Trandolapril

Trandolapril is a prescription medication used to treat high blood pressure (hypertension) and to improve survival after a heart attack.

• Trandolapril is available under the following different brand names: Mavik

Common side effects of Trandolapril include:

• dizziness
• drowsiness
• lightheadedness
• diarrhea
• dry cough
• blurred vision as the body adjusts to the medication

Serious side effects of Trandolapril include:

• cold symptoms (stuffy nose, sneezing, sore throat)
• muscle pain
• headache
• sleep problems (insomnia)
• upset stomach
• diarrhea
• constipation
• skin itching or rash
• fainting
• decreased sexual ability
• symptoms of a high potassium blood level (such as muscle weakness, slow or irregular heartbeat)
• changes in the amount of urine
• signs of infection (e.g., fever, chills, persistent sore throat)

Rare side effects of Trandolapril include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 1 mg
• 2 mg
• 4 mg

Hypertension

Adult dosage

• In patients not taking a diuretic
• Initial dose
  • 1 mg orally once a day in nonblack patients
  • 2 mg orally once a day in black patients
• Maintenance dose
  • 2 to 4 mg orally once a day; may divide every 12 hours if BP response diminishes

Congestive heart failure or left ventricular dysfunction post-MI

Adult dosage

• Initial: 1 mg orally once a day
• Maintenance: 4 mg orally once a day

Dosage Considerations – Should be Given as Follows:

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, healthcare provider, or pharmacist first.

• Trandolapril has severe interactions with the following drugs:
  • aliskiren
  • protein a column
  • sacubitril/valsartan
• Trandolapril has serious interactions with at least 38 other drugs
• Trandolapril has moderate interactions with at least 98 other drugs
• Trandolapril has minor interactions with at least 31 other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Hypersensitivity
• History of hereditary or angioedema associated with previous ACE inhibitor treatment
• Coadministration of neurolysin inhibitors (e.g., Sacubitril) with ACE inhibitors may increase angioedema risk; do not administer ACE inhibitors within 36 hours of switching to or from sacubitril/valsartan
• Bilateral renal artery stenosis
• Do not coadminister aliskiren in patients with diabetes mellitus or with renal impairment (i.e., GFR below 60 mL/min/1.73 m²)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Trandolapril?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Trandolapril?”

Cautions

• Less effective in people with dark skin tones
• Excessive hypotension if concomitant diuretics, hypovolemia, hyponatremia
• Renal impairment may occur
• Coadministration with mTOR inhibitors (eg, Temsirolimus, Sirolimus, Everolimus) may increase the risk for angioedema
• Neutropenia/agranulocytosis was reported
• Cough may occur within the first few months
• Cholestatic jaundice may occur
• Risk of hyperkalemia, especially in renal impairment, diabetes mellitus, or coadministration with potassium-elevating drugs
• ACE inhibition also causes increased bradykinin levels which putatively mediates angioedema, higher incidence of angioedema in black than nonblack patients
• Dual blockade of the renin-angiotensin system with ARBs, ACE inhibitors, or aliskiren is associated with increased risk for hypotension, hyperkalemia, and renal function changes (including acute renal failure) compared to monotherapy
• Intestinal angioedema is reported in patients treated with ACE inhibitors; it should be included in the differential diagnosis of patients, taking ACE inhibitors, and presenting with abdominal pain

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during 1st trimester; Use in LIFE-THREATENING emergencies when no safer drug is available during 2nd and 3rd trimesters
• Lactation
  • Possibly excreted in breast milk; nursing not recommended