Trandolapril and Verapamil

Get emergency medical help if you have signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• sudden weakness or ill feeling, fever, chills, sore throat, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms;

• upper stomach pain, and jaundice (yellowing of the skin or eyes);

• chest pain, fast, slow, or uneven heart rate;

• lung problems--anxiety, sweating, pale skin, severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus;

• high potassium--nausea, slow or unusual heart rate, weakness, loss of movement; or

• kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath.

Common side effects may include:

• cough;

• cold symptoms such as stuffy nose, sneezing, sore throat;

• headache, dizziness;

• chest pain, back pain;

• constipation;

• feeling tired; or

• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Chest pain
• chills
• cough (with mucus)
• dark urine
• fever
• general feeling of discomfort or illness
• lightheadedness or fainting
• pain in the right side of the abdomen or stomach
• shortness of breath
• slow heartbeat
• sore throat
• swelling of the face, mouth, hands, or feet
• trouble in swallowing or breathing (sudden) accompanied by hoarseness
• wheezing
• yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Constipation
• cough (dry, continuing)
• diarrhea
• dizziness
• itching
• joint pain or pain in the arms or legs
• nausea
• unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

• It is used to treat high blood pressure.
• It may be given to you for other reasons. Talk with the doctor.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
• Signs of a high potassium level like a heartbeat that does not feel normal; change in thinking clearly and with logic; feeling weak, lightheaded, or dizzy; feel like passing out; numbness or tingling; or shortness of breath.
• Very bad dizziness or passing out.
• Cough that does not go away.
• Chest pain or pressure or a fast heartbeat.
• Slow heartbeat.
• A heartbeat that does not feel normal.
• Muscle weakness.
• Shortness of breath, a big weight gain, or swelling in the arms or legs.
• Liver problems have happened with drugs like this one. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

• Store at room temperature.
• Protect from light.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Check with your pharmacist about how to throw out unused drugs.

• Trandolapril/Verapamil HCl
• Verapamil and Trandolapril

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); however, since verapamil is hepatically metabolized, lower doses are recommended.

See individual agents.

Initial dose should be based on the patient's requirements for each drug.

Comments: Patients receiving trandolapril (up to 8 mg) and verapamil (up to 240 mg) in separate tablets may receive this drug once a day in equivalent dosages.

Dose adjustment recommended; however, no specific guidelines have been suggested.

Dose adjustment may be required; however, no specific guidelines have been suggested. Caution recommended.

If jaundice or marked elevation of hepatic enzymes occurs: Discontinue this drug and seek medical attention.