trandolapril-verapamil Oral

This medication is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains 2 medications, trandolapril and verapamil. Trandolapril is an ACE inhibitor, and verapamil is a calcium channel blocker. They both work differently to relax the blood vessels so that blood can flow more easily. Verapamil may also decrease the heart rate. They are used together when one medication is not controlling your blood pressure.

How to use trandolapril-verapamil Oral
Take this medication by mouth with food, usually once daily or as directed by your doctor. Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.
The dosage is based on your medical condition and response to treatment.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick. It may take up to several weeks before you get the full benefit of this drug.
Do not suddenly stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.
Tell your doctor if your condition does not improve or if it worsens (for example, your routine blood pressure readings remain high or increase).

Dizziness may occur as your body adjusts to the medication. Dry cough, slow heartbeat, constipation, and nausea may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: swelling ankles/feet, unusual tiredness, shortness of breath, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat), fast heartbeat, fainting.
This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor immediately if you notice any of the following rare but very serious side effects: yellowing eyes/skin, dark urine, severe stomach/abdominal pain, persistent nausea/vomiting.
Tell your doctor immediately if any of these rare but very serious side effects occur: signs of infection (such as fever, persistent sore throat), easy bruising/bleeding, change in the amount of urine.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this product, tell your doctor or pharmacist if you are allergic to trandolapril or verapamil; or to other ACE inhibitors (such as benazepril, lisinopril); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain types of heart rhythm problems (such as second- or third-degree atrioventricular block, sick sinus syndrome unless you have a pacemaker, Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome), a history of an allergic reaction that included swelling of the face/lips/tongue/throat (angioedema).
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease (such as renal artery stenosis), collagen vascular disease (such as lupus, scleroderma), loss of too much body water (dehydration), certain types of heart problems (such as aortic stenosis, heart failure), certain muscle/nerve disorders (muscular dystrophy, myasthenia gravis), untreated salt imbalance (such as high potassium, low sodium).
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Losing too much body water (such as too much sweating, diarrhea, or vomiting) can lower your blood pressure and worsen dizziness. Tell your doctor if you have prolonged diarrhea or vomiting. Drink enough fluids during exercise. Consult your doctor for more details.
Before having surgery, tell your doctor or dentist that you are taking this medication.
This product may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.
If you have diabetes, this product may cause low blood sugar levels (hypoglycemia) when you first start using it. Check your blood sugar levels regularly as directed by your doctor. Treat symptoms of low blood sugar quickly. Tell your doctor immediately if you have signs of low blood sugar such as nervousness, hunger, and shaking.
Older adults may be more sensitive to the effects of this product, especially dizziness.
This medication is not recommended for use during pregnancy due to the risk for harm to an unborn baby. Consult your doctor for more details. (See also Warning section.)
Verapamil passes into breast milk. It is unknown if trandolapril passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.

See also Precautions section.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
This drug should not be used with the following medication because very serious interactions may occur: dofetilide.
If you are currently using the medication listed above, tell your doctor or pharmacist before starting this product.
Before using this medication, it is important to tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: aliskiren, clonidine, disopyramide, fingolimod, gold injections, lithium, drugs that may increase the level of potassium in the blood (such as birth control pills containing drospirenone).
Other medications can affect the removal of verapamil from your body, which may affect how this product works. Examples include atorvastatin, erythromycin, phenobarbital, rifamycins (such as rifampin), ritonavir, St. John\'s wort, among others.
Verapamil can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include buspirone, carbamazepine, colchicine, eplerenone, midazolam, certain drugs for organ transplant (cyclosporine, sirolimus, tacrolimus), certain \"statin\" drugs (lovastatin, simvastatin), temsirolimus, theophylline, tizanidine, triazolam, among others.
A very serious reaction may occur if you are getting injections for bee/wasp sting allergy (desensitization) and are also taking trandolapril/verapamil. Make sure all your doctors know which medicines you are using.
Check the labels on all your medicines (such as cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen for pain/fever reduction) because they may contain ingredients that could increase your blood pressure or heart rate. Ask your pharmacist about using those products safely.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting, very slow heartbeat.

NOTES:
Do not share this medication with others.
Talk with your doctor about making changes to your lifestyle that may help this medication work better (such as stress reduction programs, exercise, and dietary changes).
Laboratory and/or medical tests (such as kidney/liver function, potassium levels) should be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.
Have your blood pressure and pulse (heart rate) checked regularly while taking this medication. Learn how to check your own blood pressure and pulse at home, and share the results with your doctor.

MISSED DOSE:
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:
Store at room temperature at 59-77 degrees F (15-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
Information last revised August 2012. Copyright(c) 2012 First Databank, Inc.