Trandolapril and Verapamil

Trandolapril and verapamil is a combination drug, taken orally, and utilised to combat high blood pressure, or hypertension, in patients.

Overview

High blood pressure is known to increase the workload of the arteries and heart and, if left unchecked, the heart and arteries might no longer function properly. This can cause damage to blood vessels found in the brain, kidneys, and heart, potentially resulting in a stroke, renal failure, or heart failure. Successfully lowering blood pressure will reduce the risk of heart attacks and strokes.

The two ingredients – trandolapril and verapamil – work in conjunction with one another to reduce blood pressure.

Trandolapril is an ACE (angiotensin-converting enzyme) inhibitor, which works by blocking certain substances in the patient’s body that cause their blood vessels to tighten.

Verapamil, on the other hand, is a CCB (calcium channel blocker), which works by affecting calcium in the patient’s body, and how it moves into the blood vessel and heart cells.

The effects of these two drugs, both individually and taken together, is to relax the patient’s blood vessels, increase the flow of oxygen and blood to the heart, and lower blood pressure.

Trandolapril and verapamil is only available with a prescription from your doctor, or other healthcare professional.

Conditions Treated

  • hypertension (high blood pressure)

Type of Medicine

  • angiotensin-converting enzyme (ACE) inhibitor [trandolapril]
  • calcium channel blocker (CCB) [verapamil]

Side Effects

As with any medication, trandolapril and verapamil, along with their expected and required effects, may cause some side effects that are less welcome. It is the responsibility of the patient to discuss with their prescribing doctor whether the desired result of this course of treatment outweighs the potential side effects.

Trandolapril and verapamil have several serious side effects reported in patients. Whilst it is unlikely that all of these effects will occur with any given patient, should they do so, you may require medical attention.

You should check with your prescribing doctor straight away should any of the following occur:

  • chest pains
  • chills
  • cough (with mucus)
  • dark urine
  • fever
  • general feeling of illness or discomfort
  • fainting, or lightheadedness
  • pains to the right-hand side of the stomach or abdomen
  • shortness of breath
  • slow heartbeat
  • sore throat
  • sudden trouble with breathing or swallowing, accompanied by hoarseness
  • swelling of the face, hands, mouth, or feet
  • wheezing
  • yellow eyes or skin

Trandolapril and verapamil are also reported to have some side effects that would not typically require medical attention. Such effects might go away during the course of treatment as the patient’s body adjusts to the medication. Additionally, your doctor or health care professional might be able to advise you on ways to reduce or prevent some of these side effects. If any of the following side effects should continue, or are particularly bothersome, you should check with your prescribing doctor:

  • constipation
  • cough (dry, continuous)
  • diarrhea
  • dizziness
  • itching
  • nausea
  • pains in the arms and/or legs, or joint pain
  • unusual tiredness

Other side effects may occur, which are not listed above. If you notice any unusual effects that only started with your course of treatment, be sure to check with your healthcare professional.

Dosage

You should always follow your doctor's instructions, or the directions printed on the label, as dosage for this type of medication varies from patient to patient. The following information shows the average doses for this medicine only. If your dose differs from that shown here, you should not change it, unless told to by your prescribing doctor.

The amount of trandolapril and verapamil you take will depend on how strong the medicine is. Similarly, the time allowed in between doses, the number of doses your doctor tells you to take, and the length of your full course of medication, will all depend on the specific medical condition you are currently suffering from.

Adults: 1 or 2 tablets each day

Children: dosage and use must be determined by the prescribing doctor

If you happen to miss a dose of trandolapril and verapamil, you should take it as soon as you can. However, should it be nearly time for the next dose, you should skip the missed dose, returning to your regular dosage schedule. Under no circumstances should you double doses.

Major Drug Interactions

There are certain medicines that should never be used together, as they, or their effects, interact negatively with one another. In certain situations, two different medications might still be used in conjunction with one another, even if an interaction is likely. In such cases, your prescribing doctor will likely change the dose or one or other of the medications, or suggest other precautions you can take throughout the course of treatment.

When prescribed trandolapril and verapamil, it is essential that your doctor knows if you are currently taking any of the drugs listed here. This is a selective list, based on known interactions and their potential significance, and it is not necessarily all-inclusive.

Using trandolapril and verapamil with the following medications is not recommended. Your prescribing doctor may choose not to treat you with this particular medicine, or to alter the other medications you take.

  • aliskiren
  • colchicine
  • dofetilide
  • flibanserin
  • lomitapide
  • sacubitril

Using trandolapril and verapamil with the following medications is typically not recommended, but in some cases it may be necessary. If both drugs are prescribed at the same time, your doctor might change the dosage, or frequency of use of one or both of the medications.

  • acebutolol
  • adenosine
  • afatinib
  • alprenolol
  • alteplase, Recombinant
  • amiloride
  • amiodarone
  • apixaban
  • aprepitant
  • atazanavir
  • atenolol
  • atorvastatin
  • azathioprine
  • azilsartan
  • azilsartan medoxomil
  • betaxolol
  • bevantolol
  • bisoprolol
  • bosutinib
  • brexpiprazole
  • bucindolol
  • bupivacaine
  • bupivacaine liposome
  • candesartan cilexetil
  • canrenoate
  • carbamazepine
  • carteolol
  • carvedilol
  • celiprolol
  • ceritinib
  • cilostazol
  • clarithromycin
  • clonidine
  • clopidogrel
  • clozapine
  • cobimetinib
  • conivaptan
  • crizotinib
  • cyclobenzaprine
  • dabigatran etexilate
  • dantrolene
  • digoxin
  • dilevalol
  • domperidone
  • doxorubicin
  • doxorubicin hydrochloride liposome
  • dronedarone
  • eliglustat
  • eplerenone
  • eprosartan
  • erythromycin
  • esmolol
  • everolimus
  • fentanyl
  • fingolimod
  • fosaprepitant
  • hydrocodone
  • ibrutinib
  • idelalisib
  • ifosfamide
  • irbesartan
  • ivabradine
  • ivacaftor
  • ketoconazole
  • labetalol
  • lacosamide
  • levobunolol
  • lithium
  • losartan
  • lovastatin
  • lurasidone
  • mepindolol
  • mepivacaine
  • mercaptopurine
  • metipranolol
  • metoprolol
  • morphine
  • morphine sulfate liposome
  • nadolol
  • naloxegol
  • nebivolol
  • nilotinib
  • olaparib
  • olmesartan medoxomil
  • oxprenolol
  • penbutolol
  • pindolol
  • piperaquine
  • pixantrone
  • potassium
  • propranolol
  • ranolazine
  • simeprevir
  • simvastatin
  • sirolimus
  • sonidegib
  • sotalol
  • spironolactone
  • tacrolimus
  • talinolol
  • telmisartan
  • tertatolol
  • timolol
  • tizanidine
  • tolvaptan
  • topotecan
  • triamterene
  • trimethoprim
  • valsartan
  • venetoclax
  • vincristine
  • vincristine sulfate liposome

Using trandolapril and verapamil with the following medication might see an increase in the risk of certain side effects. However, using both drugs together might be the best course of treatment for your condition. If both medications are prescribed at the same time, your doctor may choose to change the dosage or frequency of use for one or both of them:

  • aceclofenac
  • acemetacin
  • amtolmetin Guacil
  • azosemide
  • bromfenac
  • bufexamac
  • bumetanide
  • bupivacaine
  • bupivacaine liposome
  • buspirone
  • capsaicin
  • celecoxib
  • choline salicylate
  • clonixin
  • cyclosporine
  • dalfopristin
  • dexibuprofen
  • dexketoprofen
  • diclofenac
  • diflunisal
  • digitoxin
  • dipyrone
  • droxicam
  • dutasteride
  • ethacrynic acid
  • etodolac
  • etofenamate
  • etoricoxib
  • felbinac
  • fenoprofen
  • fepradinol
  • feprazone
  • flecainide
  • floctafenine
  • flufenamic acid
  • flurbiprofen
  • fosphenytoin
  • furosemide
  • gold sodium thiomalate
  • ibuprofen
  • indinavir
  • indomethacin
  • ketoprofen
  • ketorolac
  • lithium
  • lornoxicam
  • loxoprofen
  • lumiracoxib
  • meclofenamate
  • mefenamic acid
  • meloxicam
  • midazolam
  • morniflumate
  • nabumetone
  • naproxen
  • nepafenac
  • nesiritide
  • nevirapine
  • niflumic acid
  • nimesulide
  • nimesulide beta cyclodextrin
  • oxaprozin
  • oxcarbazepine
  • oxyphenbutazone
  • pancuronium
  • parecoxib
  • phenobarbital
  • phenylbutazone
  • phenytoin
  • piketoprofen
  • piretanide
  • piroxicam
  • proglumetacin
  • propionic acid
  • propyphenazone
  • quinidine
  • quinupristin
  • rofecoxib
  • salicylic acid
  • salsalate
  • sirolimus
  • sodium salicylate
  • St John's Wort
  • sulindac
  • suvorexant
  • tedisamil
  • telithromycin
  • tenoxicam
  • tiaprofenic acid
  • tolfenamic acid
  • tolmetin
  • torsemide
  • tubocurarine
  • valdecoxib
  • vecuronium

When using trandolapril and verapamil, it is also advisable to avoid using tobacco, as negative interactions have been observed among smokers. Likewise, ethanol and grapefruit juice have also exhibited negative interactions with the drugs.

Warnings

Aside from the drug interactions listed above, there are certain other issues you should raise with your doctor before beginning a course of trandolapril and verapamil.

If you have had an allergic or other unusual reaction to this medication, or any other medicine before, you should inform your doctor. You should also advise them of any other allergies you might have: to dyes, foods, animals, or preservatives, for instance.

Studies among pregnant women have demonstrated some risk to the fetus. It may be decided, however, that the benefit of treatment in a serious, or life-threatening situation, might outweigh the potential risk.

Other medical conditions might affect the use of trandolapril and verapamil. If you suffer from any of the following ailments, you should let your doctor know immediately:

  • history of angioedema (a swelling of the lips, throat, face, tongue, legs, or arms) with other ACE inhibitors
  • AV block, without a pacemaker
  • cardiogenic shock (a shock caused by a heart attack)
  • diabetes, if you are also taking aliskiren
  • severe heart disease (left ventricular dysfunction, for instance)
  • heart rhythm problems (including Wolff-Parkinson-White syndrome, atrial flutter, Lown-Ganong-Levine sydrome, and atrial fibrillation)
  • hypotension (low blood pressure)
  • sick sinus syndrome (anabnormal heart rhythm), without a pacemaker
  • collagen vascular disease, together with kidney disease
  • congestive heart failure
  • diabetes
  • kidney problems
  • Duchenne's muscular dystrophy (a muscle problem)
  • electrolyte imbalance (including low levels of salt, sodium, or potassium in the body)
  • fluid imbalance (owing to excessive vomiting, perspiration, diarrhea)
  • heart disease (such as hypertrophic cardiomyopathy)
  • heart rhythm problems (including prolonged PR interval)
  • kidney disease
  • liver disease

It is vital that your prescribing doctor check your progress regularly to ensure the medication is working correctly. Blood tests may be required to confirm the existence of unwanted effects.

Dizziness, lightheadedness, and fainting have been known to occur with this drug. Be sure you know your reaction to the medication before driving, using machines, or doing anything else that may be dangerous should you become dizzy, or not alert. Should you feel dizzy, you should lie down so you don’t faint. If you do faint, you should stop using this medication and immediately call your doctor right away.

Check with your doctor immediately if you become sick during your course of treatment, especially if it involves severe or continuing diarrhea, vomiting, or nausea. This may cause loss of salt or water, potentially leading to low blood pressure.

Inform your doctor right away should you exhibit any symptoms of liver problems, including pale stools, dark-colored urine, vomiting, nausea, loss of appetite, yellow skin or eyes, or a pain in your upper stomach.

Hyperkalemia (high levels of potassium in the blood) might occur whilst using this medicine. Check with your doctor immediately should you have any of the following symptoms: stomach or abdominal pain, difficulty with breathing, confusion, an irregular heartbeat, vomiting or nausea, nervousness, tingling or numbness in the hands, lips, or feet, weakness, or heaviness of the legs, or sudden shortness of breath. Do not use any supplements or salt substitutes that contain potassium without checking first with your prescribing doctor.

Ensure any doctor or dentist treating you is aware that you’re using this medication, as it might affect other medical procedures.

Do not take other medication unless discussed with your prescribing doctor, including over-the-counter medicines.

Storage

Trandolapril and verapamil should be stored in a closed container, away from heat, direct light, and moisture, at room temperature. It should be kept from freezing, and kept away from children’s reach. Outdated, or no longer needed medication should be disposed of immediately. Speak to your prescribing doctor on the best way to do so.

Summary

Trandolapril and verapamil is a useful and effective course of treatment for patients suffering from hypertension, though it is generally not the first course of action taken by a healthcare professional to treat the condition. The two drugs combined into one tablet means that the blood vessels are affected in two distinct ways to help lower the pressure. This does mean that trandolapril and verapamil is susceptible to negative interactions with a host of other drugs, as well as a number of unwanted side effects, owing to its dual action.

That said, the drug has been proven to be remarkably effective where other more pedestrian courses of treatment have failed.

Resources
Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
Content Source: