PRECAUTIONS: This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: history of an allergic reaction which included swelling of the face/lips/tongue/throat (angioedema). Tell your doctor your medical history, including: any allergies, heart problems very low blood pressure, high blood levels of potassium, a salt restricted diet, liver disease, kidney disease, swelling disorder (angioedema), muscular disorders, diabetes, upcoming surgeries/anesthesia. To minimize dizziness and lightheadedness when rising from a seated or lying position, get up slowly. Verapamil prolongs and intensifies the effects of alcohol in your system. Avoid (or very carefully limit) alcoholic beverages while using this medication. Use caution when exercising or during hot weather as these can aggravate dizziness and light-headedness. Use caution performing tasks requiring alertness (e.g., driving) if drowsiness occurs. This product should be used only when clearly needed during the first three months of pregnancy, and is not recommended for use during the last six months of pregnancy. Discuss the risks and benefits with your doctor. Verapamil is known to be excreted into breast milk. It is unknown if trandolapril is excreted into breast milk. Because of the potential risk to the infant, breast-feeding while using this product is not recommended. Consult your doctor before you breast feed. Caution is advised when this medication is used in the elderly since this group may be more sensitive to drug side effects.

DRUG INTERACTIONS: Tell your doctor of all nonprescription and prescription medication you may use, especially of: diuretics (e.g., potassium sparing "water pills" such as spironolactone, triamterene, amiloride), potassium supplements, intravenous (IV) calcium, digoxin, lithium, trimethoprim-containing medications (e.g., sulfamethoxazole/trimethoprim), beta-blockers (e.g., propranolol, metoprolol, timolol), anti-arrhythmic heart drugs (e.g., disopyramide, flecainide, quinidine), rifampin, cyclosporine, theophylline, "NSAIDs" (e.g., ibuprofen, naproxen, ketoprofen), other high blood pressure drugs. Report other drugs which may cause drowsiness, such as: anti-anxiety or anti-seizure drugs (e.g., phenobarbital or carbamazepine), sedatives, tranquilizers, narcotic pain relievers, psychiatric medicines (e.g., chlorpromazine or amitriptyline), muscle relaxants, certain antihistamines (e.g., diphenhydramine) including those found in nonprescription cough- and-cold products. Avoid "stimulant" drugs that may increase your heart rate, such as decongestants or caffeine. Decongestants are commonly found in nonprescription cough/cold medications. Do not eat grapefruit or drink grapefruit juice unless your doctor instructs you otherwise. Do not start or stop any medicine without doctor or pharmacist approval.