In controlled studies in the United States and overseas, approximately 3,000
patients were treated with felodipine as either the extended-release or the
immediate-release formulation.
The most common clinical adverse events reported with felodipine extendedrelease
tablets administered as monotherapy at the recommended dosage
range of 2.5 mg to 10 mg once a day were peripheral edema and headache.
Peripheral edema was generally mild, but it was age and dose related and
resulted in discontinuation of therapy in about 3% of the enrolled patients.
Discontinuation of therapy due to any clinical adverse event occurred in
about 6% of the patients receiving felodipine extended-release tablets,
principally for peripheral edema, headache, or flushing.
Adverse events that occurred with an incidence of 1.5% or greater at any of
the recommended doses of 2.5 mg to 10 mg once a day (felodipine extendedrelease
tablets, N = 861; Placebo, N = 334), without regard to causality, are
compared to placebo and are listed by dose in the table below. These events are
reported from controlled clinical trials with patients who were randomized to
a fixed dose of felodipine extended-release tablets or titrated from an initial
dose of 2.5 mg or 5 mg once a day. A dose of 20 mg once a day has been
evaluated in some clinical studies. Although the antihypertensive effect of
felodipine extended-release tablets 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).
Adverse events that occurred in 0.5% up to 1.5% of patients who received
felodipine extended-release tablets in all controlled clinical trials at the
recommended dosage range of 2.5 mg to 10 mg once a day, and serious
adverse events that occurred at a lower rate, or events reported during
marketing experience (those lower rate events are in italics) are listed
below. These events are listed in order of decreasing severity within each
category, and the relationship of these events to administration of felodipine
extended-release tablets is uncertain:
Body as a Whole: Chest pain, facial edema, flu-like illness
Cardiovascular: Myocardial infarction, hypotension, syncope, angina pectoris,
arrhythmia, tachycardia, premature beats
Digestive: Abdominal pain, diarrhea, vomiting, dry mouth, flatulence, acid
regurgitation
Endocrine: Gynecomastia
Hematologic: Anemia
Metabolic: ALT (SGPT) increased
Musculoskeletal: Arthralgia, back pain, leg pain, foot pain, muscle cramps,
myalgia, arm pain, knee pain, hip pain
Nervous/Psychiatric: Insomnia, depression, anxiety disorders, irritability,
nervousness, somnolence, decreased libido
Respiratory: Dyspnea, pharyngitis, bronchitis, influenza, sinusitis, epistaxis,
respiratory infection
Skin: Angioedema, contusion, erythema, urticaria, leukocytoclastic vasculitis
Special Senses: Visual disturbances
Urogenital: Impotence, urinary frequency, urinary urgency, dysuria, polyuria.
Gingival Hyperplasia: Gingival hyperplasia, usually mild, occurred in < 0.5%
of patients in controlled studies. This condition may be avoided or may regress
with improved dental hygiene. (See
PRECAUTIONS: Information for Patients.)
Clinical Laboratory Test Findings
Serum Electrolytes
No significant effects on serum electrolytes were observed during short- and
long-term therapy (see
CLINICAL PHARMACOLOGY: Renal/Endocrine
Effects).
Serum Glucose
No significant effects on fasting serum glucose were observed in patients
treated with felodipine extended-release tablets in the U.S. controlled study.
Liver Enzymes
One of two episodes of elevated serum transaminases decreased once drug
was discontinued in clinical studies; no follow-up was available for the other
patient.