Trandolapril & Verapamil

Trandolapril/verapamil is a prescription medication used to treat high blood pressure. It is a single tablet containing 2 medications, trandolapril and verapamil. Trandolapril, an angiotensin converting enzyme (ACE) inhibitor, and verapamil, a calcium channel blocker, both work by relaxing veins and arteries so that blood can more easily pass through them.

This medication comes in an extended release tablet form and is taken once or twice a day with food.

Common side effects of trandolapril/verapamil include constipation, nausea, and diarrhea. Trandolapril/verapamil can cause dizziness. Do not drive or operate heavy machinery until you know how trandolapril/verapamil affects you.

Trandolapril/verapamil is a prescription medication used to treat high blood pressure, medically known as hypertension.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Take trandolapril/verapamil exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose range for trandolapril is 1 to 4 mg given once a day or divided into smaller doses given twice a day.

The recommended dose range for verapamil is 120 to 480 mg given once a day or divided into smaller doses given twice a day.

Starting dose and dose adjustments may be done based on the severity of your condition, response to the medication, age, liver function, kidney function, heart condition, and other medications you may be taking.

WARNING: FETAL TOXICITY

• When pregnancy is detected, discontinue trandolapril/verapamil as soon as possible.
• Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Serious side effects have been reported with trandolapril/verapamil including:

• congestive heart failure (CHF). Tell your healthcare provider right away if you experience any of the following symptoms of CHF:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing to use more pillows to go to sleep or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• hypotension. Hypotension, or low blood pressure, may cause you to feel faint or dizzy. Inadequate fluid intake, excessive sweating, diarrhea, or vomiting can lead to an excessive fall in blood pressure too. Lie down if you feel faint or dizzy. Call your doctor right away.
• liver problems. Your doctor may want to closely monitor liver function tests. Tell your healthcare provider right away if you experience any of the following symptoms of liver problems:
  • a general feeling of discomfort, illness, or lack of well-being (malaise)
  • fever
  • right upper abdominal (stomach area) pain
• new irregular heartbeats. Tell your healthcare provider right away if you experience any of the following symptoms of an irregular heartbeat, medically known as an arrhythmia:
  • fast or slow heart beat
  • skipping beats
  • lightheadedness or dizziness
  • chest pain
  • shortness of breath
  • sweating
• angioedema (a severe allergic reaction). Tell your healthcare provider right away if you have signs or symptoms of angioedema, which include:
  • swelling of face, eyes, lips, tongue, larynx and extremities
  • difficulty in swallowing or breathing
  • hoarseness (having difficulty making sounds when trying to speak)
• neutropenia (a decreased amount of white blood cells). Report any sign of infection such as sore throat or fever, which may be a signs of neutropenia.

Trandolapril/verapamil can cause dizziness. Do not drive or operate heavy machinery until you know how trandolapril/verapamil affects you.

Do not take trandolapril/verapamil if you:

• are allergic to trandolapril/verapamil or any of this medication’s ingredients
• are taking aliskiren and are also diagnosed with diabetes
• have severe left ventricular dysfunction
• have low blood pressure (systolic pressure less than 90 mm Hg) or cardiogenic shock
• have sick sinus syndrome (except in patients with a functioning artificial pacemaker)
• have second- or third-degree AV block (except in patients with a functioning artificial pacemaker)
• have atrial flutter or atrial fibrillation and an accessory bypass tract such as Wolff-Parkinson-White or Lown-Ganong-Levine syndromes

Serious side effects have been reported with trandolapril/verapamil. See the “Drug Precautions” section.

Common side effects of trandolapril/verapamil include:

• constipation
• nausea
• diarrhea
• dizziness
• fatigue
• cough

This is not a complete list of trandolapril/verapamil side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that block the enzyme CYP3A4 such as  some macrolide antibiotics (clarithromycin, telithromycin, erythromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan, delavirdine, and nefazodone
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's wort, and nimodipine (Nimotop)
• anti-arrhythmic (irregular heartbeat) medications such as disopyramide (Norpace), flecainide (Tambocor), and quinidine
• medications that treat high blood pressure such vasodilators, angiotensin-converting enzyme inhibitors (ACEIs), diuretics, beta blockers, and angiotensin receptor blockers (ARBs)
• lithium
• theophylline
• digoxin (Lanoxin)
• cimetidine (Tagamet)
• simvastatin (Zocor)
• atorvastatin (Lipitor)
• colchicine (Colchrys)
• the immunosuppressant medications cyclosporine (Neoral, Gengraf, Sandimmune), tacrolimus (Prograf), and sirolimus (Rapamune)
• antidepressants such as buspirone (Buspar) and imipramine (Tofranil)
• midazolam (Versed)

This is not a complete list of trandolapril/verapamil drug interactions. Ask your doctor or pharmacist for more information.

 

Tell your doctor if you are pregnant or plan to become pregnant. Trandolapril/verapamil is not usually recommended for use during pregnancy. See the “FDA Warning” section.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Trandolapril/verapamil falls into category D. See the "Trandolapril/verapamil FDA Warning" section for details.

Tell your doctor if you are breastfeeding or plan to breastfeed.

This medication is excreted in human milk. Because of the potential for adverse reactions in nursing infants from trandolapril/verapamil, nursing should be stopped while trandolapril/verapamil is being taken.

Avoid using salt substitutes containing potassium while taking trandolapril/verapamil.

Avoid over the counter medications for cough/cold. Ask your doctor or pharmacist what over the counter medications you can take.

Report facial swelling, difficulty breathing, infection to your doctor.