Plendil can affect this through 2 different nutrient pathways: Calcium, Magnesium. This medication is commonly used for Hypertension.
Each nutrient below contributes to this impact through a different mechanism.
In adults, chronically low calcium intake can quietly erode skeletal integrity, contributing to osteopenia, osteoporosis, and a higher risk of low‑trauma fractures over time. In children, inadequate calcium (often alongside vitamin D deficiency) impairs normal mineralization of the growing skeleton, leading to rickets with bone pain, deformities, and delayed growth, while in adults the same process manifests as osteomalacia with diffuse bone pain and muscle weakness rather than early fractures. The encouraging reality is that optimizing daily calcium intake, paired with sufficient vitamin D, protein, and weight‑bearing activity, has been shown to improve bone mineral density and meaningfully reduce fracture risk in at‑risk populations.
Bischoff-Ferrari HA, Rees JR, Grau MV, Barry E, Gui J, Baron JA. Effect of calcium supplementation on fracture risk: a double-blind randomized controlled trial. Am J Clin Nutr. 2008 Jun;87(6):1945-51. Cong B, Zhang H. The effects of combined calcium and vitamin D supplementation on bone mineral density and fracture risk in postmenopausal women with osteoporosis: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2025 Oct 8;26(1):928. Heaney RP. Lifelong calcium intake and prevention of bone fragility in the aged. Calcif Tissue Int. 1991;49 Suppl:S42-5. Arnaud, C. D., Sanchez, S. D. The Role of Calcium in Osteoporosis. September 6, 2013. NASA. Lyndon B. Johnson Space Center, Spacelab Life Sciences 1: Reprints of Background Life Sciences Publications. Cairoli E, Aresta C, Giovanelli L, Eller-Vainicher C, Migliaccio S, Giannini S, Giusti A, Marcocci C, Gonnelli S, Isaia GC, Rossini M, Chiodini I, Di Stefano M; Italian Society for Osteoporosis, Mineral Metabolism, Skeletal Diseases (SIOMMMS). Dietary calcium intake in a cohort of individuals evaluated for low bone mineral density: a multicenter Italian study. Aging Clin Exp Res. 2021 Dec;33(12):3223-3235. Uday S, Högler W. Nutritional Rickets and Osteomalacia in the Twenty-first Century: Revised Concepts, Public Health, and Prevention Strategies. Curr Osteoporos Rep. 2017 Aug;15(4):293-302.
Low or depleted magnesium levels are associated with a higher risk of osteoporosis and fractures, with studies linking magnesium deficiency to a 25–35% increased risk of hip, wrist, and spine fractures in some populations. Magnesium deficiency impairs bone mineralization and vitamin D activation, compounding skeletal weakness by disrupting osteoblast function and calcium balance. This is particularly concerning for older adults or those with additional risk factors, where monitoring magnesium status and considering supplementation may help mitigate bone loss.
Front Pharmacol. 2025 May 12;16:1592048. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr. 2009 Apr;28(2):131-41. Liu L, Luo P, Wen P, Xu P. The role of magnesium in the pathogenesis of osteoporosis. Front Endocrinol (Lausanne). 2024 Jun 6;15:1406248. Li S, Chang W, Wu G, Wang K, Sun X, Sun H, Zhou J. Association between magnesium deficiency scores and hip bone health in adults: a population-based study. Magnes Res. 2025 Dec 1;38(3):81-94. Belluci MM, de Molon RS, Rossa C Jr, Tetradis S, Giro G, Cerri PS, Marcantonio E Jr, Orrico SRP. Severe magnesium deficiency compromises systemic bone mineral density and aggravates inflammatory bone resorption. J Nutr Biochem. 2020 Mar;77:108301.
Some side effects may be linked to nutrient depletion caused by this medication.
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.
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.