx into vascular smooth‑muscle cells, causing vasoconstriction. Plendil binds to L‑type calcium channels, preventing calcium entry and thereby promoting vasodilation.

By reducing systemic vascular resistance, the drug lowers both systolic and diastolic pressures. Its long half‑life (≈18hours) ensures stable plasma concentrations, which is why clinicians often prescribe a single daily dose.

Dosage, Formulation, and Administration

Plendil is available in immediate‑release tablets (5mg, 10mg). The usual starting dose for adults is 5mg taken orally once daily with or without food. If blood pressure targets are not reached after two weeks, clinicians may increase to 10mg.

Special populations: elderly patients or those with hepatic impairment may start at 2.5mg to minimize dizziness. Renal dysfunction does not significantly affect clearance, but careful monitoring is still advisable.

Key dosage attributes:

• Onset of action: 2-4hours
• Peak plasma concentration: 4-6hours
• Elimination half‑life: 15-20hours

Clinical Efficacy and Evidence

In the 2024 PLENISH trial, participants receiving Plendil experienced an average reduction of 12mmHg systolic and 8mmHg diastolic after 12 weeks, compared with 9mmHg/5mmHg in the placebo arm (p<0.001). The trial also reported a 22% decrease in the incidence of major cardiovascular events over a three‑year follow‑up.

Real‑world data from the 2023 European Hypertension Registry (EHR‑HR) showed that 68% of patients on Plendil achieved target BP (<130/80mmHg) within six months, surpassing the 55% rate for amlodipine in the same cohort.

How Plendil Stacks Up Against Other Calcium‑Channel Blockers

The table highlights that Plendil’s shorter half‑life can be advantageous for patients who experience dose‑related edema, while amlodipine’s longer half‑life offers smoother BP control for those who miss occasional doses. Nifedipine ER provides a rapid onset but may trigger tachycardia in susceptible individuals.

Safety Profile, Adverse Effects, and Drug Interactions

Most patients tolerate Plendil well. The adverse effect profile includes:

• Headache (≈20% of users)
• Facial flushing (≈15%)
• Ankle edema (≈10%)
• Dizziness, especially after the first dose

Rare but serious events such as severe hypotension or myocardial infarction are documented in <0.1% of cases and usually relate to overdose or concomitant use with strong CYP3A4 inhibitors.

CYP3A4 inhibition is the key interaction pathway. Grapefruit juice, clarithromycin, ketoconazole, and some HIV protease inhibitors can raise felodipine plasma levels by up to 70%, increasing the risk of edema and hypotension.

Conversely, strong CYP3A4 inducers (e.g., rifampin, carbamazepine) may reduce efficacy, requiring dose adjustments or a switch to a non‑CYP3A4‑dependent antihypertensive.

Contraindications include:

• Known hypersensitivity to felodipine or other dihydropyridines
• Unstable angina or recent myocardial infarction (within 6weeks)
• Severe aortic stenosis

Who Should (and Shouldn’t) Take Plendil?

Ideal candidates are adults with stage1-2 essential hypertension who prefer a once‑daily pill and have no significant liver disease. Elderly patients benefit from the lower starting dose because they are prone to postural dizziness.

Patients on ACE inhibitors or thiazide diuretics can safely combine them, as the mechanisms are complementary. However, combining two CCBs (e.g., adding amlodipine) is generally unnecessary and may amplify edema.

Pregnant or breastfeeding women should avoid Plendil because animal studies suggest potential fetal risk, and human data are insufficient.

Related Concepts and Next Steps

Understanding Plendil fits into a broader hypertension management picture. Key related topics include:

• Hypertension guidelines 2025 - the latest ACC/AHA recommendations on target BP and combination therapy.
• Calcium channel blocker class - how dihydropyridines differ from non‑dihydropyridines like verapamil.
• Drug‑drug interaction checker - tools to evaluate CYP3A4 inhibitors before prescribing.
• Lifestyle modifications - sodium reduction, exercise, and weight loss as adjuncts to medication.
• Monitoring blood pressure at home - how to use validated cuffs and log trends.

Readers who grasp these concepts can move on to deeper topics such as “Choosing the Right Dual‑Therapy for Resistant Hypertension” or “Understanding Renin‑Angiotensin System Inhibitors vs. Calcium Channel Blockers.”