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Trandolapril Side Effects

It is possible that some side effects of trandolapril may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to trandolapril: oral capsule, oral tablet

As well as its needed effects, trandolapril may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking trandolapril, check with your doctor immediately:

More common
  • Abdominal or stomach pain
  • blurred vision
  • confusion
  • difficulty with breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fainting
  • irregular heartbeat
  • nausea or vomiting
  • nervousness
  • numbness or tingling in the hands, feet, or lips
  • sweating
  • unusual tiredness or weakness
  • weakness or heaviness of the legs
Less common
  • Abdominal or stomach cramps
  • chest pain or discomfort
  • cool, sweaty skin
  • difficulty with speaking
  • double vision
  • inability to move the arms, legs, or facial muscles
  • muscle cramps in the hands, arms, feet, legs, or face
  • numbness and tingling around the mouth
  • seizures
  • slow heartbeat
  • tremor

Some trandolapril side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Acid or sour stomach
  • belching
  • cough
  • heartburn
  • indigestion
  • stomach discomfort or upset
Less common
  • Burning feeling in the chest or stomach
  • difficulty with moving
  • joint pain
  • muscle aches, pain, or stiffness
  • swollen joints
  • tenderness in the stomach area

For Healthcare Professionals

Applies to trandolapril: oral tablet


Based on limited data, trandolapril appears to be generally well-tolerated. Trandolapril has been evaluated for safety in more than 2,200 patients with mild to moderate hypertension and has demonstrated a side effect profile similar to other angiotensin converting enzyme (ACE) inhibitors. The overall incidence of reported adverse events from large multicenter trials ranged from 4% to 11%. Most side effects have been described as "mild" and "transient". Approximately 3% to 8% of patients discontinued therapy due to adverse events. Postmarketing reports of malaise and fever were reported in clinical trials.[Ref]


A retrospective study has revealed a significantly higher incidence of discontinuation of angiotensin converting enzyme inhibitor therapy due to cough among black patients compared with non-black patients (9.6% vs. 2.4%).

Several agents have been studied for treating cough with ACE inhibitors. No long term trials exist to allow a definitive treatment option. Cromolyn has the most data showing some benefit. Other agents studied include baclofen, theophylline, sulindac, and benzonatate.[Ref]

Respiratory side effects including cough is observed in up to 4% of patients. Other respiratory complaints include dyspnea, wheezing, and bronchitis. Postmarketing reports have included bronchitis.[Ref]

Nervous system

Nervous system side effects include headache, dizziness (probably symptomatic hypotension), weakness, sleep disturbances, taste disturbances, nervousness, mood changes, tinnitus, asthenia, and anxiety in approximately 2% of patients. Postmarketing reports have included cerebral hemorrhage.[Ref]


Angina pectoris has been reported in as many as 36% of patients in the Trandolapril Cardiac Evaluation (TRACE) study, but the incidence of underlying coronary artery disease (patients with a history of myocardial infarction) in the patient population studied was essentially 100%. The incidence of angina pectoris among placebo patients in the TRACE study was 38% (not significantly different).[Ref]

Cardiovascular side effects include peripheral edema in 3% of patients and symptomatic hypotension, postural hypotension, or syncope in 1% to 31% of patients. Angina or myocardial infarction, palpitations, rhythm disturbances, or cerebrovascular accidents have been reported in approximately 0.5% of patients. Angioedema is a rare side effect that indicates discontinuation of therapy. Postmarketing side effects include myocardial infarction, myocardial ischemia, angina pectoris, cardiac failure, ventricular tachycardia, tachycardia, transient ischemic attack, and arrhythmia.[Ref]


Gastrointestinal side effects are uncommon. Reported effects include nausea in 3% of patients and abdominal pain, constipation, vomiting, appetite or weight changes, and dry mouth in approximately 0.5% of patients. Postmarketing reports have included dry mouth and pancreatitis.[Ref]


Renal side effects including new or worsened renal insufficiency has been associated with the use of ACE inhibitors, particularly in patients with underlying cardiovascular or renal disease. Postmarketing reports have included renal failure, elevated creatinine, and elevated blood urea nitrogen.[Ref]


Angioedema associated with laryngeal edema can be fatal. If laryngeal stridor or angioedema of the face, tongue or glottis occurs, trandolapril should be discontinued immediately, the patient treated in accordance with accepted medical care and carefully observed until the swelling disappears. In cases where the swelling is confined to the face and lips, the condition generally resolves without treatment; antihistamines may be useful in relieving symptoms. Where there is involvement of the tongue, glottis, or larynx, likely to cause airway obstruction, emergency therapy, including, but not limited to subcutaneous epinephrine solution 1:1000 (0.3 to 0.5 mL) should be administered promptly.

Patients with intestinal angioedema generally present with abdominal pain (with or without nausea or vomiting) and in some cases there was no prior history of facial angioedema, and C-1 esterase levels were normal. These symptoms resolve after stopping the ACE inhibitor.[Ref]

Hypersensitivity reactions to angiotensin converting enzyme (ACE) inhibitors may be life threatening. Angioedema of the face, extremities, lips, tongue, glottis and/or pharynx have been reported rarely in patients receiving ACE inhibitors. In addition, intestinal angioedema has been reported in patients treated with ACE inhibitors. It is recommended that any patient with dyspnea, dysphagia, or significant facial angioedema stop therapy immediately and avoid ACE inhibitor therapy in general.

Urticaria, rash, pemphigus, pruritus, and photosensitivity have been reported in less than 1% of patients.[Ref]


Metabolic side effects including mild hyperkalemia, the result of inhibition of aldosterone secretion, has been reported. Postmarketing reports include hyponatremia.[Ref]


Hematologic side effects rarely associated with some ACE inhibitors include agranulocytosis and bone marrow depression. Postmarketing reports have included thrombocytopenia, agranulocytosis and pancytopenia.[Ref]


Musculoskeletal pains have rarely been associated with trandolapril.[Ref]


Hepatic side effects associated with the use of ACE inhibitors have included a rare syndrome that begins with cholestatic jaundice and progresses to fulminant hepatic necrosis and (sometimes) death. Experts recommend discontinuation of therapy with this drug if jaundice or markedly elevated hepatic serum enzymes develop. Postmarketing clinical trials revealed reports of increased SGOT (AST). Other postmarketing reports include elevated liver transaminases, elevated bilirubin, jaundice and hepatitis.[Ref]


Dermatologic side effects have included postmarketing reports of alopecia, sweating, Stevens-Johnson syndrome and toxic epidermal necrolysis.[Ref]


Psychiatric side effects have included postmarketing reports of hallucination and depression.


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