CHF and arrhythmias:
Indications for: Trandolapril
In stabilized patients after MI, who have LV systolic dysfunction or CHF symptoms.
Adult Dosage:
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 Dosage:
Not established.
Trandolapril 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.
Boxed Warning:
Fetal toxicity.
Trandolapril 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 Classification:
ACE inhibitor.
Trandolapril 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.
Adverse Reactions:
Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.
Note:
Formerly known under the brand name Mavik.
How Supplied:
Contact supplier
Hypertension:
Indications for: Trandolapril
Hypertension.
Adult Dosage:
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 Dosage:
Not established.
Trandolapril 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.
Boxed Warning:
Fetal toxicity.
Trandolapril 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 Classification:
ACE inhibitor.
Trandolapril 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.
Adverse Reactions:
Cough, dizziness, hypotension, syncope, hyperkalemia, myalgia; anaphylactoid reactions; rare: hepatic failure.
Note:
Formerly known under the brand name Mavik.
How Supplied:
Contact supplier
