Trandolapril

— THERAPEUTIC CATEGORIES —
  • CHF and arrhythmias
  • Hypertension

Trandolapril Generic Name & Formulations

General Description

Trandolapril 1mg+, 2mg, 4mg; tabs; +scored.

Pharmacological Class

ACE inhibitor.

How Supplied

Contact supplier

Trandolapril Indications

Indications

In stabilized patients after MI, who have LV systolic dysfunction or CHF symptoms.

Trandolapril Dosage and Administration

Adult

Initially 1mg once daily; titrate to 4mg once daily as tolerated. Renal dysfunction (CrCl <30mL/min) or hepatic cirrhosis: initially 0.5mg once daily.

Children

Not established.

Trandolapril Contraindications

Contraindications

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Trandolapril Boxed Warnings

Boxed Warning

Fetal toxicity.

Trandolapril Warnings/Precautions

Warnings/Precautions

Fetal toxicity may develop; discontinue if pregnancy is detected. Renal or hepatic impairment. Salt/volume depletion; correct prior to initiation. CHF. Avoid hypotension in CHF, aortic stenosis, ischemic heart disease, or cerebrovascular disease. Renal artery stenosis. Dialysis (esp. high-flux membrane). Diabetes. Surgery. Discontinue if laryngeal edema, angioedema, or jaundice occurs. Monitor WBCs in renal or collagen vascular disease. Monitor BP, electrolytes and renal function. Black patients may have higher risk of angioedema than non-Black patients. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.

Trandolapril Pharmacokinetics

See Literature

Trandolapril Interactions

Interactions

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+ supplements, K+-sparing diuretics, or salt substitutes. Excessive hypotension with diuretics, inhalation anesthetics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Potentiates insulin or oral hypoglycemic agents. Nitritoid reactions with injectable gold (sodium aurothiomalate); rare.

Trandolapril Adverse Reactions

Adverse Reactions

Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.

Trandolapril Clinical Trials

See Literature

Trandolapril Note

Notes

Formerly known under the brand name Mavik.

Trandolapril Patient Counseling

See Literature

Trandolapril Generic Name & Formulations

General Description

Trandolapril 1mg+, 2mg, 4mg; tabs; +scored.

Pharmacological Class

ACE inhibitor.

How Supplied

Contact supplier

Trandolapril Indications

Indications

Hypertension.

Trandolapril Dosage and Administration

Adult

If not on diuretic: initially 1mg once daily in non-black patients; 2mg in black patients. If on diuretic: suspend diuretic for 2–3 days before starting therapy; resume diuretic if BP not controlled with trandolapril alone. If diuretic cannot be discontinued (supervise closely until stabilized), or in renal impairment (CrCl <30mL/min) or hepatic cirrhosis: initially 0.5mg once daily. For all: adjust at 1-week intervals; usual range 2–4mg once daily; usual max 8mg/day; may give in 2 divided doses.

Children

Not established.

Trandolapril Contraindications

Contraindications

History of ACEI-associated or other angioedema. Concomitant aliskiren in patients with diabetes. Concomitant neprilysin inhibitor (eg, sacubitril); do not give within 36 hours of switching to or from sacubitril/valsartan.

Trandolapril Boxed Warnings

Boxed Warning

Fetal toxicity.

Trandolapril Warnings/Precautions

Warnings/Precautions

Fetal toxicity may develop; discontinue if pregnancy is detected. Renal or hepatic impairment. Salt/volume depletion; correct prior to initiation. CHF. Avoid hypotension in CHF, aortic stenosis, ischemic heart disease, or cerebrovascular disease. Renal artery stenosis. Dialysis (esp. high-flux membrane). Diabetes. Surgery. Discontinue if laryngeal edema, angioedema, or jaundice occurs. Monitor WBCs in renal or collagen vascular disease. Monitor BP, electrolytes and renal function. Black patients may have higher risk of angioedema than non-Black patients. Neonates. Pregnancy (Cat.D); avoid. Nursing mothers: not recommended.

Trandolapril Pharmacokinetics

See Literature

Trandolapril Interactions

Interactions

See Contraindications. Increased risk of angioedema with concomitant neprilysin inhibitor or mTOR inhibitor (eg, temsirolimus, sirolimus, everolimus). Dual inhibition of the renin-angiotensin system with ARBs, ACEIs, or aliskiren may increase risk of hypotension, hyperkalemia, renal function changes; monitor closely. Avoid concomitant aliskiren in renal impairment (CrCl <60mL/min). Hyperkalemia with K+ supplements, K+-sparing diuretics, or salt substitutes. Excessive hypotension with diuretics, inhalation anesthetics. May increase lithium levels. May be antagonized by, and renal toxicity potentiated by NSAIDs, including selective COX-2 inhibitors (monitor renal function in elderly and/or volume-depleted). Potentiates insulin or oral hypoglycemic agents. Nitritoid reactions with injectable gold (sodium aurothiomalate); rare.

Trandolapril Adverse Reactions

Adverse Reactions

Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.

Trandolapril Clinical Trials

See Literature

Trandolapril Note

Notes

Formerly known under the brand name Mavik.

Trandolapril Patient Counseling

See Literature