Medications and Drugs
GENERIC NAME: trandolapril
BRAND NAME: Mavik
DRUG CLASS AND MECHANISM: Trandolapril is a drug that is used to lower blood pressure. Blood pressure is dependent on the degree of constriction (narrowing) of the arteries and veins. The narrower the arteries and veins, the higher the blood pressure. Angiotensin II is a chemical substance made in the body that causes the muscles in the walls of arteries and veins to contract, narrowing the arteries and veins and thereby elevating blood
pressure. Angiotensin II is formed by an enzyme called angiotensin converting enzyme (ACE). Trandolapril is an inhibitor of ACE and blocks the formation of angiotensin II thereby lowering blood pressure. The drop in blood pressure also means that the heart doesn't have to work as hard because the pressure it must pump blood against is less. The efficiency of a failing heart improves, and the output of blood from the heart increases. Thus, ACE inhibitors such as trandolapril are useful in treating heart failure. Other ACE inhibitors include
enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril; Prinivil),
benazepril (Lotensin), ramipril (Altace), and quinapril (Accupril).
Trandolapril was approved by the FDA in 1996.
GENERIC AVAILABLE: no
PRESCRIPTION: yes
PREPARATIONS: Tablets: 1mg (salmon), 2mg (yellow), 4mg (rose).
STORAGE: Tablets should be stored at room temperature,
15 -30 °C (59-86 °F).
PRESCRIBED FOR: Trandolapril can be used alone in treating high
blood pressure. Its blood pressure lowering effect can be further enhanced
by the addition of a diuretic medication ("water pill"), such as
hydrochlorothiazide. Trandolapril also can be useful in the treatment of congestive heart failure, and ACE inhibitors have been shown to reduce symptoms
and hospitalization and improve survival in patients with heart failure. After a heart
attack, ACE inhibitors have been found to be effective in improving the
function of the damaged heart, and in reducing symptoms and
hospitalizations related to heart failure.
DOSING: Trandolapril is taken once or twice daily.
African-American patients generally require higher doses than do
Caucasians. Food reduces the amount of trandolapril that is absorbed, so it
is best to take this medication one hour before or two hours after meals.
Patients with advanced renal or liver diseases may need to take lower doses.
DRUG INTERACTIONS: Although the combination of ACE inhibitors
and diuretics is generally beneficial (see above), trandolapril and
other ACE inhibitors can interact with diuretics to cause an excessive drop
in blood pressure, causing symptoms of weakness, dizziness, and
lightheadedness. This is most likely to occur when patients who are already
taking a diuretic are started on an ACE inhibitor. Combining
trandolapril with potassium supplements, potassium containing salt
substitutes, or potassium-conserving diuretics such as amiloride (Moduretic), spironolactone
(Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of blood potassium. It is
recommended that trandolapril not be taken at the same time as aluminum- or
magnesium- based antacids, such as Mylanta or Maalox; these antacids
bind to trandolapril in the intestine and decrease its absorption into the body. Therefore, patients should
separate doses of antacids and trandolapril by at least two
hours. Trandolapril can cause an increase in the amount of lithium in the body in
patients taking lithium, sometimes with associated side effects of lithium
toxicity. Nitritoid reactions (with symptoms of facial flushing, nausea,
vomiting and low blood pressure) may occur when injectable gold (sodium
aurothiomalate)
for the treatment of rheumatoid arthritis is combined with ACE inhibitors including trandolapril.
PREGNANCY: ACE inhibitors, including trandolapril, can be harmful
to the fetus and should not be taken by pregnant women.
NURSING MOTHERS: Trandolapril is secreted in breast
milk and is
not recommended for nursing mothers.
SIDE EFFECTS: Trandolapril is generally well tolerated. The
most common side effects are headache, cough, dizziness, diarrhea, fatigue,
nausea, vomiting, complaints of sexual dysfunction, and abnormal liver tests.
Impairment of kidney function has been reported with ACE inhibitors, especially
in patients with severe heart failure or pre-existing kidney disease. In rare
instances, low white blood cell counts have been reported with the use of
captopril, another ACE inhibitor. Low white blood cells increase the risk of
infections.
Reference: FDA Prescribing Information
Last Editorial Review: 2/6/2000 10:53:00 PM
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
Latest Medical News
Back to Medications Index
High Blood Pressure RSS