FELODIPINE tablet, film coated, extended release

Felodipine by

Drug Labeling and Warnings

Felodipine by is a Prescription medication manufactured, distributed, or labeled by NCS HealthCare of KY, Inc dba Vangard Labs. Drug facts, warnings, and ingredients follow.

Drug Details [pdf]

Nursing Mothers

It is not known whether this drug is secreted in human milk and because of the potential for serious adverse reactions from felodipine in the infant, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

Clinical studies of felodipine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Pharmacokinetics, however, indicate that the availability of felodipine is increased in older patients (see CLINICAL PHARMACOLOGY: Geriatric Use). In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

  • ADVERSE REACTIONS

    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 extended-release 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, 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 extended-release, 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).

    Percent of Patients with Adverse Events in Controlled Trials* of Felodipine Extended-Release (N = 861) as Monotherapy without Regard to Causality (Incidence of discontinuations shown in parentheses)
  • * Patients in titration studies may have been exposed to more than one dose level of felodipine extended-release tablets.
  •  Body System
    Adverse Events
     Placebo
    N = 334
     2.5 mg
    N = 255
     5 mg
    N = 581
     10 mg
    N = 408
     Body as a Whole
     Peripheral Edema 3.3 (0) 2 (0) 8.8 (2.2) 17.4 (2.5)
     Asthenia 3.3 (0) 3.9 (0) 3.3 (0) 2.2 (0)
     Warm Sensation 0 (0) 0 (0) 0.9 (0.2) 1.5 (0)
     Cardiovascular
     Palpitation 2.4 (0) 0.4 (0) 1.4 (0.3) 2.5 (0.5)
     Digestive
     Nausea 1.5 (0.9) 1.2 (0) 1.7 (0.3) 1 (0.7)
     Dyspepsia 1.2 (0) 3.9 (0) 0.7 (0) 0.5 (0)
     Constipation 0.9 (0) 1.2 (0) 0.3 (0) 1.5 (0.2)
     Nervous
     Headache 10.2 (0.9) 10.6 (0.4) 11 (1.7) 14.7 (2)
     Dizziness 2.7 (0.3) 2.7 (0) 3.6 (0.5) 3.7 (0.5)
     Paresthesia 1.5 (0.3) 1.6 (0) 1.2 (0) 1.2 (0.2)
     Respiratory
     Upper Respiratory Infection 1.8 (0) 3.9 (0) 1.9 (0) 0.7 (0)
     Cough 0.3 (0) 0.8 (0) 1.2 (0) 1.7 (0)
     Rhinorrhea 0 (0) 1.6 (0) 0.2 (0) 0.2 (0)
     Sneezing 0 (0) 1.6 (0) 0 (0) 0 (0)
     Skin
     Rash 0.9 (0) 2 (0) 0.2 (0) 0.2 (0)
     Flushing 0.9 (0.3) 3.9 (0) 5.3 (0.7) 6.9 (1.2)

    Adverse events that occurred in 0.5% up to 1.5% of patients who received felodipine extended-release 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 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 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.

  • OVERDOSAGE

    Oral doses of 240 mg/kg and 264 mg/kg in male and female mice, respectively, and 2390 mg/kg and 2250 mg/kg in male and female rats, respectively, caused significant lethality.

    In a suicide attempt, one patient took 150 mg felodipine together with 15 tablets each of atenolol and spironolactone and 20 tablets of nitrazepam. The patient's blood pressure and heart rate were normal on admission to hospital; he subsequently recovered without significant sequelae.

    Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly bradycardia.

    If severe hypotension occurs, symptomatic treatment should be instituted. The patient should be placed supine with the legs elevated. The administration of intravenous fluids may be useful to treat hypotension due to overdosage with calcium antagonists. In case of accompanying bradycardia, atropine (0.5 mg to 1 mg) should be administered intravenously. Sympathomimetic drugs may also be given if the physician feels they are warranted.

    It has not been established whether felodipine can be removed from the circulation by hemodialysis.

    To obtain up-to-date information about the treatment of overdose, consult your Regional Poison-Control Center. Telephone numbers of certified poison-control centers are listed in the Physicians' Desk Reference (PDR). In managing overdose, consider the possibilities of multiple-drug overdoses, drug-drug interactions, and unusual drug kinetics in your patient.

  • DOSAGE AND ADMINISTRATION

    The recommended starting dose is 5 mg once a day. Depending on the patient's response, the dosage can be decreased to 2.5 mg or increased to 10 mg once a day. These adjustments should occur generally at intervals of not less than 2 weeks. The recommended dosage range is 2.5 mg to 10 mg once daily. In clinical trials, doses above 10 mg daily showed an increased blood pressure response but a large increase in the rate of peripheral edema and other vasodilatory adverse events (see ADVERSE REACTIONS). Modification of the recommended dosage is usually not required in patients with renal impairment.

    Felodipine extended-release tablets should regularly be taken either without food or with a light meal (see CLINICAL PHARMACOLOGY, Pharmacokinetics and Metabolism). Felodipine extended-release tablets should be swallowed whole and not crushed or chewed.

    Geriatric Use

    Patients over 65 years of age are likely to develop higher plasma concentrations of felodipine (see CLINICAL PHARMACOLOGY). In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range (2.5 mg daily). Elderly patients should have their blood pressure closely monitored during any dosage adjustment.

    Patients with Impaired Liver Function

    Patients with impaired liver function may have elevated plasma concentrations of felodipine and may respond to lower doses of felodipine extended-release tablets; therefore, patients should have their blood pressure monitored closely during dosage adjustment of felodipine extended-release tablets (see CLINICAL PHARMACOLOGY).

  • HOW SUPPLIED

    Felodipine Extended-release Tablets, USP are available containing 2.5 mg, 5 mg or 10 mg of felodipine, USP.

    The 2.5 mg tablet is a white film-coated, round, unscored tablet debossed with M on one side of the tablet and F11 on the other side.

    The 5 mg tablet is a yellow film-coated, round, unscored tablet debossed with M on one side of the tablet and F12 on the other side. They are available as follows:

    NDC: 0615-6573-39 blistercards of 30 tablets

    The 10 mg tablet is a blue film-coated, round, unscored tablet debossed with M on one side of the tablet and F13 on the other side. They are available as follows:

    NDC: 0615-6572-39 blistercards of 30 tablets

    Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]

    Protect from light.

    Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

    Mylan Pharmaceuticals Inc.
    Morgantown, WV 26505

    OCTOBER 2009
    FLDP:R2

  • PRINCIPAL DISPLAY PANEL -5mg

    Felodipine ER Tabs, USP 5mg

  • PRINCIPAL DISPLAY PANEL -10mg

    Felodipine ER Tabs, USP 10mg

  • INGREDIENTS AND APPEARANCE
    FELODIPINE 
    felodipine tablet, film coated, extended release
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC: 0615-6573(NDC: 0378-5012)
    Route of AdministrationORAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    FELODIPINE (UNII: OL961R6O2C) (FELODIPINE - UNII:OL961R6O2C) FELODIPINE5 mg
    Inactive Ingredients
    Ingredient NameStrength
    BUTYLATED HYDROXYANISOLE (UNII: REK4960K2U)  
    BUTYLATED HYDROXYTOLUENE (UNII: 1P9D0Z171K)  
    SILICON DIOXIDE (UNII: ETJ7Z6XBU4)  
    HYPROMELLOSES (UNII: 3NXW29V3WO)  
    CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U)  
    POLYDEXTROSE (UNII: VH2XOU12IE)  
    POLYETHYLENE GLYCOLS (UNII: 3WJQ0SDW1A)  
    POVIDONES (UNII: FZ989GH94E)  
    SODIUM STEARYL FUMARATE (UNII: 7CV7WJK4UI)  
    TITANIUM DIOXIDE (UNII: 15FIX9V2JP)  
    D&C YELLOW NO. 10 (UNII: 35SW5USQ3G)  
    FD&C BLUE NO. 2 (UNII: L06K8R7DQK)  
    FD&C YELLOW NO. 6 (UNII: H77VEI93A8)  
    Product Characteristics
    ColorYELLOWScoreno score
    ShapeROUNDSize11mm
    FlavorImprint Code M;F12
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC: 0615-6573-3930 in 1 BLISTER PACK
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    ANDAANDA07885511/16/2009
    FELODIPINE 
    felodipine tablet, film coated, extended release
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC: 0615-6572(NDC: 0378-5013)
    Route of AdministrationORAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    FELODIPINE (UNII: OL961R6O2C) (FELODIPINE - UNII:OL961R6O2C) FELODIPINE10 mg
    Inactive Ingredients
    Ingredient NameStrength
    BUTYLATED HYDROXYANISOLE (UNII: REK4960K2U)  
    BUTYLATED HYDROXYTOLUENE (UNII: 1P9D0Z171K)  
    SILICON DIOXIDE (UNII: ETJ7Z6XBU4)  
    HYPROMELLOSES (UNII: 3NXW29V3WO)  
    CELLULOSE, MICROCRYSTALLINE (UNII: OP1R32D61U)  
    POLYDEXTROSE (UNII: VH2XOU12IE)  
    POLYETHYLENE GLYCOLS (UNII: 3WJQ0SDW1A)  
    POVIDONES (UNII: FZ989GH94E)  
    SODIUM STEARYL FUMARATE (UNII: 7CV7WJK4UI)  
    TITANIUM DIOXIDE (UNII: 15FIX9V2JP)  
    FD&C BLUE NO. 2 (UNII: L06K8R7DQK)  
    FD&C YELLOW NO. 6 (UNII: H77VEI93A8)  
    Product Characteristics
    ColorBLUEScoreno score
    ShapeROUNDSize11mm
    FlavorImprint Code M;F13
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC: 0615-6572-3930 in 1 BLISTER PACK
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    ANDAANDA07885511/16/2009
    Labeler - NCS HealthCare of KY, Inc dba Vangard Labs (050052943)
    Establishment
    NameAddressID/FEIBusiness Operations
    NCS HealthCare of KY, Inc dba Vangard Labs050052943RELABEL(0615-6573, 0615-6572) , REPACK(0615-6573, 0615-6572)

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