Trandolapril
ACE Inhibitor · ACE inhibitor
Indications
Mild to moderate hypertension. Left ventricular dysfunction after myocardial infarction.
Dosage
Adults: Hypertension: Initially 0.5 mg once daily, increased at intervals 2-4 wk, usual range 1-2 mg once daily; Max 4 mg daily. Prophylaxis after MI: (Starting as early as 3 days after infarction), initially 0.5 mg once daily; gradually increased to max 4 mg once daily. Children: Not recommended.
Adverse Effects
Cough, headache, asthaenia, dizziness, rash, symptomatic hypotension, palpitations. Reports of angioedema (discontinue), bone marrow depression, agranulocytosis, hepatic failure, Steven's Johnson syndrome, toxic epidermal necrolysis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Angioneurotic oedema: hereditary, idiopathic or related to previous ACE inhibitor therapy. Aortic stenosis or outflow obstruction. Renal transplantation. Precautions: Monitor renal function and serum electrolytes. Hyperkalaemia, renal or hepatic impairment, renal artery stenosis, CHF, angina, cerebrovascular disorders, collagen vascular diseases, haemodialysis, apheresis, surgery, anaesthesia. Correct salt or volume depletion before starting therapy.
Interactions
Potassium sparing diuretics or potassium supplements, NSAIDs, lithium, antidiabetic agents, neuroleptics, TCADs, antihypertensive, trimethoprim, heparin, antacids, antipsychotics, hyposensitising agents, allopurinol, procainamide, cytostatics, immunosuppressants, corticosteroids, sympathomimetics, anaesthetics, everolimus, temsirolimus, high-flux dialysis membranes, alcohol.
Advice to Patient
Take as directed by prescriber. Avoid taking antacids within 2 hours of medication. Contact prescriber if there is swelling of face/lips/tongue/throat, chest pain, palpitations, swelling of ankles/feet, skin rash, difficulty in breathing or unusual cough. Do not take potassium supplements or salt substitutes without consulting prescriber. Change position slowly when climbing stairs and from lying or sitting to standing position. Loss of taste occurs as a side effect which is usually reversed after 2 to 3 months.
Pharmacokinetics
Onset: 1-2 hrs. Duration: 72 hrs after single dose. Absorption: Rapid. Approx. 40%-60% absorbed. Metabolism: Hepatic; 36% of the absorbed amount is converted to active metabolite Trandolaprilat. Bioavailability: Trandolapril: 4%-14%. Trandolaprilat: 40%-60%. Half-life elimination: Trandolapril: 6 hrs. Trandolaprilat: After multiple doses of trandolapril, 16-24 hrs. Time to peak, plasma: Oral: Trandolapril: 1 hr. Trandolaprilat: 4-6 hrs. Excretion: Oral: Urine (33%). Faeces (66%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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