Trandolapril/
Verapamil

Trandolapril/Verapamil is used for:

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Treating high blood pressure.

Trandolapril/Verapamil is an angiotensin-converting enzyme (ACE) inhibitor and calcium channel blocker combination. It works by helping to relax blood vessels. This helps to lower blood pressure.

Do NOT use Trandolapril/Verapamil if:

• you are allergic to any ingredient in Trandolapril/Verapamil
• you have ever had an allergic reaction (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue) to any other ACE inhibitor (eg, captopril, lisinopril)
• you are pregnant
• you have very low blood pressure, moderate to severe congestive heart failure, an irregular heartbeat, or any other heart problems
• you are taking dofetilide, eletriptan, erythromycin, or disopyramide

Contact your doctor or health care provider right away if any of these apply to you.

Before using Trandolapril/Verapamil :

Some medical conditions may interact with Trandolapril/Verapamil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are planning to become pregnant or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have bone marrow depression, heart problems, high blood potassium levels, low blood sodium levels, liver problems, muscular dystrophy, low blood pressure, nervous system problems, kidney disease or transplant, an autoimmune disease, lupus, or thickening of the skin, or if you are having an allergic reaction
• if you are on a sodium-restricted diet
• if you have low blood volume, diarrhea, vomiting, or are undergoing dialysis

Some MEDICINES MAY INTERACT with Trandolapril/Verapamil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Ketolide antibiotics (eg, telithromycin), lincomycin, or macrolide antibiotics (eg, erythromycin) because the actions and side effects of Trandolapril/Verapamil , some potentially life-threatening, may be increased
• Barbiturates (eg, phenobarbital), rifampin, salicylates (eg, aspirin), or St. John's wort because they may decrease Trandolapril/Verapamil 's effectiveness
• Aldosterone blockers (eg, spironolactone), beta-blockers (eg, propranolol), carbamazepine, cyclosporine, digoxin, disopyramide, dofetilide, eletriptan, erythromycin, flecainide, general anesthetics, HMG-CoA reductase inhibitors (eg, simvastatin), indomethacin, lithium, loop diuretics (eg, furosemide), nondepolarizing muscle relaxants (eg, atracurium), quinazolines (eg, prazosin), quinidine, sulfonylureas (eg, glipizide), theophyllines (eg, aminophylline), or thiopurines (eg, azathioprine) because the actions and side effects, some potentially life-threatening, may be increased by Trandolapril/Verapamil

This may not be a complete list of all interactions that may occur. Ask your health care provider if Trandolapril/Verapamil may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Trandolapril/Verapamil :

Use Trandolapril/Verapamil as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Trandolapril/Verapamil by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Eating grapefruit or drinking grapefruit juice may affect the amount of Trandolapril/Verapamil in your blood. Talk with your doctor before including grapefruit or grapefruit juice in your diet.
• Taking Trandolapril/Verapamil at the same time each day will help you remember to take it.
• Do not take an antacid within 1 hour before or 2 hours after you take Trandolapril/Verapamil .
• Do not take dextran sulfate within 2 hours of Trandolapril/Verapamil .
• Drinking extra fluids while you are taking Trandolapril/Verapamil is recommended. Check with your doctor for instructions.
• If you miss a dose of Trandolapril/Verapamil , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Trandolapril/Verapamil .

Important safety information:

• Trandolapril/Verapamil may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Trandolapril/Verapamil with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Trandolapril/Verapamil ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Trandolapril/Verapamil may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. If lightheadedness occurs, especially during the first few days of treatment, contact your health care provider.
• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
• Tell your doctor or dentist that you take Trandolapril/Verapamil before you receive any medical or dental care, emergency care, or surgery.
• Check with your doctor before you use a salt substitute or a product that has potassium in it.
• Trandolapril/Verapamil may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
• Lab tests, including liver function, kidney function, complete blood cell count, and blood pressure, may be performed while you use Trandolapril/Verapamil . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Trandolapril/Verapamil should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Do not take Trandolapril/Verapamil after the third month of pregnancy. It may cause injury or death to the fetus. If you become pregnant, contact your doctor right away. Trandolapril/Verapamil is found in breast milk. Do not breast-feed while taking Trandolapril/Verapamil .

Possible side effects of Trandolapril/Verapamil :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; fatigue; headache; indigestion; lightheadedness when sitting up or standing; muscle aches; nausea; persistent, dry cough; tiredness; vomiting; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; dark urine; fainting; fever; hoarseness; shortness of breath; sore throat; swelling of the hands or feet; unusual stomach pain; unusually fast, slow, or irregular heartbeat; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm ), or emergency room immediately. Symptoms may include dizziness; lightheadedness, especially upon standing; weakness.

Store Trandolapril/Verapamil at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Trandolapril/Verapamil out of the reach of children and away from pets.

General information:

• If you have any questions about Trandolapril/Verapamil , please talk with your doctor, pharmacist, or other health care provider.
• Trandolapril/Verapamil is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Trandolapril/Verapamil . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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