trandolapril, Mavik (cont.)

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Trandolapril can cause an increase in the amount of lithium (Lithobid, Eskalith) 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.

There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors. Combining trandolapril or other ACE inhibitors with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.

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 trandolapril. Low white blood cells increase the risk of infections. Trandolapril may cause hypersensitivity reactions and angioedema (swelling of face, lips, tongue, throat).

Reference: FDA Prescribing Information

Last Editorial Review: 6/28/2012

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