trandolapril / verapamil

Trandolapril/verapamil can cause severe and sometimes life-threatening harm to an unborn baby if the medication is taken during pregnancy. Because of this potential risk, you should avoid taking trandolapril/verapamil while pregnant.

Stop taking trandolapril/verapamil and tell your care team right away if you find out that you're pregnant while you're taking this medication. Your prescriber can recommend safer blood pressure medications for you if you're pregnant or planning to become pregnant.

• Risk factors: History of angioedema | Black people | Taking Entresto (sacubitril / valsartan) | Taking sirolimus (Rapamune) or everolimus (Zortress, Affinitor)

Angioedema is a rare but serious side effect of ACE inhibitors, such as trandolapril in trandolapril/verapamil. It causes swelling in different parts of the body, like the face, throat, tongue, arms, legs, and stomach. Swelling of the throat or tongue can be life-threatening since it can make it hard to breathe. You're more likely to experience angioedema if you're Black or of older age.

Stop taking trandolapril/verapamil and get medical help right away if you have trouble breathing, swelling of the face or tongue, or belly pain. These can be signs of angioedema. The medical team can help manage these symptoms.

• Risk factors: Heart failure | Taking beta blockers

Some people who took verapamil (an ingredient in trandolapril/verapamil) had heart failure. This is because verapamil can affect how well the heart pumps blood to the rest of the body.

Tell your prescriber before you start taking trandolapril/verapamil if you have heart failure or if you're taking a beta blocker. People with severe heart failure or people who are taking beta blockers shouldn't take trandolapril/verapamil because the medication can make the heart work even less well.

Let your care team know right away if you have symptoms of heart failure, such as trouble breathing, tiredness, dizziness, swelling in your body, or sudden weight gain.

• Risk factors: Dehydration (e.g., diarrhea, vomiting) | Low-salt diet | Heart failure | People on dialysis | Taking diuretics for a long time

Sometimes, taking trandolapril/verapamil can cause your blood pressure to drop too much. Low blood pressure can make you feel dizzy, tired, or lightheaded.

Make sure to stay well hydrated while you're taking trandolapril/verapamil to make sure your blood pressure doesn't drop too low. Lie down if you feel dizzy, lightheaded, or faint. Then, get up slowly when you feel better. Let your healthcare team know if you feel dizzy, lightheaded, tired, or confused often while you're taking trandolapril/verapamil.

• Risk factors: Having medical conditions that slow your heart rate | Taking beta blockers or digoxin (Lanoxin)

Although rare, trandolapril/verapamil can slow down your heart rate and cause heart block. When your heart beats too slowly, you might feel weak or lightheaded or even pass out.

You have a higher risk of a slow heart rate while you're taking trandolapril/verapamil if you also take other medications that slow your heart, like digoxin (Lanoxin) or beta blockers. The risk is also higher if you have other health problems that affect your heart rate or rhythm.

Tell your healthcare team about all the medical conditions you have before you start taking trandolapril/verapamil. Ask your prescriber if you're not sure whether this medication is safe for you to take.

• Risk factor: History of liver problems

Some people who took trandolapril/verapamil have had higher liver enzyme levels on their results from blood work. These lab results can be a sign of liver injury. Rarely, people had severe liver problems or liver failure.

Your prescriber might check your liver enzyme levels every so often while you're taking trandolapril/verapamil. Call your healthcare team if you have belly pain, tiredness, or yellowing of your skin and the whites of your eyes. These can be signs of liver problems.

• Risk factors: Severe heart failure | Kidney problems | Kidney artery blockage | Taking other medications that can cause kidney damage | Not enough fluid in the body

Trandolapril/verapamil can usually improve blood flow to the kidneys, which is good for people with high blood pressure and chronic kidney disease (CKD). But in some cases, trandolapril/verapamil can cause kidney damage. The risk for kidney damage from trandolapril/verapamil is higher for people who have certain medical conditions, such as blockage of the kidney artery (renal artery stenosis) or severe heart failure.

Your prescriber might order lab tests before you start taking trandolapril/verapamil to check your kidneys and make sure it's safe for you to take. They also might check your lab work throughout treatment, especially if you're at higher risk for kidney damage. Let your care team know if you're urinating less often than usual, feeling tired, feeling nauseous, or having chills. These can be symptoms of kidney damage.

• Risk factors: Kidney problems | Diabetes | Taking other medications that also raise potassium levels

Very rarely, trandolapril/verapamil can raise the amount of potassium in your body, which can sometimes be dangerous. Your risk of developing high potassium is greater if you have diabetes, or kidney problems. It's also higher if you're taking other medications that also raise potassium levels, like potassium supplements or certain diuretics.

Make sure your healthcare team knows your full medical history and the medications you're taking before you start trandolapril/verapamil. They can monitor your risk for high potassium levels. Tell your care team right away if you have symptoms of high potassium levels, such as muscle weakness, tingling or numbness, nausea, or abnormal heartbeat.

Trandolapril/verapamil can cause a dry cough. This happens because trandolapril raises the level of a protein in the body called bradykinin. And this can make your airways narrower. The dry cough usually goes away after you stop taking the medication. Tell your prescriber if you have a dry cough with trandolapril/verapamil and it starts to bother you.

• Risk factors: Kidney problems | Lupus

It's not clear whether trandolapril, one of the ingredients in trandolapril/verapamil, can lower white blood cell counts. But some people with kidney problems and lupus have had low white blood cell counts with a different ACE inhibitor. To be safe, your prescriber might check your white blood cell count during treatment if you have kidney problems or lupus.