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Trandolapril-Verapamil HCl ER
Trandolapril-Verapamil HCl ER is a combination medication used to treat high blood pressure (hypertension). It combines trandolapril, an angiotensin-converting enzyme (ACE) inhibitor, and verapamil, a calcium channel blocker. Trandolapril works by relaxing blood vessels, making it easier for the heart to pump blood, while verapamil lowers blood pressure by relaxing the muscles in the walls of blood vessels and slowing the heart rate. This dual action makes the medication effective for controlling blood pressure and reducing the risk of heart attack and stroke.
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Frequently Asked Questions
How long does it take for Trandolapril-Verapamil HCl ER to start working?
It may take 2 to 4 weeks to see the full blood pressure-lowering effects of this medication, though some patients may notice improvements sooner.
Can I stop taking Trandolapril-Verapamil HCl ER if my blood pressure improves?
No, you should not stop taking the medication without consulting your doctor. High blood pressure often requires long-term treatment, and stopping the medication suddenly can cause a dangerous spike in blood pressure.
Can I drink alcohol while taking Trandolapril-Verapamil HCl ER?
Alcohol can lower your blood pressure and increase the risk of side effects such as dizziness or fainting. It’s best to limit alcohol consumption while taking this medication.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember, but if it’s close to the time of your next dose, skip the missed dose. Do not take two doses at once to make up for the missed dose.
Can I take over-the-counter medications with Trandolapril-Verapamil HCl ER?
Some over-the-counter medications, especially NSAIDs (such as ibuprofen or naproxen), can interfere with the effectiveness of this medication or increase the risk of side effects. Always check with your healthcare provider before taking any new medications.
Comprehensive Drug Guide
How Does Trandolapril-Verapamil HCl ER Work?
- Trandolapril inhibits the enzyme responsible for converting angiotensin I to angiotensin II, a substance that causes blood vessels to constrict. By lowering angiotensin II levels, trandolapril helps relax and widen blood vessels, reducing blood pressure.
- Verapamil blocks calcium from entering the cells of the heart and blood vessels, which relaxes the blood vessels and decreases heart rate. This helps lower blood pressure and reduces the heart's workload.
Common Dosages
- Extended-release tablets: 2 mg/180 mg, 4 mg/240 mg
Typical Dosing
- The typical starting dose for adults is one tablet once daily, usually in the morning. The specific dose (2 mg/180 mg or 4 mg/240 mg) is determined based on the patient's blood pressure and individual response to treatment.
- The dose may be adjusted by the healthcare provider depending on the patient's response and tolerance to the medication.
Typical Dosing
FDA Approved Indications
- The treatment of hypertension (high blood pressure) in adults.
Who Shouldn't Take Trandolapril-Verapamil HCl ER?
- Severe heart failure or severe left ventricular dysfunction
- Hypotension (low blood pressure)
- Atrioventricular (AV) block or sick sinus syndrome without a pacemaker
- Angioedema related to ACE inhibitor therapy
- Severe kidney or liver impairment
Advice From The Pharmacist
- Trandolapril-Verapamil HCl ER should be taken as directed by your doctor, usually once daily with food.
- Do not crush or chew the extended-release tablets, as this can release all of the medication at once and increase the risk of side effects.
- If you miss a dose, take it as soon as you remember, but if it's near the time for your next dose, skip the missed dose. Do not double up doses.
- Regular monitoring of blood pressure, kidney function, and electrolyte levels (especially potassium) is necessary while taking this medication.
- Avoid using salt substitutes that contain potassium without consulting your doctor, as ACE inhibitors can increase potassium levels.
Side Effects of Trandolapril-Verapamil HCl ER
Common Side Effects
- Dizziness or lightheadedness
- Fatigue
- Nausea or constipation
- Headache
- Swelling of the legs or ankles (due to verapamil)
Uncommon/Severe Side Effects
- Severe hypotension (low blood pressure)
- Angioedema (swelling of the face, lips, or throat)
- Slow or irregular heart rate
- Hyperkalemia (high potassium levels)
Risks and Warnings of Trandolapril-Verapamil HCl ER
- Risk of Angioedema: ACE inhibitors like trandolapril can cause angioedema, which may be life-threatening. If you experience swelling of the face, lips, tongue, or throat, stop the medication and seek immediate medical attention.
- Hypotension: Trandolapril-Verapamil HCl ER can cause significant drops in blood pressure, especially after the first dose or if combined with diuretics. Patients should be monitored closely, especially at the beginning of treatment.
- Bradycardia: Verapamil can slow the heart rate. Patients with existing heart conditions or those on other medications that affect the heart rate should be carefully monitored.
Interactions with Trandolapril-Verapamil HCl ER
Common Drug Interactions
- Beta-blockers: Combining Trandolapril-Verapamil HCl ER with beta-blockers can increase the risk of slow heart rate (bradycardia) and low blood pressure.
- Diuretics (water pills): Diuretics can enhance the blood pressure-lowering effect of this medication, leading to an increased risk of hypotension.
- Potassium supplements or potassium-sparing diuretics: ACE inhibitors can raise potassium levels, so combining them with these agents may result in dangerous hyperkalemia.
- NSAIDs: Nonsteroidal anti-inflammatory drugs may reduce the effectiveness of Trandolapril-Verapamil HCl ER in lowering blood pressure and increase the risk of kidney damage.
Alternatives to Trandolapril-Verapamil HCl ER
- Lisinopril-Amlodipine: Another combination of an ACE inhibitor and a calcium channel blocker for the treatment of hypertension.
- Losartan-Hydrochlorothiazide: A combination of an angiotensin II receptor blocker (ARB) and a diuretic for blood pressure control.
- Atenolol-Chlorthalidone: A combination of a beta-blocker and a diuretic for managing hypertension.
