Felodip 30 extended-release film-coated tablets 2.5 mg

Compound

Description of the dosage form

Extended-release film-coated tablet, 2.5 mg: round, biconvex, yellow film-coated, odorless, with “2.5” engraved on one side.

Extended-release film-coated tablet, 5 mg: round, biconvex, light pink, odorless, film-coated, with “5” engraved on one side.

Extended-release film-coated tablet, 10 mg: round, biconvex, red-brown, odorless, film-coated, with “10” engraved on one side.

On the break of the tablet you can see a white or almost white core (for all dosages).

Pharmacokinetics

Absorption and distribution. The slow release of felodipine from film-coated tablets leads to an extension of the absorption phase of the drug and ensures a uniform concentration of felodipine in the blood plasma over 24 hours. Felodipine is almost completely absorbed from the gastrointestinal tract. The bioavailability of the drug does not depend on the dose within the therapeutic interval and is approximately 15%. 99% of felodipine binds to plasma proteins, primarily albumin.

Metabolism and excretion. Felodipine is completely metabolized in the liver, and all its metabolites are inactive. T1/2 of felodipine is 25 hours. With long-term use, felodipine does not accumulate.

Pharmacokinetics in special groups of patients

Elderly patients. In elderly patients and in cases of impaired liver function, the concentration of felodipine in the blood plasma is higher than in young patients.

Renal dysfunction. The pharmacokinetic parameters of felodipine do not change in patients with impaired renal function, including those undergoing hemodialysis. About 70% of the dose taken is excreted by the kidneys, and the rest by the intestines in the form of metabolites. Less than 0.5% of the dose taken is excreted unchanged by the kidneys. Felodipine penetrates the BBB into the placenta and is excreted in breast milk.

Pharmacological properties of the drug Felodip

Pharmacodynamics. Felodip is a dihydropyridine derivative, a selective blocker of L-type calcium channels. It has a high affinity for smooth muscle cells of peripheral arterioles and coronary arteries. Felodip dilates arterioles, reduces peripheral vascular resistance and blood pressure. In therapeutic doses it has virtually no effect on myocardial contractility. Felodip has an antianginal effect by reducing vascular resistance of the coronary vessels, improving coronary circulation and oxygen supply to the myocardium, and also reduces afterload on the heart, which leads to a decrease in myocardial oxygen demand. Felodip improves exercise tolerance and reduces the frequency of attacks in patients with stable angina, and has an anti-ischemic effect in vasospastic angina. The primary hemodynamic effect of Felodip is a decrease in general peripheral vascular resistance, thereby reducing blood pressure. This effect is dose dependent. As a rule, a decrease in blood pressure is observed 2 hours after a single dose and lasts for at least 24 hours, the T/P ratio (plateau/peak) reaches a value well above 50%. There is a positive relationship between the concentration of the drug in the blood plasma, the level of decrease in OPSS and the decrease in blood pressure. Felodip has a slight natriuretic and diuretic effect, since it reduces tubular reabsorption of sodium. Felodip does not affect the daily excretion of potassium. In patients with reduced renal function, glomerular filtration rate may increase during treatment with Felodip. Felodip is well tolerated by patients after kidney transplantation. The drug does not affect the concentration of glucose in the blood and the lipid profile. Pharmacokinetics. Felodip is completely absorbed into the gastrointestinal tract. Bioavailability is about 15% and does not depend on the dose taken (first pass effect through the liver). 99% of Felodipa binds to blood plasma proteins, mainly albumin. Due to the peculiarities of the dosage form, the prolonged release of felodipine extends the absorption phase and ensures its uniform concentration in the blood plasma over 24 hours. The drug penetrates the BBB and the placental barrier, and into breast milk. Felodipine is completely metabolized in the liver, all of its metabolites are inactive. The half-life of felodipine is 25 hours. With prolonged use, accumulation of the active substance does not occur. In elderly patients and with impaired liver function, plasma concentrations of felodipine are higher than in young patients. The pharmacokinetics of Felodip does not change in patients with impaired renal function, including those undergoing hemodialysis. About 70% of the dose taken is excreted in the urine, and 30% is excreted in the feces in the form of metabolites. 0.5% of the dose taken is excreted unchanged in the urine.

Side effects

As with other CCBs, Felodip may cause facial flushing, headache, palpitations, dizziness and fatigue. These reactions are reversible and most often occur at the beginning of treatment or when the dose of the drug is increased. Also, depending on the dose, peripheral edema may appear, which is a consequence of precapillary vasodilation. Patients with gum disease or periodontitis may experience mild swelling of the gums. This can be prevented by practicing good oral hygiene.

The incidence of side effects is classified according to WHO recommendations: very often - at least 10%; often - at least 1%, but less than 10%; infrequently - not less than 0.1%, but less than 1%; rarely - not less than 0.01%, but less than 0.1%; very rarely (including isolated cases) - less than 0.01%.

From the immune system: very rarely - hypersensitivity reaction, angioedema.

From the central and peripheral nervous system: often - headache; infrequently - dizziness, paresthesia; rarely - fainting.

From the cardiovascular system: very often - peripheral edema; often - hot flashes; rarely - tachycardia, palpitations.

From the gastrointestinal tract: infrequently - nausea, abdominal pain; rarely - vomiting; very rarely - gum hyperplasia, gingivitis.

From the liver and biliary tract: very rarely - increased activity of hepatic transaminases.

From the skin and subcutaneous tissues: infrequently - rash, itching of the skin; rarely - urticaria; very rarely - photosensitivity reaction, leukocytoclastic vasculitis.

From the musculoskeletal system and connective tissue: rarely - arthralgia, myalgia.

From the kidneys and urinary tract: very rarely - pollakiuria.

Other: infrequently - fatigue; rarely - sexual dysfunction.

Felodip tab ppo prolong release 5mg No. 30

Compound

Active substance: felodipine - 5 mg.
Excipients: lactose monohydrate - 23.95 mg, microcrystalline cellulose (type Avicel PH101) - 50.5 mg, hypromellose (Methocel E50LV) - 110 mg, povidone (type K-25) - 7.35 mg, propyl gallate - 0.067 mg, microcrystalline cellulose (type Emcocel 90M) - 8 mg, colloidal silicon dioxide - 1.3 mg, magnesium stearate - 0.833 mg.

Film shell composition: hypromellose (type Pharmacoat 606) - 6.666 mg, red iron oxide dye (E172) - 0.019 mg, yellow iron oxide dye (E172) - 0.007 mg, titanium dioxide (E171) - 0.435 mg, talc - 1.008 mg, propylene glycol - 1.165 mg.

Pharmacokinetics

Absorption and distribution
After taking the drug orally, felodipine is almost completely absorbed from the gastrointestinal tract. Due to the peculiarities of the dosage form, the delayed release of felodipine leads to an extension of the absorption phase and ensures a uniform concentration of felodipine in the blood plasma over 24 hours. The bioavailability of the drug does not depend on the dose (in the range of therapeutic doses) and is about 15%.

Binding to plasma proteins, mainly albumin, is about 99%. Penetrates through the BBB and placental barrier, excreted in breast milk. With long-term use, felodipine does not accumulate.

Metabolism

Felodipine is almost completely metabolized in the liver to form inactive metabolites.

Removal

T1/2 of felodipine is 25 hours. It is excreted in the form of metabolites: about 70% of the dose taken is in urine, the rest is in feces. Less than 0.5% of the dose is excreted unchanged in the urine.

Pharmacokinetics in special groups of patients

In elderly people and in patients with impaired liver function, the concentration of felodipine in the blood plasma is higher than in young patients.

The pharmacokinetic parameters of felodipine do not change in patients with impaired renal function, incl. and during hemodialysis.

Indications for use

• Arterial hypertension;

• stable angina (including Prinzmetal's angina).

Contraindications

• Hypersensitivity to felodipine and other dihydropyridine derivatives;
• unstable angina;
• acute myocardial infarction and within one month after myocardial infarction;
• cardiogenic shock;
• clinically significant aortic stenosis;
• pregnancy;
• breastfeeding period;
• heart failure in the stage of decompensation;
• severe arterial hypotension;
• age under 18 years (efficacy and safety have not been established);
• lactose intolerance, lactase deficiency; glucose-galactose malabsorption.

With caution: Hepatic and/or renal failure, age over 65 years.

Directions for use and doses

The drug is best taken orally in the morning, before meals or after a light breakfast.
Film-coated tablets should not be cracked, divided or crushed.

Arterial hypertension

Adults (including elderly patients):

The dose is always determined individually.

Therapy begins with a dose of 5 mg once a day. If necessary, the dose can be increased; Usually maintenance dose is 5-10 mg 1 time per day. To determine your individual dose, it is best to use tablets containing felodipine 2.5 mg.

In elderly patients or patients with impaired liver function, the recommended starting dose is 2.5 mg once daily.

Stable angina

Adults:

The dose is always determined individually.

Treatment begins with a dose of 5 mg 1 time per day; if necessary, the dose can be increased to 10 mg 1 time per day. The maximum daily dose is 20 mg 1 time per day.

The drug Felodip can be used in combination with beta-blockers, angiotensin-converting enzyme (ACE) inhibitors or diuretics. Combination therapy usually enhances the hypotensive effect of the drug. It is necessary to beware of the development of arterial hypotension.

In patients with severe liver dysfunction, the therapeutic dose should be reduced.

In patients with impaired renal function, the pharmacokinetics of the drug does not change significantly.

Storage conditions

Store at a temperature not exceeding 25°C, in the original packaging (blister in a pack). Keep out of the reach of children.

Best before date

4 years. Do not use after the expiration date.

special instructions

The drug Felodip, as well as other vasodilators, can in rare cases cause significant arterial hypotension, which in some predisposed patients can lead to the development of myocardial ischemia. Currently, there is no data on the advisability of using the drug as secondary prevention of myocardial infarction.

The drug Felodip is effective and well tolerated by patients regardless of gender and age, as well as by patients with concomitant diseases such as bronchial asthma and other lung diseases; impaired renal function; diabetes; gout; hyperlipidemia; Raynaud's syndrome, as well as after lung transplantation.

The drug Felodip does not affect the concentration of glucose in the blood and the lipid profile.

Description

Calcium channel blocker.

Use in children

Contraindication: children and adolescents under 18 years of age (efficacy and safety have not been established).

Pharmacodynamics

Blocker of slow calcium channels from the group of dihydropyridine derivatives.
Has a hypotensive, antianginal effect. Reduces blood pressure by reducing peripheral vascular resistance. Has a dose-dependent anti-ischemic effect. Reduces the size of myocardial infarction and protects against complications of reperfusion.

It has virtually no negative inotropic effect and has minimal effect on the conduction system.

Side effects

The drug (as with other slow calcium channel blockers) can cause facial flushing, headache, palpitations, dizziness, and fatigue.
These reactions are reversible and most often occur at the beginning of treatment and when the dose of the drug is increased. Also, depending on the dose, peripheral edema may appear, which is a consequence of precapillary vasodilation. Patients with gum disease or periodontitis may experience mild swelling of the gums. This can be prevented by maintaining good oral hygiene. The frequency of side effects is determined according to the recommendations of the World Health Organization: very often (≥10%); often (≥1%, <10%); uncommon (≥0.1%, <1%); rare (≥0.01%, <0.1%); very rare, including isolated cases (<0.01%).

Allergic reactions: rarely - urticaria; very rarely - hypersensitivity reactions, angioedema.

From the nervous system: often - headache; infrequently - dizziness, paresthesia; rarely - fainting.

From the cardiovascular system: very often - peripheral edema; often - “hot flashes”; rarely - palpitations, tachycardia.

From the digestive system: infrequently - nausea, abdominal pain; rarely - vomiting; very rarely - gingival hyperplasia, gingivitis, increased activity of liver transaminases.

From the urinary system: very rarely - pollakiuria.

From the skin and subcutaneous tissues: infrequently - rash, itching; very rarely - photosensitivity reactions, leukocytoclastic vasculitis.

From the musculoskeletal system: rarely - arthralgia, myalgia.

Other: infrequently - fatigue; rarely - sexual dysfunction.

Use during pregnancy and breastfeeding

Felodip is contraindicated for use during pregnancy and lactation (breastfeeding).

Interaction

• When used simultaneously with felodipine, the concentration of digoxin in plasma increases, however, a change in the dosage regimen of the drug Felodipine is not required.
• When used simultaneously with cytochrome P450 inhibitors (including cimetidine, erythromycin, itraconazole, ketoconazole), the metabolism of felodipine in the liver slows down, which leads to an increase in its concentration in the blood plasma.
• When used simultaneously with inducers of microsomal liver enzymes (including phenytoin, carbamazepine, rifampicin, barbiturates), the concentration of felodipine in the blood plasma decreases.
• NSAIDs do not reduce the hypotensive effect of felodipine.
• The high degree of binding of felodipine to plasma proteins does not affect the binding of free fractions of other drugs (including warfarin).
• Beta-blockers, verapamil, tricyclic antidepressants and diuretics enhance the hypotensive effect of felodipine.
• With simultaneous use of felodipine with tacrolimus, it is possible to increase the concentration of the latter in the blood plasma, which may require adjustment of the dose of tacrolimus.
• Felodipine should not be used concomitantly with grapefruit juice due to the flavonoid it contains, which increases the bioavailability of felodipine.

Overdose

Symptoms: excessive decrease in blood pressure, bradycardia.

Treatment: symptomatic therapy. If blood pressure decreases excessively, the patient should be placed in a horizontal position with a low headboard. For bradycardia - intravenous administration of atropine at a dose of 0.5-1 mg. If necessary, to increase blood volume, infusion of a solution of dextrose (glucose), sodium chloride or dextran. Drugs with a predominant effect on α-adrenergic receptors are prescribed when the above measures are ineffective.

Impact on the ability to drive vehicles and operate machinery

Patients who experience weakness or dizziness during treatment with Felodip should avoid performing activities that require increased concentration and speed of psychomotor reactions.

Interaction

Felodipine increases the concentration of digoxin in the blood plasma, but no dose adjustment of felodipine is required.

Cytochrome P450 inhibitors (for example, cimetidine, erythromycin, itraconazole, ketoconazole) slow down the metabolism of felodipine in the liver, increasing the concentration of the drug in the blood plasma.

Inducers of microsomal enzymes (phenytoin, carbamazepine, rifampicin, barbiturates) reduce the concentration of felodipine in the blood plasma.

NSAIDs do not reduce the hypotensive effect of felodipine.

The high degree of protein binding of felodipine does not affect the binding of the free fraction of other drugs (for example, warfarin).

Felodipine should not be used concomitantly with grapefruit juice due to the flavonoid it contains, which increases the bioavailability of felodipine.

Beta-blockers, verapamil, tricyclic antidepressants and diuretics enhance the hypotensive effect of felodipine.

With simultaneous use, it is possible to increase the concentration of tacrolimus in the blood plasma, which may require adjustment of the tacrolimus dose.

Directions for use and doses

Inside. The drug is best taken in the morning, before meals or after a light breakfast. Film-coated tablets should not be cracked, divided or crushed.

Arterial hypertension

Adults (including the elderly). The dose is always determined individually. Therapy begins with a dose of 5 mg once a day. If necessary, the dose can be increased; The usual maintenance dose is 5–10 mg once a day. To determine your individual dose, it is best to use tablets containing felodipine 2.5 mg. In elderly patients or patients with impaired liver function, the recommended starting dose is 2.5 mg once daily.

Stable angina

Adults. The dose is always determined individually. Treatment begins with a dose of 5 mg 1 time per day; if necessary, the dose can be increased to 10 mg 1 time per day. The maximum daily dose is 20 mg 1 time per day.

The drug Felodip can be used in combination with β-blockers, ACE inhibitors or diuretics. Combination therapy usually enhances the hypotensive effect of the drug. It is necessary to beware of the development of arterial hypotension. In patients with severe liver dysfunction, the therapeutic dose should be reduced. In patients with impaired renal function, the pharmacokinetics of the drug does not change significantly.

Clinical case

Patient B.

, 62 years old, was hospitalized from 08/29/18 to 09/09/18. She was admitted through emergency medical care with decompensated CHF. Upon admission, she complained of shortness of breath at rest, a feeling of lack of air, severe swelling of the lower extremities, general weakness, and pain in the lower extremities.

From the anamnesis it is known that the patient has been suffering from hypertension for a long time with maximum blood pressure values ​​of 200/110 mm Hg, the usual blood pressure figures are 120-130/90 mm Hg. On an outpatient basis I took daily: bisoprolol 5 mg, losartan 50 mg, furosemide 20 mg, clopidogrel 75 mg, aspirin 100 mg. The patient had a history of myocardial infarction (of unknown duration) and a long-term persistent form of atrial fibrillation. I have type 2 diabetes mellitus, insulin dependent. Denies any history of cerebrovascular accident. About 2 years ago, atherosclerosis of peripheral arteries and occlusion of the arteries of the lower extremities were detected. She was repeatedly hospitalized due to S.N.’s decompensation. The condition worsened over the course of a week, when the above complaints began to increase.

The condition at admission was of moderate severity. The patient is conscious, the position is forced - orthopnea. The physique is normosthenic, body weight 60 kg, height 155 cm, BMI 25 kg/m2. The skin and mucous membranes are pale in color and clean. Symmetrical pronounced dense swelling of the legs and feet. The right lower limb is cold to the touch. Trophic ulcers of the right leg. In the lungs, breathing is harsh, fine wheezing on both sides, breathing is not audible in the lower sections. Heart sounds are muffled, irregular, there is no noise. Heart rate (HR) 117 beats/min, blood pressure 120/78 mm Hg. The abdomen is not enlarged, soft, painless. Stool and diuresis are not disturbed.

Data from clinical tests upon admission: hemoglobin 100 g/l, leukocytes 11.5·109/l; ESR 40 mm/h, neutrophils 9.4%. General urine test - without significant pathology, biochemical blood test: creatinine 203.66 mmol/l, urea 17.8, glucose 11.5 mmol/l, AST 33 U/l, ALT 60 U/l, potassium 5.6 mmol /l, sodium 137 mmol/l, natriuretic peptide BNP 3568 pg/ml, cholesterol 3.5 mmol/l. LDL 2.1 mmol/l, HDL 0.56 mmol/l.

Instrumental research data: electrocardiography (ECG) dated 08/29/18 - atrial fibrillation rhythm, heart rate 117 beats/min. The electrical axis of the heart is deviated to the left.

On the chest x-ray dated 08/30/18: bilateral hydrothorax.

Echocardiographic examination of the heart (EchoCG) dated 08/30/18

— aorta: sinus of Valsalva 3.5 cm. Left atrium 4.5×5.0×5.5 cm (4.0×4.0×6.0 cm), interventricular septum 1.0 cm (0.7— 1.1 cm); posterior wall of the left ventricle 0.9 cm (0.7-1.1 cm), end-systolic size 4.4 cm (2.5-4.1 cm), end-diastolic size 5.5 cm (3.5-5 .6 cm). The contractility of the left ventricular (LV) myocardium is diffusely reduced. Pronounced hypokinesia of the septum, anterior wall, akinesia of the apex. LVEF 40%, right atrium 5.0×5.0 cm (4.4×6.0 cm), right ventricle 2.5×4.0 cm (3.0×4.3 cm), additional formations: parietal thrombus 3.0×1.5 cm in the apex of the left vein. Contractility of the right ventricle is not impaired. The aortic valve is tricuspid, the leaflets are thickened, the leaflets are fully opened, the maximum pressure gradient is 3 mm Hg, degree I regurgitation. Mitral valve - multidirectional movement, regurgitation of the second degree. The tricuspid valve is not changed, regurgitation of II-III degree. The average pressure in the pulmonary artery is 50 mm Hg. There is 1.0 cm of fluid in the pericardial cavity. Bilateral hydrothorax.

Clinical diagnosis made:

Basic:

IHD. Post-infarction cardiosclerosis. Atherosclerosis of the aorta and coronary arteries. Atherosclerosis of the arteries of the lower extremities. Chronic arterial insufficiency of the 4th degree according to Fontaine-Pokrovsky. Occlusion of the tibial arteries on the right. Trophic ulcers of the right leg, I, II toes of the right foot. Forming gangrene of the right leg and foot.

Background disease:

stage III hypertension, stage 3 arterial hypertension, the risk of cardiovascular complications is very high.

Complication:

NK 2B, 3rd functional class according to NYHA. Chronic kidney disease - C4 (glomerular filtration rate - GFR - according to CKD-EPI 22 ml/min). Bilateral hydrothorax. Hydropericardium. Permanent form of atrial fibrillation. The risk of thromboembolic complications according to the CHADS2VASC scale is 6 points. The risk of bleeding on the HASBLED scale is 3 points.

Related:

diabetes mellitus type 2, insulin-requiring. Duodenal ulcer, without exacerbation. Chronic mixed gastritis.

Treatment in hospital: due to the presence of tachyform atrial fibrillation, the dose of bisoprolol was increased to 7.5 mg/day; For the first few days, intravenous furosemide was prescribed at a dose of 40 mg/day, followed by a transition to oral torsemide 10 mg/day. There was no significant decrease in creatinine levels after the administration of intravenous furosemide; creatinine clearance according to CKD-EPI was 24 ml/min (creatinine from 08/01/19 - 190 mlmol/l). After transferring the patient to an oral diuretic, it became possible to prescribe the drug sacubitril/valsartan (Uperio) 100 mg/day. Antiplatelet therapy was carried out with rivaroxaban 15 mg/day and clopidogrel 75 mg/day. The patient also received omeprazole 40 mg/day for gastroprotection and amoxiclav 3 g/day due to the presence of trophic ulcers.

After 7 days of therapy

Complaints of general weakness persist, shortness of breath at rest does not bother him, pain in the legs, mainly at night.

Objective status:

the condition is relatively satisfactory. The patient is conscious and moves around within the ward. The skin and mucous membranes are pale in color and clean. Edema of the lower extremities has regressed, some pastiness remains. Breathing in the lungs is harsh, somewhat weakened in the lower sections. Heart sounds are muffled, irregular, there is no noise. Heart rate 80 beats/min. Blood pressure 110/70 mm Hg. The abdomen is not enlarged, soft, painless. Stool and diuresis are not disturbed.

Laboratory tests indicate a decrease in creatinine to 120 mmol/l, urea 15.0, natriuretic peptide BNP 2000.2 pg/ml, glucose 10 mmol/l, potassium 4.9 mmol/l, ALT 9 mmol/l, AST 25 mmol/l.

Instrumental studies: ECG dated 09/05/18 - atrial fibrillation, heart rate 80 beats/min. On a repeat X-ray of the chest organs dated 09/07/18: positive dynamics of stagnant changes. Positive dynamics on EchoCG: improvement in LV myocardial contractility, increase in EF up to 50%, decrease in pressure in the pulmonary artery, resolution of hydropericardium and hydrothorax on the left.

Due to the stabilization of the patient’s condition and a decrease in creatinine levels during treatment, it became possible to conduct angiography of the vessels of the lower extremities. The patient was transferred to the surgery department, where recanalization, balloon angioplasty and stenting of the right superficial femoral artery were performed, Abbott SUPERA 5.0×200 mm stents were implanted distally, Abbott SUPERA 6.0×150 mm proximally. After the operation, the patient noted a decrease in pain.

Overdose

Symptoms: marked decrease in blood pressure, bradycardia.

Treatment: carry out symptomatic therapy. If there is a pronounced decrease in blood pressure, the patient should be placed in a horizontal position with his legs elevated. If bradycardia develops, intravenous administration of atropine at a dose of 0.5–1 mg is indicated. If this is not enough, it is necessary to increase the volume of blood plasma by infusion of a solution of dextrose (glucose), sodium chloride or dextran. Symptomatic drugs with a predominant effect on alpha-adrenergic receptors are used when the above measures are ineffective.

Felodip overdose, symptoms and treatment

Symptoms: arterial hypotension and bradycardia. Treatment: the stomach is washed, activated carbon is used, and the patient is subsequently placed in an intensive observation room to monitor the function of the cardiovascular and respiratory systems. In case of severe arterial hypotension, it is necessary to place the patient in a horizontal position with the lower limbs raised upward, increase the volume of blood plasma by administering a physiological solution of sodium chloride, glucose, dextran; introduce sympathomimetics: norepinephrine, mesaton, dopamine, dobutamine, as well as calcium chloride. In case of bradycardia, AV block of II–III degree, or the appearance of asystole, atropine sulfate, norepinephrine or calcium chloride is administered intravenously. If necessary and if indicated, an artificial pacemaker is used.

special instructions

The drug Felodip, as well as other vasodilators, can in rare cases cause significant arterial hypotension, which in some predisposed patients can lead to the development of myocardial ischemia. Currently, there is no data on the advisability of using the drug as secondary prevention of myocardial infarction.

The drug Felodip is effective and well tolerated by patients regardless of gender and age, as well as by patients with concomitant diseases such as bronchial asthma and other lung diseases; impaired renal function; diabetes; gout; hyperlipidemia; Raynaud's syndrome, as well as after lung transplantation.

The drug Felodip does not affect the concentration of glucose in the blood and the lipid profile.

Impact on the ability to drive vehicles and work with equipment. Patients who experience weakness or dizziness during treatment with Felodip should avoid performing activities that require increased concentration and speed of psychomotor reactions.