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- What is trandolapril, and how does it work (mechanism of action)?
- What brand names are available for trandolapril?
- Is trandolapril available as a generic drug?
- Do I need a prescription for trandolapril?
- What are the side effects of trandolapril?
- What is the dosage for trandolapril?
- Which drugs or supplements interact with trandolapril?
- Is trandolapril safe to take if I'm pregnant or breastfeeding?
- What else should I know about trandolapril?
What is trandolapril, and how does it work (mechanism of action)?
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:
- 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).
Quick GuideHow to Lower Blood Pressure: Exercise Tips
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.
Which drugs or supplements 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.
What else should I know about trandolapril?
What preparations of trandolapril are available?
Tablets: 1, 2, and 4 mg.
How should I keep trandolapril stored?
Tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
Reference: FDA Prescribing Information
Quick GuideHow to Lower Blood Pressure: Exercise Tips
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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Top trandolapril Related ArticlesComplete List
ACE inhibitors, or angiotensin (generic name) converting enzyme inhibitors, is a class of drugs that interact with blood enzymes to enlarge or dilate blood vessels and reduce blood pressure. These drugs are used to:
- Control high blood pressure (hypertension)
- Treat of heart failure and ventricular dysfunction
- Prevent and treat of kidney disease in people with diabetes or hypertension.
These drugs also improve the survival rate of people who have survived heart attacks and they prevent early death of people from heart attacks, high blood pressure, and heart failure. Sometimes ACE inhibitors are combined with other drugs for treating a condition. Examples of ACE inhibitors include:
- benazepril (Lotensin)
- captopril (Capoten)
- enalapril (Vasotec)
- fosinopril (Monopril)
- ramipril (Altace)
Examples of the most common side effects of this class of drugs are:
- chest pain,
- and rash.
There are serious side effects of this drug like
- kidney failure,
- severe allergic reactions,
- and liver dysfunction or failure.
ACE inhibitors all are similar in the way they work; however, they differ in how the body eliminates doses of the drug. Drug interactions, dosage, and pregnancy and safety information should be reviewed prior to taking this medication.
Congestive Heart Failure (CHF) OverviewCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
Febrile SeizuresFebrile seizures, or convulsions caused by fever, can be frightening in small children or infants. However, in general, febrile seizures are harmless. Febrile seizure is not epilepsy. It is estimated that one in every 25 children will have at least one febrile seizure. It is important to know what to do to help your child if he/she has a febrile seizure. Some of the features of a febrile seizure include:
- losing consciousness,
- moving limbs on both sides of the body,
- lasts 1-2 minutes.
Heart AttackHeart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Heart Attack and Atherosclerosis Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience:
- Extreme fatigue
- Pain in the upper abdomen
Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
High Blood Pressure HypertensionHigh blood pressure is defined as a pressure of 140/90 mmHg or higher in the arteries. Genetic factors, high salt intake, and increased arterial stiffness cause high blood pressure. Dizziness, headache, nausea, and shortness of breath are just a few symptoms of high blood pressure. Untreated high blood pressure increases the risk of heart disease, kidney disease, atherosclerosis, eye damage, stroke, and increased risk of aneurysms. High blood pressure can be managed with weight loss, lifestyle changes, and medication.
High Blood Pressure Medication
High blood pressure (hypertension) medications include drugs from a variety of different drug classes and types.
- ACE inhibitors
- ARB (angiotensin receptor blockers)
- Beta blockers
- Calcium channel blockers (CCBs)
- Alpha-beta blockers
Clonidine (Catapres) and minoxidil also are drugs prescribed for the treatment of high blood pressure. Side effects, warnings and precautions, safety information, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.
High Blood Pressure TreatmentHigh blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Hypertension PictureHigh blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90. See a picture of Hypertension and learn more about the health topic.
Kidney FailureKidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure are:
- multiple myeloma, and
- acute glomerulonephritis.
- bladder obstruction,
- prostate problems,
- tumors, or
- kidney stones.
Lisinopril (Zestril, Prinivil, Qbrelis) is an ACE inhibitor prescribed for the treatment of:
- High blood pressure
- Heart failure
- Heart attack survival
- Preventing kidney failure due to high blood pressure
Side effects are, nasal congestion, anxiety, headaches, insomnia, drowsiness, and nausea. ACE inhibitors may cause a nonproductive cough that resolves once you stop taking the drug. Drug interactions include potassium supplements or derivatives of potassium, lithium (Eskalith, Lithobid), nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen), and symptoms of flushing; high blood pressure; nausea; and vomiting. Warnings and precautions, pregnancy information, and other safety information should be reviewed prior to taking any medication.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Pregnancy Drug DangersTaking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.