What is happening. Green tea catechins can inhibit intestinal organic anion transporting polypeptides and may modestly affect CYP3A4 and P-glycoprotein, with the potential to alter felodipine absorption. Concentrated green tea extracts in supplement form deliver far higher catechin loads than brewed tea and carry an established risk of hepatotoxicity that can complicate the picture.
Mechanism. Green tea polyphenols (notably EGCG) can inhibit drug transporters and modulate CYP3A4 in the gut, potentially changing the oral exposure of CYP3A4 substrates such as felodipine; the high-potency extract also poses an independent hepatotoxicity risk.
Recommendation. Be cautious with high-dose green tea extract supplements while on felodipine. Separate ingestion from the dose where possible, watch for changes in blood pressure or unexpected adverse effects, and report signs of liver injury such as dark urine, jaundice, or abdominal pain.