What is trandolapril, and what is it used for?
Trandolapril is an oral drug that is used to treat high blood pressure. It belongs to a class of drugs called angiotensin converting enzyme (ACE) inhibitors. Other ACE inhibitors include enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril; Prinivil), benazepril (Lotensin), ramipril (Altace), and quinapril (Accupril). 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 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 in addition to high blood pressure, are also useful in treating heart failure. Trandolapril was approved by the FDA in 1996.
What are the side effects of trandolapril?
Trandolapril is generally well tolerated. The most common side effects are:
- headache,
- cough,
- dizziness,
- diarrhea,
- fatigue,
- nausea,
- vomiting,
- 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).
What is the dosage for trandolapril?
The recommended starting dose for treating high blood pressure in patients not receiving a diuretic is 1 mg once daily in Caucasian patients and 2 mg in black patients. Doses may be increased at weekly intervals.
Most patients require 2 to 4 mg daily, and there is no additional benefit from doses larger than 8 mg daily.
Patients receiving a diuretic should start at 0.5 mg daily if the diuretic cannot be stopped for 2 to 3 days before starting trandolapril.
For heart failure the starting dose is 1 mg once daily. The dose should be increased to 4 mg once daily or the largest tolerated dose.

SLIDESHOW
How to Lower Blood Pressure: Exercise and Tips See SlideshowWhich drugs interact with trandolapril?
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 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 (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.
Is trandolapril safe to take if I'm pregnant or breastfeeding?
ACE inhibitors, including trandolapril, can be harmful to the fetus and should not be taken by pregnant women.
Trandolapril is secreted in breast milk and is not recommended for nursing mothers.
Summary
Trandolapril (Mavik) is a medication prescribed for the treatment of high blood pressure, congestive heart failure, and after a heart attack to decrease the risk of death related to heart failure. Side effects, drug interactions, dosing information, and pregnancy safety should be reviewed prior to taking any medication.
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High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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Kidney (Renal) Failure
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Things to Know About High Blood Pressure Treatment
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Can High Blood Pressure Hurt My Eyes?
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Heart Attack Prevention
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Febrile Seizures
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What Is the Drug of Choice for Hypertension?
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What Causes High Blood Pressure in Children?
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What BP Is Hypertension?
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Medications & Supplements
- ACE Inhibitors
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Vasodilators
- Types of High Blood Pressure Medications
- Drug Interactions
- lisinopril (Zestril, Prinivil, Qbrelis) ACE Inhibitor
- ramipril
- Congestive Heart Failure Medications
- benazepril (Lotensin HTC)
- captopril (Capoten)
- enalapril (Vasotec, Epaned)
- quinapril (Accupril)
- lisinopril and hydrochlorothiazide (Zestoretic, Prinzide)
- fosinopril sodium, Monopril
- captopril and hydrochlorothiazide (Capozide)
- benazepril and hydrochlorothiazide (Lotensin HCT)
- enalapril and hydrochlorothiazide (Vaseretic)
- Side Effects of Mavik (trandolapril)
Prevention & Wellness

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.
REFERENCE:
FDA Prescribing Information