Trandolapril

For treatment of high blood pressure, the recommended adult starting dose is 1 mg once daily with increases in dose every 2 to 4 weeks until blood pressure is controlled. The maximum recommended dose is 4 mg once daily. After a heart attack, the recommended starting dose is 1 mg once daily starting no earlier than the third day after the heart attack has taken place. After 2 days, the recommended dose is increased to 2 mg once daily and after one month, the recommended dose is increased to 4 mg once daily if the medication is tolerated.

Trandolapril may be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Trandolapril exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Trandolapril at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause indigestion; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may alter your sense of taste; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; on occasion, it may cause a dry cough - contact your pharmacist or doctor if it becomes bothersome. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

0.5 mg
Each size no. 2, hard gelatin capsule with a light scarlet opaque body and rich yellow opaque cap, contains 0.5 mg of trandolapril. Nonmedicinal ingredients: dimeticone, microcrystalline cellulose, lactose monohydrate, starch pregelatinized, colloidal silicon dioxide, magnesium stearate, and empty gelatin capsules; capsule: gelatin, titanium dioxide, erythrosine, sunset yellow, and quinoline yellow.

1 mg
Each size no. 2, hard gelatin capsule with a light scarlet opaque body and light orange opaque cap, contains 1 mg of trandolapril. Nonmedicinal ingredients: dimeticone, microcrystalline cellulose, lactose monohydrate, starch pregelatinized, colloidal silicon dioxide, magnesium stearate, and empty gelatin capsules; capsule: gelatin, titanium dioxide, erythrosine, and sunset yellow.

2 mg
Each size no. 2, hard gelatin capsule with a light scarlet opaque body and light scarlet opaque cap, contains 2 mg of trandolapril. Nonmedicinal ingredients: dimeticone, microcrystalline cellulose, lactose monohydrate, starch pregelatinized, colloidal silicon dioxide, magnesium stearate, and empty gelatin capsules; capsule: gelatin, titanium dioxide, erythrosine, and sunset yellow.

4 mg
Each size no. 2, hard gelatin capsule with a Swedish orange opaque body and Swedish orange opaque cap, contains 4 mg of trandolapril. Nonmedicinal ingredients: dimeticone, microcrystalline cellulose, lactose monohydrate, starch pregelatinized, colloidal silicon dioxide, magnesium stearate, and empty gelatin capsules; capsule: gelatin, titanium dioxide, erythrosine, red iron oxide, and yellow iron oxide.

Do not take trandolapril if you:

• are allergic to trandolapril or any ingredients of the medication
• are allergic to any other ACE inhibitors
• are pregnant or plan to become pregnant
• are breast-feeding
• are taking the medication sacubitril - Valsartan
• are taking the medication Aliskiren or another ACE inhibitor or an angiotensin receptor blocker (ARB) and have one of the following conditions:
  • Diabetes
  • Kidney Disease
  • high levels of potassium in the blood
  • have congestive heart failure combined with Low Blood Pressure
• have been diagnosed with hereditary angioedema
• have severely low blood pressure
• have any condition that makes you intolerant to lactose
• have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) after taking any other ACE inhibitors (e.g., Captopril, Ramipril)
• have narrowing of the blood vessels in the kidneys

There may be an interaction between trandolapril and any of the following:

• acetylsalicylic acid (Asa)
• alcohol
• Aldesleukin
• aliskiren
• Allopurinol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
• angiotensin II receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• antacids (e.g., calcium carbonate, magnesium hydroxide)
• Azathioprine
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Cyclosporine
• dexmethylphenidate
• diabetes medications (e.g., Canagliflozin, chlorpropamide, glipizide, Glyburide, insulin, Metformin, Rosiglitazone)
• diazoxide
• Dipyridamole
• diuretics (water pills; e.g., Furosemide, Amiloride, Spironolactone, triamterene)
• drospirenone
• Duloxetine
• Eplerenone
• Everolimus
• gold salts
• grass pollen allergen extract
• Guanfacine
• Heparin
• iron dextran
• iron gluconate
• levodopa
• lithium
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• medications that increase blood levels of potassium (e.g., potassium chloride, salt substitutes containing potassium)
• medications that lower blood pressure
• Methylphenidate
• nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Indomethacin)
• Obinutuzumab
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pregabalin
• sacubitril
• second generation anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Sirolimus
• sodium phosphates
• Tacrolimus
• Temsirolimus
• Tizanidine
• Tolvaptan
• Trimethoprim
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Trandolapril. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Trandolapril.

Angioedema: Angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) may occur with trandolapril, although uncommonly. Angioedema may also affect the digestive system. If swelling of the face, tongue, or glottis occurs, or you experience unexpected abdominal pain that may be accompanied by nausea or vomiting, stop the medication at once and seek immediate medical attention. If you experience angioedema with trandolapril, you should not take any of the other ACE inhibitors, such as Enalapril, Lisinopril, or Quinapril.

People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor such as trandolapril.

Blood disorders: In rare cases, a low white blood cell count has been reported by people taking Trandolapril. Your doctor may occasionally monitor your level of white blood cells by performing blood tests. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection (e.g., fever, sore throat), contact your doctor as soon as possible.

Cough: People taking trandolapril may develop a dry, persistent cough that usually disappears only after stopping or lowering the trandolapril dose. Be sure to tell your doctor of any cough which does not seem to be related to a usual cause.

Dizziness/reduced alertness: Trandolapril can cause side effects such as dizziness, drowsiness, headache or fatigue that may reduce alertness, especially when you first start to take Trandolapril. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by Trandolapril.

Fluid and electrolyte balance: Increases in blood levels of potassium may occur as a result of taking trandolapril. This rarely causes problems, but your doctor will probably want to monitor your potassium levels regularly with blood tests. If you experience unexplained nausea, fatigue, muscle weakness, or tingling sensations, contact your doctor.

Kidney function: Certain people who take Trandolapril may experience changes in kidney function. Some people may be more likely to experience changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe congestive heart failure). The use of diuretics (water pills), aliskiren, or nonsteroidal anti-inflammatory drugs (NSAIDs), may further increase risk of kidney problems for those at risk for this problem. If you have kidney disease, discuss with your doctor how Trandolapril may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trandolapril, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Trandolapril to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Trandolapril may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Trandolapril, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Trandolapril.

Trandolapril may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: Occasionally, blood pressure drops too low after taking trandolapril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren, water pills, have a salt restricted diet, are on dialysis, or are experiencing diarrhea or vomiting. These individuals should be monitored closely by their doctor for the first weeks of treatment and whenever the dose of the medication is increased. To reduce the risk of dizziness, get up slowly from a lying down or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.

Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.

Pregnancy: ACE inhibitors such as trandolapril may cause severe harm or death to a developing baby if taken by the mother during pregnancy. Trandolapril should not be used during pregnancy. If you become pregnant while taking Trandolapril, contact your doctor immediately.

Breast-feeding: Trandolapril passes into breast milk. If you are a breast-feeding mother and are taking trandolapril, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Trandolapril have not been established for children.

Seniors: Seniors may have an increased risk of experiencing side effects when taking trandolapril due to reduced kidney function. Lower doses may be necessary to minimize side effects.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.