trandolapril
Trandolapril is a prescription medication that's used to treat high blood pressure (hypertension). It's also used to lower the risk of death and hospitalization in people with heart failure after a heart attack. Trandolapril is taken by mouth, typically once daily. Although the brand name for this medication (Mavik) has been discontinued, trandolapril is available as a lower-cost generic tablet. Common side effects include dry cough and dizziness.
What is Trandolapril?
What is Trandolapril used for?
- Treatment of high blood pressure
- Lowering the risk of death and hospitalization in people with certain types of heart failure after a recent heart attack
How Trandolapril works
Trandolapril is an angiotensin-converting enzyme (ACE) inhibitor. It works by blocking a hormone called angiotensin II. The main role of angiotensin II is to narrow your blood vessels, which can raise your blood pressure and cause your heart to work harder to pump out blood to the rest of your body. By blocking this hormone, trandolapril relaxes your blood vessels, which helps to lower your blood pressure and stress on your heart.
Drug facts
Side effects of Trandolapril
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Cough (35%)
- Dizziness (23%)
- Higher uric acid levels (15%)
- Low blood pressure (11%)
Please note: The side effects above were reported by people taking this medication to lower the risk of death and hospitalization in certain heart failures after recent heart attack.
Less Common Side Effects
- Indigestion
- Fainting
- Slow heart rate
- Muscle pain
Trandolapril serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema (severe swelling): swelling of the face, arms or legs, lips, tongue, or throat
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
- Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
- High blood potassium levels: nausea, muscle weakness, abnormal heartbeat
- Serious liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
The following Trandolapril side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision
confusion
difficulty with breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
irregular heartbeat
nervousness
numbness or tingling in the hands, feet, or lips
stomach pain
sweating
unusual tiredness or weakness
vomiting
weakness or heaviness of the legs
Less common
Chest pain or discomfort
cool, sweaty skin
difficulty with speaking
double vision
inability to move the arms, legs, or facial muscles
muscle cramps in the hands, arms, feet, legs, or face
numbness and tingling around the mouth
seizures
slow heartbeat
stomach cramps
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Trandolapril
Pros
- Available as a lower-cost generic medication
- Only taken once a day
- Can help protect the kidneys in people with diabetes and high blood pressure
Cons
- More likely to cause dry cough compared to angiotensin II receptor blockers (ARBs)
- Can’t take while pregnant
- Requires regular blood work to make sure your kidneys are healthy
Pharmacist tips for Trandolapril
- You can track how well trandolapril is working to control your blood pressure by checking your blood pressure regularly at home. Write down your blood pressure readings and bring them to your appointments with your provider so you can discuss how well trandolapril is working for you.
- Let your provider know if you develop a dry cough after starting trandolapril since it's a common side effect of this medication. If your dry cough doesn't go away, your provider might suggest a different treatment option.
- Trandolapril works to lower your blood pressure, but this can cause dizziness and lightheadedness. These are more likely to happen if you're suddenly standing up from a sitting or lying down position. Make sure to get up slowly from these positions after taking trandolapril. Tell your provider if you experience fainting or dizziness while taking this medication.
- Make sure to drink enough water to stay hydrated while you're taking trandolapril, especially on hot days or after exercising. Dehydration can raise your risk of kidney damage during treatment with this medication. In addition, your blood pressure might also drop too much if you don't have enough fluids in your body. This can worsen dizziness and raise your risk of falls.
- Mark your calendar with your appointments to see your provider and to get any blood work done when you take trandolapril. Your provider might order tests (e.g., potassium level, kidney health, blood pressure) during treatment and might change your dose of this medication based on your lab results or tests.
- Don't take trandolapril if you're pregnant since it can cause harm to the unborn baby. If you're pregnant or thinking of getting pregnant during treatment, contact your provider right away. Your provider might prescribe you a different medication that's safer during pregnancy or suggest lifestyle changes.
Common questions about Trandolapril
No, trandolapril isn't a beta blocker, but both medications can be used in people with high blood pressure or heart failure. Trandolapril is an ACE inhibitor, which works by relaxing your blood vessels by blocking a hormone (angiotensin II) from squeezing your blood vessels. If you're taking trandolapril to lower blood pressure and it's not enough on its own, your provider might prescribe additional blood pressure-lowering medications, such as a beta blocker, to help. Similarly, trandolapril and metoprolol succinate (Toprol XL), a beta blocker, are both used to lower the risk of death in people with certain types of heart failure.
People who took trandolapril in clinical studies didn't report erectile dysfunction (ED) as a side effect. While other blood pressure medications can cause ED, trandolapril isn't known to cause this side effect. Talk to your provider if you experience ED while taking trandolapril; they can see what might be the cause and recommend some treatment options.
Yes, trandolapril and verapamil can be taken together. In fact, there's a medication that combines the two ingredients together (trandolapril/verapamil). Typically, you might take the two medications together if your blood pressure is not controlled on one medication alone. Each medication works differently to lower your blood pressure. Talk to your provider to see whether a combination of trandolapril and verapamil is part of your treatment plan.
Rarely, trandolapril can cause high potassium levels. In fact, all ACE inhibitors can raise your risk for high potassium levels. Your risk of this side effect is higher if you're also taking other medications that can raise your potassium levels. During treatment with trandolapril, your provider will probably order blood work regularly to make sure your potassium levels are within a safe range. Talk to your provider right away if you have symptoms of nausea, vomiting, trouble breathing, and chest pain. Don't start any new medications or supplements without talking to your provider first.
It's best to avoid or limit drinking alcohol if you're taking trandolapril. In general, alcohol raises your risk of high blood pressure. In addition, if you've heart failure, drinking too much alcohol can raise the risk of alcoholic cardiomyopathy, which is when your heart is damaged from too much alcohol. If you drink alcohol regularly and it's difficult for you to cut it out completely, ask your provider what's a safer amount to drink.
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Risks and warnings for Trandolapril
Trandolapril can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Harm to unborn baby
Taking trandolapril during second and third trimesters of pregnancy might raise the risk for birth defects, such as small skull, low blood pressure, and kidney failure. Because of this potential risk, if you find out that you're pregnant while taking this medication, stop and let your provider know right away. If you're pregnant or are planning to become pregnant, discuss safer treatment options with your provider.
Angioedema (swelling)
- Risk factors: Black people | History of angioedema | Taking Entresto (sacubitril / valsartan)
People who take medications that contain an ACE inhibitor, like trandolapril, can experience a rare, but serious side effect called angioedema. Angioedema is a medical condition that involves swelling in different parts of the body, including the face, throat, tongue, and guts. In particular, swelling of the tongue or throat can be life-threatening, since it can lead to difficulty breathing. Get medical attention right away if you experience swelling in the facial area, as well as belly pain, nausea, vomiting, or shortness of breath. Your provider will ask you to stop taking trandolapril and monitor you until these symptoms go away.
Low blood pressure
- Risk factors: Dehydration (e.g., diarrhea, vomiting) | Low salt levels in your body | People on dialysis | Taking diuretics for a long time
Sometimes, taking trandolapril can cause your blood pressure to drop too much. This can cause you to feel dizzy, tired, or lightheaded. Low blood pressure is more common in the first 2 weeks of starting trandolapril and when your dose goes up. Make sure to stay well-hydrated during treatment. Don't get up suddenly from a sitting or lying down position, since this can cause your blood pressure to drop quickly. If you frequently feel dizzy, lightheaded, faint, tired, or confused while taking trandolapril, let your provider know.
Liver problems
- Risk factor: History of liver problems
In some rare cases, people who took ACE inhibitors, like trandolapril, have developed a blocked bile duct. This can lead to severe liver problems or liver failure. Although it's not clear how trandolapril can cause these problems, make sure to let your provider know if you have belly pain, tiredness, or yellowing of your skin and the whites of your eyes.
Worsening kidney problems
- Risk factors: Severe heart failure | Kidney problems | Taking diuretics
Trandolapril can usually improve blood flow to the kidneys, which is good for people with high blood pressure and chronic kidney problems. But in some cases, trandolapril can make kidney problems worse. The risk is higher for people who have certain medical conditions, such as blockage of the kidney artery or severe heart failure. As a result, your provider might order lab tests before and during treatment to make sure your kidneys are healthy and working properly. Let your provider know if you're urinating less often than usual, feeling tired, nauseous, or have chills. These can be symptoms of kidney damage.
In some rare cases, if you've kidney problems and lupus, taking medications like trandolapril might lower your white blood cell counts or cause bone marrow suppression, which can lead to blood problems. Tell your provider about your full medical history before starting trandolapril.
High levels of potassium
- Risk factors: Diabetes | Kidney problems | Taking other medications that also raise potassium
Very rarely, trandolapril can raise the amount of potassium in your body, which can be dangerous. Your risk of developing high potassium is greater if you've diabetes, kidney problems, or are taking other medications that also raise potassium levels. For this reason, make sure your provider knows your full medical history and what medications you're taking before starting trandolapril. If you experience signs of high potassium, such as nausea, muscle weakness, or abnormal heartbeat, tell your provider right away.
Dry cough
Trandolapril can cause you to develop a dry cough. This is because it blocks a protein called bradykinin, which cause your airways to narrow, leading to a cough. Typically, dry cough goes away after you stop taking trandolapril. If you notice a dry cough after starting this medication, let your provider know.
Trandolapril dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1mg | 90 tablets | $24.72 | $0.27 |
| 2mg | 90 tablets | $24.46 | $0.27 |
| 4mg | 90 tablets | $27.40 | $0.30 |
Typical dosage for Trandolapril
-
High blood pressure: Most people start with 1 mg to 2 mg by mouth once daily. Your provider will raise your dose after a week if you need to lower your blood pressure more. The usual dosage range is 2 mg to 4 mg by mouth once daily. The maximum dose is 8 mg daily.
-
Heart failure after a heart attack: Most people start with 1 mg by mouth once daily. Your provider will raise your dose until you reach the typical maintenance dose of 4 mg by mouth once daily.
Your dose might differ depending on your ethnicity, if you have kidney or liver problems, or if you're taking a diuretic (water pill).
Interactions between Trandolapril and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Aliskiren
- Sacubitril
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alteplase, Recombinant
- Amiloride
- Azathioprine
- Azilsartan
- Azilsartan Medoxomil
- Candesartan Cilexetil
- Canrenoate
- Eplerenone
- Eprosartan
- Everolimus
- Irbesartan
- Lithium
- Losartan
- Mercaptopurine
- Olmesartan Medoxomil
- Potassium
- Potassium Phosphate
- Sirolimus
- Spironolactone
- Telmisartan
- Triamterene
- Trimethoprim
- Valsartan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Azosemide
- Bromfenac
- Bufexamac
- Bumetanide
- Bupivacaine
- Bupivacaine Liposome
- Capsaicin
- Celecoxib
- Choline Salicylate
- Clonixin
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Diflunisal
- Dipyrone
- Droxicam
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Floctafenine
- Flufenamic Acid
- Flurbiprofen
- Furosemide
- Gold Sodium Thiomalate
- Ibuprofen
- Indomethacin
- Ketoprofen
- Ketorolac
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Morniflumate
- Nabumetone
- Naproxen
- Nepafenac
- Nesiritide
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Oxaprozin
- Oxyphenbutazone
- Parecoxib
- Phenylbutazone
- Piketoprofen
- Piretanide
- Piroxicam
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Rofecoxib
- Salicylic Acid
- Salsalate
- Sodium Salicylate
- Sulindac
- Tenoxicam
- Tiaprofenic Acid
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Valdecoxib
How much does Trandolapril cost?
$24.46
Trandolapril contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Trandolapril will not be safe for you to take.
- History of angioedema (e.g., puffy or swollen face, swollen hands or feet)
- Take with aliskiren (Tekturna) in people who have diabetes
- Take within 36 hours of Entresto (sacubitril / valsartan)
What are alternatives to Trandolapril?
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