In some patients, significant calcium deficiency can culminate in hypocalcemia that presents with neuromuscular irritability, including perioral numbness, carpopedal spasm, frank tetany, and potentially generalized seizures or life‑threatening arrhythmias. Clinical data in children with hypocalcemic seizures suggest that, once acute stabilization is achieved, carefully dosed oral calcium can be as effective as continued intravenous calcium in maintaining serum calcium over the first 24–48 hours, with similar calcium levels and seizure‑recurrence rates reported between groups. The key clinical implication is that prompt recognition and correction of hypocalcemia, followed by an appropriate transition to ongoing oral calcium (and vitamin D when indicated), can help prevent recurrent tetany, seizures, and cardiac instability while longer‑term etiologies of calcium deficiency are addressed. This medication is commonly used for Hypertension.
Han, P., Trinidad, B. J., & Shi, J. (2015). Hypocalcemia-Induced Seizure: Demystifying the Calcium Paradox. ASN Neuro, 7(2). Uday S, Högler W. Nutritional rickets & osteomalacia: A practical approach to management. Indian J Med Res. 2020 Oct;152(4):356-367. Ashwin Reddy S. Ventricular Arrhythmia Precipitated by Severe Hypocalcaemia Secondary to Primary Hypoparathyroidism. Case Rep Cardiol. 2019 Apr 7;2019:4851073. Dhir H, Kumar D, Shah D, Batra P, Ahmed RS, Gupta P. Efficacy of Oral vs. Intravenous Calcium Supplementation for Continuation Therapy in Hypocalcemic Seizures: A Randomized, Controlled Trial. Indian J Pediatr. 2023 May;90(5):433-437.
Some side effects may be linked to nutrient depletion caused by this medication.
An increased excretion of potassium can occur in people taking calcium channel blocker drugs like felodipine. Supplementation may need to be considered if blood levels of potassium are low.
Studies suggest that Felodipine, a type of calcium channel blocker (CCB), may increase the excretion of calcium in the urine. While the long-term effects on bone health are unclear, some healthcare professionals suggest calcium supplementation for patients taking felodipine, especially those at higher risk of osteoporosis.
Research suggests that Felodipine, a type of calcium channel blocker (CCB), may increase the excretion of magnesium in the urine. This can potentially lead to magnesium deficiency. Studies have shown an increase in fractional excretion of magnesium following felodipine treatment, and the drug may also alter how magnesium moves across red blood cell membranes. Therefore supplementation with magnesium should be considered when on this therapy.