section name header

Pronunciation

tran-DOE-la-pril

Classifications

Therapeutic Classification: antihypertensives

Pharmacologic Classification: ace inhibitors

Indications

REMS


Action

  • Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also plasma renin levels and aldosterone levels. Net result is systemic vasodilation.
Therapeutic effects:
  • Lowering of BP in patients with hypertension.
  • Increased survival after MI.

Pharmacokinetics

Absorption: 70% absorbed following oral administration.

Distribution: Crosses the placenta; enters breast milk.

Metabolism/Excretion: Converted by the liver to trandolaprilat, the active metabolite; 33% excreted in urine, 66% in feces.

Half-Life: Trandolapril: 6 hr; Trandolaprilat: 22.5 hr ( in renal impairment).

Time/Action Profile

(antihypertensive effect)

ROUTEONSETPEAKDURATION
POwithin 1–2 hr*within 1 wkup to 24 hr



*After single dose.

Chronic dosing.



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension

Derm: rash

F and E: hyperkalemia, hypocalcemia

GI: diarrhea, dyspepsia

GU: renal impairment

Metab: hyperuricemia

MS: myalgia

Neuro: weakness

Resp: cough

Misc: ANGIOEDEMA

Interactions

Drug-drug:

Route/Dosage

Hypertension

Renal Impairment

Hepatic Impairment

Heart Failure Post-MI or Left Ventricular Dysfunction Post-MI

Renal Impairment

Hepatic Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

Canadian Brand Names

Mavik