Plendil (Felodipine) vs. Other Hypertension Drugs: Full Comparison

Quick Summary

• Plendil (Felodipine) is a long‑acting calcium‑channel blocker used for high blood pressure.
• It works slower than amlodipine but offers a smoother blood‑pressure curve.
• Key alternatives include amlodipine, nifedipine, lercanidipine, ramipril, losartan, hydrochlorothiazide, and diltiazem.
• Choose based on half‑life, side‑effect profile, cost, and co‑existing conditions.
• Consult your prescriber before switching - some drugs interact with grapefruit, others affect kidney function.

What is Plendil (Felodipine)?

Felodipine is a long‑acting dihydropyridine calcium‑channel blocker (CCB) that relaxes arterial smooth muscle, lowering peripheral resistance and thus blood pressure. It was first approved in the UK in 1990 and is marketed under the brand name Plendil.

The usual starting dose for adults is 5mg once daily, with a typical maintenance range of 5‑10mg. Because its half‑life is about 20hours, the drug can be taken at any time of day without a strict schedule.

Common side effects include headache, flushing, ankle swelling, and occasional dizziness. These are generally milder than the rapid‑onset CCBs, which can cause a sudden drop in blood pressure.

How to Pick the Right Blood‑Pressure Pill

When comparing any antihypertensive you’ll weigh a handful of practical factors:

1. Pharmacokinetics - how quickly the drug works and how long it stays in the body.
2. Side‑effect profile - does the drug cause edema, cough, or metabolic changes?
3. Comorbidities - kidney disease, diabetes, or heart failure may steer you toward a specific class.
4. Cost and availability - generic versions are cheaper but may differ in formulation.
5. Drug interactions - grapefruit juice, CYP3A4 inhibitors, or other prescribed medicines can raise or lower levels.

Using these criteria, let’s see how the most common alternatives stack up.

Alternative Hypertension Drugs

Amlodipine is another dihydropyridine CCB, known for its very long half‑life (30‑50hours) and steady blood‑pressure control. It’s often the go‑to when a patient needs a once‑daily pill with minimal dosing fuss.

Nifedipine comes in both immediate‑release (IR) and sustained‑release (SR) forms. The IR version can cause sharp drops in pressure, so the SR version is preferred for hypertension.

Lercanidipine is a newer dihydropyridine that offers a gentle onset and lower incidence of ankle swelling. It’s taken once daily but is slightly more expensive than generic felodipine.

Ramipril belongs to the ACE‑inhibitor class. It works by blocking the conversion of angiotensin I to angiotensin II, reducing vasoconstriction. Ideal for patients with diabetic kidney disease.

Losartan is an angiotensin‑II receptor blocker (ARB). It provides similar blood‑pressure reductions as ACE inhibitors but causes far fewer cough side effects.

Hydrochlorothiazide is a thiazide diuretic that lowers blood volume. Often paired with a CCB or ACE‑inhibitor for synergistic effect, especially in resistant hypertension.

Diltiazem is a non‑dihydropyridine CCB that also slows heart rate. It’s useful when a patient has both high blood pressure and atrial tachyarrhythmia.

Side‑Effect Snapshot

Below is a quick look at the most frequently reported adverse events for each drug.

Head‑to‑Head Comparison: Key Attributes

When to Pick Felodipine Over the Rest

If you’re looking for a CCB that:

• Provides a steady drop in systolic pressure without a dramatic early dip,
• Has a relatively low incidence of peripheral edema compared with amlodipine,
• Works well in patients on multiple other meds (it has modest CYP3A4 interaction), and
• Is inexpensive as a generic in the UK market,

then felodipine is a solid choice. However, if you have a history of heart failure with reduced ejection fraction, an ACE‑inhibitor or ARB may give additional mortality benefit.

Safety, Interactions, and Monitoring

All antihypertensives need periodic checks. For felodipine, watch these labs:

• Baseline liver enzymes - rare hepatic metabolism issues.
• Serum electrolytes if combined with a diuretic.
• Blood pressure readings at 1, 4, and 12 weeks after initiation.

Key drug‑food interaction: grapefruit juice can raise felodipine levels by up to 30%. Avoid concurrent strong CYP3A4 inhibitors (e.g., clarithromycin) unless dosing is adjusted.

Other CCBs share similar interactions, but non‑dihydropyridine agents (diltiazem, verapamil) also affect cardiac conduction, so they’re contraindicated in certain AV‑block patients.

Frequently Asked Questions

Bottom Line

Felodipine (Plendil) sits comfortably between fast‑acting CCBs like nifedipine and ultra‑long agents like amlodipine. Its moderate half‑life, low edema risk, and cheap UK price make it a go‑to for many adults with uncomplicated hypertension. When comorbidities such as diabetes, heart failure, or severe renal impairment are present, alternatives like ramipril, losartan, or a thiazide diuretic may bring extra benefits.

Always review your personal health profile with a pharmacist or GP before swapping medications. The right drug is the one that fits your life, your labs, and your budget.