Adult Dosing
Hypertension
- Start 1 mg PO qd in non-black patients; 2 mg PO qd in black patients
- Adjust dose qwk. Doses >4 mg/day may be divided bid
- Max: 8 mg/day
Heart failure post MI/Left ventricular dysfunction post MI
- Start 1 mg PO qd
- Increase dose qwk if tolerated
- Target: 4 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients < 18yrs have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <30 mL/min: Starting dose 0.5 mg PO qd
- Hemodialysis: Not defined
Hepatic Dose Adjustment
- Hepatic cirrhosis: Starting dose 0.5 mg PO qd
- Life-threatening anaphylactoid reactions have occurred in patients undergoing desensitizing therapy with hymenoptera venom while receiving ACE inhibitors. Patients dialyzed with high-flux membranes and concomitantly treated with an ACE inhibitor and patients undergoing low-density lipoprotein apheresis with dextran sulfate absorption are prone to anaphylactoid reactions
- Anaphylactoid reactions including head, neck or intestinal angioedema have been reported in patients receiving trandolapril. Angioedema involving tongue, glottis or larynx can lead to airway obstruction and can be fatal. Discontinue therapy and immediately provide emergency treatment including administration of subcutaneous epinephrine injection
- Symptomatic hypotension can occur with trandolapril therapy especially in patients who are volume-and/or salt-depleted or receiving high doses of diuretics. Correct the volume depletion prior to administration of trandolapril in patients with excessive hypotension associated with oliguria or azotemia. Therapy should be started at the recommended dose under close medical supervision
- If symptomatic hypotension occurs, place the patient in a supine position and, if necessary, give an intravenous infusion of normal saline
- Agranulocytosis and bone marrow depression have been reported with ACE inhibitor therapy, particularly in patients with renal impairment, especially in those who also have collagen-vascular diseases such as systemic lupus erythematosus or scleroderma. Monitor WBC counts in patients with impaired renal function prior to starting treatment and at approximately two-week intervals for about three months, then periodically thereafter
- Cholestatic jaundice progressing to fulminant hepatic necrosis and sometimes death has occurred with ACE inhibitors; discontinue therapy and provide appropriate medical treatment
- Closely monitor infants with histories of in utero exposure to ACE inhibitors for hypotension, oliguria, and hyperkalemia. If oliguria occurs, attention should be directed toward support of blood pressure and renal perfusion
- Therapy has been associated with fetal and neonatal injury, including hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death
- ACE inhibitors cause nonproductive cough due to the inhibition of the degradation of endogenous bradykinin, which resolves on discontinuation of therapy
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Renal artery stenosis
- Volume depletion
- Congestive heart failure
- Cerebrovascular disease
- Severe CAD
- Severe CHF
- Diabetes mellitus
- Hypotension
- Hyponatremia
- Black patients
- Hypertrophic cardiomyopathy
- Aortic stenosis
- Collagen vascular disorder
- Antigen desensitization treatment
- LDL apheresis with dextran sulfate absorption
- Dialysis with high-flux membranes
- Elderly patients
Pregnancy Category:C (1st trimester) and D (2nd and 3rd trimesters)
Breastfeeding: Safety unknown for trandolapril; alternate drug might be preferred, especially while nursing a newborn baby. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACTlast accessed 16 June 2011). According to manufacturer's data, trandolapril should not be administered to nursing women.
US Trade Name(s)
US Availability
trandolapril (generic)
Mavik
Canadian Trade Name(s)
Canadian Availability
Mavik
UK Trade Name(s)
UK Availability
trandolapril (generic)
Gopten
Australian Trade Name(s)
- Dolapril
- Gopten
- Odrik
- Tranalpha
Australian Availability
trandolapril (generic)
Dolapril, Gopten, Odrik, Tranalpha
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Trandolapril 4 MG TABS [Bottle] (LUPIN PHARMACEUTICALS)
100 mg = $112
300 mg = $315.95 - Mavik 4 MG TABS [Bottle] (ABBOTT)
30 mg = $56.99
90 mg = $137.97 - Trandolapril 2 MG TABS [Bottle] (LUPIN PHARMACEUTICALS)
100 mg = $110.98
300 mg = $310.97 - Mavik 1 MG TABS [Bottle] (ABBOTT)
100 mg = $139.99
300 mg = $397.95 - Mavik 2 MG TABS [Bottle] (ABBOTT)
30 mg = $56.99
90 mg = $137.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
