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Metabolism of felodipine is mediated by the cytochrome P450 (CYP) isoenzyme 3A4 and the possibility exists that drugs that inhibit this isoenzyme (e.g. ketoconazole, itraconazole, erythromycin, grapefruit juice, cimetidine) may increase plasma felodipine concentrations several fold which result in increased cardiac effects (e.g. decreases in blood pressure and increases in heart rate).
The possibility that felodipine may share the drug interaction potential of nifedipine, another 1,4-dihydropyridine derivative, also should be considered and the usual precautions observed.
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