The effects of felodipine on the pharmacokinetics of diazepam

Twelve consenting, caucasian male volunteers participated in a double-blind, randomized, crossover study of the effects of felodipine, a calcium antagonist, on the pharmacokinetics of diazepam. There were two trial periods of 12 days each with a wash-out period of 9 days between them (total duration: 12 + 12 + 9 = 33 days). During the 12-day periods they received either felodipine or placebo each morning under fasting conditions. On day 6 of each of the two 12-day periods, diazepam, 10 mg was injected i.v. 30 minutes after the felodipine/placebo. Diazepam and desmethyldiazepam concentrations were measured in plasma up to 168 hours after the injection. Diazepam plasma concentrations and pharmacokinetic parameters were not affected by the concomitant medication with felodipine. However, the co-administration of felodipine increased desmethyldiazepam plasma concentrations relative to placebo: mean area under the plasma concentration-time curve of 4,910 vs 5,581 ng.h/ml and mean peak concentrations of 40 vs 47 ng/ml. Felodipine might cause a retarded elimination of desmethyldiazepam, possibly by obtruding the formation of oxazepam. The clinical relevance of these findings remains to be elucidated.