Trandolapril and Verapamil (Systemic)

Brand Names : Tarka

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For trandolapril and verapamil combination, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to trandolapril or to any other ACE inhibitor (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, quinapril, or ramipril) or to verapamil. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Studies with this combination medicine have not been done in pregnant women. However, use of any of the ACE inhibitors during pregnancy, especially in the second and third trimesters (after the first 3 months) can cause low blood pressure, kidney failure, an underdeveloped skull, or even death in newborns. Therefore, it is important that you check with your doctor immediately if you think that you may be pregnant . Be sure that you have discussed this with your doctor before taking this combination medicine.

Breast-feeding - Verapamil passes into breast milk. It is not known whether trandolapril passes into breast milk; however, it does pass into the milk of lactating rats. Breast-feeding is not recommended in women who are taking this combination medicine.

Children - Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of trandolapril and verapamil in children with use in other age groups.

Older adults - Although this medicine has not been shown to cause different side effects or problems in older people than it does in younger adults, blood levels of trandolapril and verapamil may be increased in the elderly. Elderly people also may be more sensitive to the effects of this medicine.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your health care professional know if you are taking any of the following:

• Beta-blockers (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], carvedilol [e.g., Coreg], labetalol [e.g., Normodyne], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Sotacor], timolol [e.g., Blocadren]) - Effects of these medicines and verapamil on the heart may be increased

• Digitalis glycosides (heart medicine [e.g., Lanoxin]) - Effects of these medicines may be increased

• Disopyramide (e.g., Norpace) - Effects of verapamil on the heart may be increased

• Diuretics (water pills) - May increase the blood pressure-lowering effects

• Potassium-containing medicines or supplements or
• Salt substitutes that contain potassium - Use of these substances with ACE inhibitors may result in an unusually high potassium level in the blood, which can lead to irregular heart rhythm and other problems

Also, tell your health care professional if you are using any of the following medicines in the eye:

• Betaxolol (e.g., Betoptic) or
• Carteolol (e.g., Ocupress) or
• Levobunolol (e.g., Betagan) or
• Metipranolol (e.g., OptiPranolol) or
• Timolol (e.g., Timoptic) - Effects on the heart may be increased

Other medical problems - The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bee-sting allergy treatments or
• Dialysis treatments - Increased risk of serious allergic reaction occurring

• Dehydration - Lowering effects on blood pressure may be increased

• Diabetes mellitus (sugar diabetes) - Increased risk of potassium levels in the body becoming too high

• Duchenne's muscular dystrophy - Verapamil may make this condition worse

• Heart disease or
• Hypotension (low blood pressure) - Further lowering of blood pressure may make problems resulting from these conditions worse

• Kidney disease or
• Liver disease - Effects may be increased because of slower removal of the medicine from the body

• Scleroderma or
• Systemic lupus erythematosus (SLE) (or history of) - Increased risk of blood problems with ACE inhibitors

• Previous reaction to any ACE inhibitor involving hoarseness; swelling of face, mouth, hands, or feet; or sudden trouble in breathing - Reaction is more likely to occur again with ACE inhibitors