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Drug Information: Verapamil and Trandolapril

IMPORTANT WARNING:

Why is this medication prescribed?

The combination of verapamil and trandolapril is used to treat high blood pressure. It is a combination of two medications. It decreases certain chemicals that tighten the blood vessels, so blood flows more smoothly. It also relaxes your blood vessels so your heart does not have to pump as hard.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

The combination of verapamil and trandolapril comes as a tablet to take by mouth. It is usually taken once a day. The tablet should be swallowed whole. Do not chew, divide, or crush the tablets. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take verapamil and trandolapril exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The combination of verapamil and trandolapril controls high blood pressure but does not cure it. Continue to take verapamil and trandolapril even if you feel well. Do not stop taking verapamil and trandolapril without talking to your doctor.

What special precautions should I follow?

Before taking verapamil and trandolapril,

• tell your doctor and pharmacist if you are allergic to trandolapril, verapamil, benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, quinapril, ramipril, or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially albuterol (Volmax, Proventil [tablets and syrup only], Ventolin [tablets and syrup only]); allopurinol (Zyloprim); antacids; betamethasone (Celestone); carbamazepine (Tegretol); chemotherapy medications; cimetidine (Tagamet); cortisone (Cortone); cyclosporine (Neoral, Sandimmune); dantrolene (Dantrium); dexamethasone (Decadron, Dexone); diuretics ('water pills'); fentanyl (Duragesic); fludrocortisone (Florinef); heart and blood pressure medications such as beta-adrenergic blockers, digoxin (Lanoxin), disopyramide (Norpace), flecainide (Tambocor), procainamide (Procan), and quinidine (Quinaglute, Quinadex); hydrocortisone (Cortef, Hydrocortone); lithium (Eskalith, Lithobid); medications that suppress your immune system; medications to treat depression or psychiatric conditions; medications to treat glaucoma (increased pressure in the eye); medications to treat pain; muscle relaxants; methylprednisolone (Medrol); nonsteroidal anti-inflammatory drugs; other medications for high blood pressure or diabetes; phenobarbital; phenytoin (Dilantin); potassium supplements; prednisolone (Prelone); prednisone (Deltasone, Orasone); rifampin (Rifadin, Rimactane); theophylline; tranquilizers; triamcinolone (Aristocort); and vitamins or herbal products.
• tell your doctor if you have or have ever had heart, liver, or kidney disease; a recent heart attack; an irregular heartbeat; muscular dystrophy; gastrointestinal obstruction (strictures); or diabetes.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking verapamil and trandolapril.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how verapamil and trandolapril will affect you.
• remember that alcohol can add to the drowsiness caused by this drug. Do not drink alcohol while taking this medication.

What special dietary instructions should I follow?

Verapamil and trandolapril may cause an upset stomach. Take verapamil and trandolapril with food or milk.Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Verapamil and trandolapril may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• cough
• dizziness or lightheadedness
• sore throat
• hoarseness
• excessive tiredness
• headache
• diarrhea
• constipation
• upset stomach
• heartburn
• flushing (feeling of warmth)
• slow heartbeat
• vivid, unusual dreams

If you experience any of the following symptoms, call your doctor immediately:

• swelling of the face, eyes, lips, tongue, arms, or legs
• difficulty breathing or swallowing
• fainting
• rash
• yellowing of the skin or eyes
• fever
• increase in frequency or severity of chest pain (angina)

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to verapamil and trandolapril.

Your doctor may ask you to check your pulse (heart rate) daily and will tell you how fast it should be. If your pulse is slower than it should be, call your doctor for directions on taking verapamil and trandolapril that day. Ask your doctor or pharmacist to teach you how to check your pulse.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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