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Tarka (trandolapril / verapamil) Disease Interactions

There are 21 disease interactions with Tarka (trandolapril / verapamil):

Major

Ace Inhibitors (Includes Tarka) ↔ Angioedema

Severe Potential Hazard, Moderate plausibility

Applies to: Angioedema

The use of these agents is contraindicated in patients with hereditary angioedema or a history of idiopathic angioedema. Patients with a history of angioedema unrelated to ACE inhibitors may be at increased risk of angioedema while receiving an ACE inhibitor. Patients should be advised to immediately report any signs or symptoms suggestive of angioedema (swelling of face, extremities, eyes, lips, or tongue, or difficulty swallowing or breathing) and to stop taking the medication until otherwise directed by their physician. Emergency therapy and/or measures to prevent airway obstruction are required for angioedema involving the tongue, glottis, or larynx. Treatment with ACE inhibitors should be discontinued permanently if angioedema develops in association with therapy.

References

  1. Seidman MD, Lewandowski CA, Sarpa JR, et al "Angioedema related to angiotensin-converting enzyme inhibitors." Otolaryngol Head Neck Surg 102 (1990): 727-31
  2. Gonzalo FE, Montagut LB, Vecina ST "Angioedema caused by ramipril." Ann Pharmacother 29 (1995): 431-2
  3. Gianos ME, Klaustermeyer WB, Kurohara M, et al "Enalapril induced angioedema." Am J Emerg Med 8 (1990): 124-6
  4. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  5. Gannon TH, Eby TL "Angioedema from angiotensin converting enzyme inhibitors: a cause of upper airway obstruction." Laryngoscope 100 (1990): 1156-60
  6. Roberts JR, Wuerz RC "Clinical characteristics of angiotensin-converting enzyme inhibitor-induced angioedema." Ann Emerg Med 20 (1991): 555-8
  7. Hedner T, Samuelsson O, Lunde H, et al "Angio-oedema in relation to treatment with angiotensin converting enzyme inhibitors." Br Med J 304 (1992): 941-6
  8. Chin HL, Buchan DA "Severe angioedema after long-term use of an angiotensin-converting enzyme inhibitor ." Ann Intern Med 112 (1990): 312-3
  9. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  10. Soo Hoo GW, Dao HT, Klaustermeyer WB "Severe angioedema and respiratory distress associated with lisinopril use." West J Med 158 (1993): 412-7
  11. Werber JL, Pincus RL "Oropharyngeal angioedema associated with the use of angiotensin-converting enzyme inhibitors." Otolaryngol Head Neck Surg 101 (1989): 96-8
  12. Gimenez JC "Angioneurotic edema produced by enalapril." Ann Pharmacother 29 (1995): 317
  13. Abidin MR, Eisele DW "Angioedema after long-term use of angiotensin-converting enzyme inhibitor ." Arch Otolaryngol Head Neck Surg 117 (1991): 1059
  14. Kaplan NM "The CARE study: a postmarketing evaluation of ramipril in 11,100 patients." Clin Ther 18 (1996): 658-70
  15. Frontera Y, Piecuch JF "Multiple episodes of angioedema associated with lisinopril, an ACE inhibitor." J Am Dent Assoc 126 (1995): 217-20
  16. Orfan N, Patterson R, Dykewicz MS "Severe angioedema related to ACE inhibitors in patients with a history of idiopathic angioedema." JAMA 264 (1990): 1287-9
  17. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  18. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  19. Jett GK "Captopril-induced angioedema ." Ann Emerg Med 13 (1984): 489-90
  20. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  21. Suarez M, Ho PW, Johnson ES, Perez G "Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy." Am J Med 81 (1986): 336-8
  22. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  23. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  24. Jason DR "Fatal angioedema associated with captopril." J Forensic Sci 37 (1992): 1418-21
  25. O'Mara NB, O'Mara EM Jr "Delayed onset of andioedema with angiotensin-converting enzyme inhibitors: case report and review of the literature." Pharmacotherapy 16 (1996): 675-9
  26. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  27. Gonnering RS, Hirsch SR "Delayed drug-induced periorbital angioedema ." Am J Ophthalmol 110 (1990): 566-8
  28. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  29. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  30. Forslund T, Tohmo H, Weckstrom G, Stenborg M, Jarvinen S "Angio-oedema induced by enalapril." J Intern Med 238 (1995): 179-81
  31. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  32. Gunkel AR, Thurner KH, Kanonier G, Sprinzl GM, Thumfart WF "Angioneurotic edema as a reaction to angiotensin-converting enzyme inhibitors." Am J Otolaryngol 17 (1996): 87-91
  33. Wood SM, Mann RD, Rawlins MD "Angio-oedema and urticaria associated with angiotensin converting enzyme inhibitors." Br Med J 294 (1987): 91-2
  34. McElligott S, Perlroth M, Raish L "Angioedema after substituting lisinopril for captopril ." Ann Intern Med 116 (1992): 426-7
View all 34 references
Major

Ace Inhibitors (Includes Tarka) ↔ Bone Marrow Suppression

Severe Potential Hazard, Moderate plausibility

Applies to: Collagen Vascular Disease, Renal Dysfunction, Bone Marrow Depression/Low Blood Counts

ACE inhibitors may cause bone marrow suppression, rarely in uncomplicated individuals but more frequently in patients with renal impairment, especially if they also have a collagen-vascular disease such as systemic lupus erythematosus or scleroderma. Neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia, eosinophilia and thrombocytopenia have been reported, mostly with captopril. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting blood dyscrasias or complications that may increase the risk of bone marrow depression during ACE inhibitor therapy. Monitoring of blood counts, particularly white blood cells, should be considered.

References

  1. Davies RO, Irvin JD, Kramsch PK, Walker JF, Moncloa F "Enalapril worldwide experience." Am J Med 77 (1984): 23-35
  2. Knapp LE, Frank GJ, McLain R, Rieger MM, Posvar E, Singer R "The safety and tolerability of quinapril." J Cardiovasc Pharmacol 15 (1990): s47-55
  3. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  4. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  5. Edwards IR, Coulter DM, Beasley DM, MacIntosh D "Captopril: 4 years of post marketing surveillance of all patients in New Zealand." Br J Clin Pharmacol 23 (1987): 529-36
  6. Gavras I, Graff LG, Rose BD, et al "Fatal pancytopenia associated with the use of captopril." Ann Intern Med 94 (1981): 58-9
  7. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  8. Shindo K, Matsuya F, Ura T, et al "Captopril-associated granulocytopenia in hypertension after renal transplantation." Clin Nephrol 22 (1984): 314-6
  9. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  10. Strair RK, Mitch WE, Faller DV, Skorecki KL "Reversible captopril-associated bone marrow aplasia ." Can Med Assoc J 132 (1985): 320-2
  11. Beroniade V "Severe side-effects of captopril in advanced chronic kidney insufficiency." Proc Eur Dial Transplant Assoc 20 (1983): 530-7
  12. Hirakata H, Onoyama K, Iseki K, et al "Worsening of anemia induced by long-term use of captopril in hemodialysis patients." Am J Nephrol 4 (1984): 355-60
  13. Grosbois B, Milton D, Beneton C, Jacomy D "Thrombocytopenia induced by angiotensin converting enzyme inhibitors." Br Med J 298 (1989): 189-90
  14. Elijovisch F, Krakoff LR "Captopril associated granulocytopenia in hypertension after renal transplantation ." Lancet 1 (1980): 927-8
  15. Suarez M, Ho PW, Johnson ES, Perez G "Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy." Am J Med 81 (1986): 336-8
  16. Loftus WK, Ierino F, Mathew TH "Enalapril and anaemia ." Med J Aust 148 (1988): 209-10
  17. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  18. Chalmers D, Whitehead A, Lawson DH "Postmarketing surveillance of captopril for hypertension." Br J Clin Pharmacol 34 (1992): 215-23
  19. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  20. Materson BJ "Adverse effects of angiotensin-converting enzyme inhibitors in antihypertensive therapy with focus on quinapril." Am J Cardiol 69 (1992): c46-53
  21. Onoyama K, Sanai T, Motomura K, Fujishima M "Worsening of anemia by angiotensin converting enzyme inhibitors and its prevention by antiestrogenic steroid in chronic hemodialysis patients." J Cardiovasc Pharmacol 13 (1989): s27-30
  22. Elis A, Lishner M, Lang R, Ravid M "Agranulocytosis associated with enalapril." Drug Intell Clin Pharm 25 (1991): 461-2
  23. Torello J, Duran JA, Abadin JA "Captopril-associated aplastic anemia ." Drug Intell Clin Pharm 24 (1990): 543-4
  24. Forslund T, Borgmastars H, Fyrquist F "Captopril-associated leucopenia confirmed by rechallenge in patient with renal failure ." Lancet 1 (1981): 166
  25. Kim CR, Maley MB, Mohler ER "Captopril and aplastic anemia." Ann Intern Med 111 (1989): 187-8
  26. Vlahakos DV, Canzanello VJ, Madaio MP, Madias NE "Enalapril-associated anemia in renal transplant recipients treated for hypertension." Am J Kidney Dis 17 (1991): 199-205
  27. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  28. Harrison BD, Laidlaw ST, Reilly JT "Fatal aplastic anaemia associated with lisinopril." Lancet 346 (1995): 247-8
  29. Elijovisch F, Krakoff LR "Captopril associated granulocytopenia in hypertension after renal transplantation." Lancet 1 (1980): 927-8
  30. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  31. Israeli A, Or R, Leitersdorf E "Captopril-associated transient aplastic anemia." Acta Haematol 73 (1985): 106-7
  32. Waeber B, Gavras I, Brunner HR, Gavras H "Safety and efficacy of chronic therapy with captopril in hypertensive patients: an update." J Clin Pharmacol 21 (1981): 508-16
  33. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  34. Vidt DG, Bravo EL, Fouad FM "Captopril." N Engl J Med 306 (1982): 214-9
  35. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  36. Pillans PI, Koopowitz A "Captopril-associated agranulocytosis: a report of 3 cases." S Afr Med J 79 (1991): 399-400
  37. el-Makri A, Larabi MS, Kechrid C, et al "Fatal bone-marrow suppression associated with captopril." Br Med J 283 (1981): 277-8
  38. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
View all 38 references
Major

Ace Inhibitors (Includes Tarka) ↔ Chf

Severe Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure

ACE inhibitors can cause marked renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic and sometimes excessive hypotension can occur in susceptible individuals, particularly during the initiation of treatment, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with ACE inhibitors may be associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia and death. Therapy with ACE inhibitors should be initiated under very close medical supervision in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. Patients should be monitored closely for several hours after an initial dose until blood pressure has stabilized, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased. If feasible, the risk of severe hypotension may be minimized by reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days prior to starting ACE inhibitor therapy. In patients who experience a worsening of renal function, discontinuation of ACE inhibitor therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with ACE inhibitors. After blood pressure stabilizes, therapy can usually be reinstated with caution, although a lower dosage of the ACE inhibitor and/or dosage reduction or discontinuation of concomitantly administered diuretics may be necessary.

References

  1. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  2. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  3. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  4. Heintz B, Verho M, Brockmeier D, Kirsten R, Nelson K, Maigatter S, Lefevre G, Kierdorf H, Sieberth HG "Influence of ramipril on renal function in patients with chronic congestive heart failure." J Cardiovasc Pharmacol 18 (1991): s174-9
  5. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  6. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  7. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  8. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. Kober L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K, Videbaek J, Cole DS, Auclert L, Pauly NC, et al "A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group." N Engl J Med 333 (1995): 1670-6
  10. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  11. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  12. Dietz R, Nagel F, Osterziel KJ "Angiotensin-converting enzyme inhibitors and renal function in heart failure." Am J Cardiol 70 (1992): c119-25
  13. Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with enalapril." Am J Cardiol 70 (1992): 479-87
  14. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  16. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  17. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  18. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  19. Schwartz D, Averbuch M, Pines A, et al "Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure." Chest 100 (1991): 1558-61
  20. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  21. Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM, Kubo SH, Schron E, Weiss MB, Willis PW, Young JB, Probstfie "Adverse effects of enalapril in the studies of left ventricular dysfunction (SOLVD)." Am Heart J 131 (1996): 350-5
View all 21 references
Major

Ace Inhibitors (Includes Tarka) ↔ Hemodialysis

Severe Potential Hazard, Moderate plausibility

Applies to: hemodialysis

Anaphylactoid reactions have been reported in patients undergoing hemodialysis with high-flux polyacrylonitrile membranes and treated concomitantly with an ACE inhibitor. The frequency and mechanism of this interaction have not been established, and it is not known whether the interaction occurs with other membrane types. Therapy with ACE inhibitors should be administered cautiously in patients requiring hemodialysis.

References

  1. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  3. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  5. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  6. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  7. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  8. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  9. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  10. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
View all 10 references
Major

Ace Inhibitors (Includes Tarka) ↔ Hyperkalemia

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Hyperkalemia, Diabetes Mellitus

In patients with hyperkalemia, especially those associated with impaired renal function or congestive heart failure, ACE inhibitors may further raise serum potassium levels. Therapy with ACE inhibitors should be administered cautiously in patients with or predisposed to hyperkalemia, and serum potassium levels should be carefully monitored. Risk factors for the development of hyperkalemia during ACE inhibitor therapy include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes.

References

  1. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  3. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  4. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  6. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  7. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  8. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  9. Kostis JB, Shelton B, Gosselin G, Goulet C, Hood WB, Kohn RM, Kubo SH, Schron E, Weiss MB, Willis PW, Young JB, Probstfie "Adverse effects of enalapril in the studies of left ventricular dysfunction (SOLVD)." Am Heart J 131 (1996): 350-5
  10. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  11. Tramonti G, Donadio C, Confessore N, Bianchi C "Antihypertensive activity and renal effects of benazepril in humans." Kidney Int (suppl 5) (1996): s107-8
  12. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  13. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  14. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  15. Kindler J, Schunkert H, Gassmann M, Lahn W, Irmisch R, Debusmann ER, Ocon-Pujadas J, Ritz E, Sieberth HG "Therapeutic efficacy and tolerance of ramipril in hypertensive patients with renal failure." J Cardiovasc Pharmacol 13 (1989): s55-8
  16. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  17. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  18. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
View all 18 references
Major

Ace Inhibitors (Includes Tarka) ↔ Hypotension

Severe Potential Hazard, Moderate plausibility

Applies to: Diarrhea, Vomiting, hemodialysis, Dehydration, Hyponatremia, Ischemic Heart Disease, Cerebrovascular Insufficiency

ACE inhibitors can cause symptomatic hypotension, most often during the initiation of therapy and in patients who are volume- and/or sodium-depleted or treated for congestive heart failure (CHF). Therapy with ACE inhibitors should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if it was recently instituted; those on dietary salt restriction; those with severe or prolonged diarrhea or vomiting; and renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with ACE inhibitors, and the patient should be hemodynamically stable. If concomitant diuretics and/or dietary sodium restriction are employed, reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days in advance can help minimize the risk of severe hypotension in patients who are able to tolerate such adjustments. ACE inhibitors should also be used cautiously in patients in whom excessive hypotension may have serious consequences, such as patients with coronary or cerebrovascular insufficiency. Patients at risk for excessive hypotension should initiate ACE inhibitor therapy under very close medical supervision, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased.

References

  1. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  2. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  3. Chalmers D, Whitehead A, Lawson DH "Postmarketing surveillance of captopril for hypertension." Br J Clin Pharmacol 34 (1992): 215-23
  4. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  5. Kaplan NM "The CARE study: a postmarketing evaluation of ramipril in 11,100 patients." Clin Ther 18 (1996): 658-70
  6. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  7. Balfour J, Goa K "Benazepril: A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in hypertension and congestive heart failure." Drugs 42 (1991): 511-39
  8. Schoenberger JA, Testa M, Ross AD, et al "Efficacy, safety, and quality-of-life assessment of captopril antihypertensive therapy in clinical practice." Arch Intern Med 150 (1990): 301-6
  9. Schnaper HW "Comparison of the efficacy and safety of quinapril vs. captopril in treatment of moderate to severe hypertension." Angiology 40 (1989): 389-95
  10. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  11. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  12. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  13. Forette B, Koen R, Vivaut E "Efficacy and safety of quinapril in the elderly hypertensive patient." Am Heart J 123 (1992): 1426-32
  14. Young BA "ACE inhibitor first dose effect." Med J Aust 158 (1993): 577
  15. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  16. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  17. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  18. Osterziel KJ, Karr M, Busch C, Dietz R "Comparison of the first-dose effect of captopril and lisinopril in heart failure." Am J Cardiol 70 (1992): c137-9
  19. Edwards IR, Coulter DM, Beasley DM, MacIntosh D "Captopril: 4 years of post marketing surveillance of all patients in New Zealand." Br J Clin Pharmacol 23 (1987): 529-36
  20. Cooper WD, Sheldon D, Brown D, et al "Post-marketing surveillance of enalapril: experience in 11,710 hypertensive patients in general practice." J R Coll Gen Pract 37 (1987): 346-9
  21. Black J, Hunt TL, Godley PJ "Initiation of captopril therapy: the first-dose effect." J Clin Pharmacol 26 (1986): 539-40
  22. Inman WH, Rawson NS, Wilton LV, et al "Postmarketing surveillance of enalapril. I: results of prescription-event monitoring." Br Med J 297 (1988): 826-9
  23. Howes LG, Nguyen T, Jackson B "Safety and efficacy of quinapril in hypertensive geriatric patients." J Am Geriatr Soc 44 (1996): 1135
  24. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  25. Russell RM, Jones RM "Postoperative hypotension associated with enalapril." Anaesthesia 44 (1989): 837-8
  26. Schmitt JK, Koch KS, Midha M "Profound hypotension in a tetraplegic patient following angiotensin-converting enzyme inhibitor lisinopril. case report." Paraplegia 32 (1994): 871-4
  27. MacNab M, Mallows S "Safety profile of benazepril in essential hypertension." Clin Cardiol 14 Suppl I (1991): iv33-7
  28. Lang RM, Dibianco R, Broderick GT, Gottlieb SS, Kostis J, Lyle PA, Makris L, Rajfer SI, Rucinska EJ "First-dose effects of enalapril 2.5 mg and captopril 6.25 mg in patients with heart failure: a double-blind, randomized, multicenter study." Am Heart J 128 (1994): 551-6
  29. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  30. Larochelle P, Haynes B, Maron N, Dugas S "A postmarketing surveillance evaluation of quinapril in 3742 canadian hypertensive patients - the ACCEPT study." Clin Ther 16 (1994): 838-53
  31. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  32. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
View all 32 references
Major

Ccbs (Includes Tarka) ↔ Aortic Stenosis

Severe Potential Hazard, High plausibility

Applies to: Aortic Stenosis

The use of some calcium channel blockers (CCBs) is contraindicated in patients with advanced aortic stenosis. CCBs whose pharmacologic effect is partially dependent on their ability to reduce afterload (e.g., diltiazem, nicardipine, nifedipine, verapamil) may be of less benefit in these patients due to a fixed impedance to flow across the aortic valve and may, in fact, worsen rather than improve myocardial oxygen balance. Rarely, heart failure has developed following the initiation of these CCBs, particularly in patients receiving concomitant beta-blocker therapy.

References

  1. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  2. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  3. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
Major

Ccbs (Includes Tarka) ↔ Bradyarrhythmia/Av Block

Severe Potential Hazard, High plausibility

Applies to: Heart Block, Sinus Node Dysfunction

The use of some calcium channel blockers (CCBs) is contraindicated in patients with severe bradyarrhythmia, sick sinus syndrome (unless a functioning pacemaker is present), or heart block greater than the first degree (unless a functioning pacemaker is present). CCBs like bepridil, diltiazem and verapamil have a negative effect on AV conduction and the SA node and may exacerbate these conditions.

References

  1. Aromatorio GJ, Uretsky BF, Reddy PS "Hypotension and sinus arrest with nifedipine in pulmonary hypertension." Chest 87 (1985): 265-7
  2. Colombo G, Zucchella G, Planca E, Grieco A "Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance." Clin Ther 9 (1987): 536-47
  3. Baky SH, Singh BN "Verapamil hydrochloride: pharmacological properties and role in cardiovascular therapeutics." Pharmacotherapy 2 (1982): 328-50
  4. Gobel EJAM, Hautvast RWM, Vangilst WH, Spanjaard JN, Hillege HL, Dejongste MJL, Molhoek GP, Lie KI "Randomised, double-blind trial of intravenous diltiazem versus glyceryl trinitrate for unstable angina pectoris." Lancet 346 (1995): 1653-7
  5. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  6. Andrivet P, Beaslay V, Kiger JP, Gnoc CV "Complete sinus arrest during diltiazem therapy - clinical correlates and efficacy of intravenous calcium." Eur Heart J 15 (1994): 350-4
  7. "Product Information. Covera-HS (verapamil)." Searle, Skokie, IL.
  8. Imamura T, Koiwaya Y, Nakamura M "Sinoatrial block induced by oral diltiazem." Clin Cardiol 9 (1986): 33-4
  9. Nagle RE, Low-Beer T, Horton R "Diltiazem and heart block." Lancet Apr (1989): 907
  10. "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  11. Woehler TR, Eff J, Graney W, et al "Multicenter evaluation of the efficacy and safety of sustained-release diltiazem hydrochloride for the treatment of hypertension." Clin Ther 14 (1992): 148-57
  12. Pahor M, Manto A, Pedone C, Carosella L, Guralnik JM, Carbonin P "Age and severe adverse drug reactions caused by nifedipine and verapamil." J Clin Epidemiol 49 (1996): 921-8
  13. Reams GP, Lau A, Messina C, et al "Efficacy, electrocardiographic and renal effects of intravenous diltiazem for essential hypertension." Am J Cardiol 60 (1987): i78-84
  14. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
View all 14 references
Major

Ccbs (Includes Tarka) ↔ Cardiogenic Shock/Hypotension

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock, Hypotension

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Stehle G, Buss J, Eibach J, et al "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet 336 (1990): 1079
  3. "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
  5. Kubota K, Pearce GL, Inman WHW "Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring." Eur J Clin Pharmacol 48 (1995): 1-7
  6. Pahor M, Manto A, Pedone C, Carosella L, Guralnik JM, Carbonin P "Age and severe adverse drug reactions caused by nifedipine and verapamil." J Clin Epidemiol 49 (1996): 921-8
View all 6 references
Major

Ccbs (Includes Tarka) ↔ Coronary Artery Disease

Severe Potential Hazard, Low plausibility

Applies to: Ischemic Heart Disease

Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.

References

  1. Thomassen AR, Bagger JP, Nielsen TT "Hemodynamic and cardiac metabolic changes during nicardipine-induced myocardial ischemia." Cathet Cardiovasc Diagn 14 (1988): 41-3
  2. Kloner RA "Nifedipine in ischemic heart disease." Circulation 92 (1995): 1074-8
  3. Manga P, Vythilingum "Unstable angina precipitated by nifedipine." S Afr Med J 66 (1984): 144
  4. Myrhed M, Wiholm B-E "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh) 58 (1986): 133-6
  5. Lambert CR, Hill JA, Feldman RL, Pepine CJ "Myocardial ischemia during intravenous nicardipine administration." Am J Cardiol 55 (1985): 844-5
  6. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  7. Oei SG, Oei SK, Brolmann HAM "Myocardial infarction during nifedipine therapy for preterm labor." N Engl J Med 340 (1999): 154
  8. Furberg CD, Psaty BM, Meyer JV "Nifedipine: dose-related increase in mortality in patients with coronary heart disease." Circulation 92 (1995): 1326-31
  9. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  10. Schanzenbacher P, Deeg P, Liebau G, Kochsiek K "Paradoxical angina after nifedipine: angiographic documentation." Am J Cardiol 53 (1984): 345-6
  11. "Product Information. Norvasc (amlodipine)." Pfizer US Pharmaceuticals, New York, NY.
  12. Sia STB, MacDonald PS, Triester B, et al "Aggravation of myocardial ischaemia by nifedipine." Med J Aust 142 (1985): 48-50
  13. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  14. "Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
  15. Yusuf S "Calcium antagonists in coronary artery disease and hypertension: time for reevaluation?" Circulation 92 (1995): 1079-82
View all 15 references
Major

Ccbs (Includes Tarka) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, several patients have developed cholestasis or hepatocellular injury that was proven by rechallenge. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function and for excessive pharmacologic effects (e.g., abnormal prolongation of PR interval) is advised, and the dosage adjusted if necessary.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.
  3. Regardh CG, Edgar B, Olsson R, Kendall M, Collste P, Shansky C "Pharmacokinetics of felodipine in patients with liver disease." Eur J Clin Pharmacol 36 (1989): 473-9
  4. Cotting J, Reichen J, Kutz K, Laplanche R, Nuesch E "Pharmacokinetics of isradipine in patients with chronic liver disease." Eur J Clin Pharmacol 38 (1990): 599-603
  5. Stern EH, Pitchon R, King BD, Wiener I "Possible hepatitis from verapamil." N Engl J Med 306 (1982): 612-3
  6. Elliott HL, Meredith PA "The clinical consequences of the absorption, distribution, metabolism and excretion of amlodipine." Postgrad Med J 67 (1991): s20-3
  7. "Product Information. Plendil (felodipine)." Merck & Co, Inc, West Point, PA.
  8. Graham D, Dow R, Hall D, Alexander O, Mroszczak E, Freedman A "The metabolism and pharmacokinetics of nicardipine hydrochloride in man." Br J Clin Pharmacol 20 (1985): s23-8
  9. Scherling D, Karl W, Ahr G, Ahr HJ, Wehinger E "Pharmacokinetics of nisoldipine. III. Biotransformation of nisoldipine in rat, dog, monkey, and man." Arzneimittelforschung 38 (1988): 1105-10
  10. Giacomini KM, Massoud N, Wong FM, Giacomini JC "Decreased binding of verapamil to plasma proteins in patients with liver disease." J Cardiovasc Pharmacol 6 (1984): 924-8
  11. Rush WR, Alexander O, Hall DJ, Cairncross L, Dow RJ, Graham DJ "The metabolism of nicardipine hydrochloride in healthy male volunteers." Xenobiotica 16 (1986): 341-9
  12. Babany G, Uzzan F, Larrey D, et al "Alcoholic-like liver lesions induced by nifedipine." J Hepatol 9 (1989): 252-5
  13. Ramsch KD, Graefe KH, Scherling D, et al "Pharmacokinetics and metabolism of calcium-blocking agents nifedipine, nitrendipine, and nimodipine." Am J Nephrol 6 (1986): 73-80
  14. "Product Information. DynaCirc (isradipine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  15. Dunselman PH, Edgar B "Felodipine clinical pharmacokinetics." Clin Pharmacokinet 21 (1991): 418-30
  16. Kurosawa S, Kurosawa N, Owada E, et al "Pharmacokinetics of diltiazem in patients with liver cirrhosis." Int J Clin Pharmacol Res 10 (1990): 311-8
  17. Stopher DA, Beresford AP, Macrae PV, Humphrey MJ "The metabolism and pharmacokinetics of amlodipine in humans and animals." J Cardiovasc Pharmacol 12 (1988): s55-9
  18. McAllister RG Jr, Hamann SR, Blouin RA "Pharmacokinetics of calcium-entry blockers." Am J Cardiol 55 (1985): b30-40
  19. Brodsky SJ, Cutler SS, Weiner DA, Klein MD "Hepatotoxicity due to treatment with verapamil." Ann Intern Med 94 (1981): 490-1
  20. Guarascio P, D'Amato C, Sette P, et al "Liver damage from verapamil." Br Med J 288 (1984): 362-3
  21. Woodcock BG, Rietbrock N "Verapamil bioavailability and dosage in liver disease." Br J Clin Pharmacol 13 (1982): 240-1
  22. Kumar KL, Colley CA "Verapamil-induced hepatotoxicity." West J Med 160 (1994): 485-6
  23. "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  24. Traverse JH, Swenson LJ, Mcbride JW "Acute hepatic injury after treatment with diltiazem." Am Heart J 127 (1994): 1636-9
  25. Benet LZ "Pharmacokinetics and metabolism of bepridil." Am J Cardiol 55 (1985): c8-13
  26. Toner M, White A, Moriarty J, Clancy L "Allergic urticarial eruption, leukocytosis and abnormal liver function tests following nifedipine administration." Chest 93 (1988): 1320-1
  27. Kleinbloesem CH, van Harten J, Wilson JP, et al "Nifedipine: kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration." Clin Pharmacol Ther 40 (1986): 21-8
  28. Kates RE "Calcium antagonists: pharmacokinetic properties." Drugs 25 (1983): 113-24
  29. Razak TA, McNeil JJ, Sewell RB, Drummer OH, Smallwood RA, Conway EL, Louis WJ "The effect of hepatic cirrhosis on the pharmacokinetics and blood pressure response to nicardipine." Clin Pharmacol Ther 47 (1990): 463-9
  30. Colombo G, Zucchella G, Planca E, Grieco A "Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance." Clin Ther 9 (1987): 536-47
  31. "Product Information. Norvasc (amlodipine)." Pfizer US Pharmaceuticals, New York, NY.
  32. Hare DL, Horowitz JD "Verapamil hepatotoxicity: a hypersensitivity reaction." Am Heart J 111 (1986): 610-11
  33. Raemsch KD, Sommer J "Pharmacokinetics and metabolism of nifedipine." Hypertension 5 (1983): 18-24
  34. Shallcross H, Padley SP, Glynn MJ, Gibbs DD "Fatal renal and hepatic toxicity after treatment with diltiazem." Br Med J 295 (1987): 1256-7
  35. "Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
  36. Stehle G, Buss J, Eibach J, et al "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet 336 (1990): 1079
  37. Gengo FM, Fagan SC, Krol G, Bernhard H "Nimodipine disposition and haemodynamic effects in patients with cirrhosis and age-matched controls." Br J Clin Pharmacol 23 (1987): 47-53
  38. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  39. Meredith P, Elliott H "Clinical pharmacokinetics of amlodipine." Clin Pharmacokinet 22 (1992): 22-31
  40. Saracheck NS, London RL, Matulewicz TJ, et al "Diltiazem and granulomatous hepatitis." Gastroenterology 88 (1985): 1260-2
  41. Challenor VF, Waller DG, Renwick AG, et al "The trans-hepatic extraction of nifedipine." Br J Clin Pharmacol 24 (1987): 473-7
  42. Somogyi A, Albrecht M, Kliems G, et al "Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis." Br J Clin Pharmacol 12 (1981): 51-60
  43. "Product Information. Nimotop (nimodipine)." Bayer, West Haven, CT.
  44. Finucci GF, Padrini R, Piovan D, et al "Verapamil pharmacokinetics and liver function in patients with cirrhosis." Int J Clin Pharmacol Res 8 (1988): 123-6
  45. Abernathy DR, Schwrtz JB "Calcium-antagonist drugs." N Engl J Med 341 (1999): 1447-57
  46. Dow RJ, Graham DJM "A reveiw of the human metabolism and pharmacokinetics of nicardipine hydrochloride." Br J Clin Pharmacol 22 (1986): s195-202
  47. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
  48. Woodcock BG, Rietbrock I, Vohringer HF, Rietbrock N "Verapamil disposition in liver disease and intensive-care patients: kinetics, clearance, and apparent blood flow relationships." Clin Pharmacol Ther 29 (1981): 27-34
  49. Johnson KE, Balderston SM, Pieper JA, Mann DE, Reiter MJ "Electrophysiologic effects of verapamil metabolites in the isolated heart." J Cardiovasc Pharmacol 17 (1991): 830-7
  50. Echizen H, Eichelbaum M "Clinical pharmacokinetics of verapamil, nifedipine and diltiazem." Clin Pharmacokinet 11 (1986): 425-49
  51. Abramson M, Littlejohn GO "Hepatic reactions to nifedipine." Med J Aust 142 (1985): 47-8
  52. Toft E, Vyberg M, Therkelsen K "Diltiazem-induced granulomatous hepatitis." Histopathology 18 (1991): 474-5
  53. Tse FL, Jaffe JM "Pharmacokinetics of PN 200-110 (isradipine), a new calcium antagonist, after oral administration in man." Eur J Clin Pharmacol 32 (1987): 361-5
View all 53 references
Major

Diltiazem/Verapamil Iv (Includes Tarka) ↔ Ventricular Tachycardia

Severe Potential Hazard, High plausibility

Applies to: Ventricular Arrhythmia

The use of intravenous diltiazem or verapamil is contraindicated in patients with ventricular tachycardia. IV administration of a calcium channel blocker can precipitate cardiac arrest in such patients. Marked hemodynamic deterioration and ventricular fibrillation have occurred in patients with wide-complex ventricular tachycardia (QRS >= 0.12 seconds) treated with IV verapamil.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  3. Winters SL, Schweitzer P, Kupersmith J, Gomes JA "Verapamil-induced polymorphous ventricular tachycardia." J Am Coll Cardiol 6 (1985): 257-9
  4. Buxton AE, Marchlinski FE, Doherty JU, et al "Hazards of intravenous verapamil for sustained ventricular tachycardia." Am J Cardiol 59 (1987): 1107-10
View all 4 references
Major

Trandolapril (Includes Tarka) ↔ Cirrhosis

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The clearance of trandolapril and its active metabolite, trandolaprilat, may be decreased in patients with hepatic cirrhosis. Following oral administration in patients with mild to moderate alcoholic cirrhosis, plasma concentrations of trandolapril and trandolaprilat were 9-fold and 2-fold greater, respectively, than in normal subjects. However, the inhibition of ACE activity was not affected. The manufacturer states that lower initial dosages should be considered in patients with hepatic insufficiency.

References

  1. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
Major

Verapamil (Includes Tarka) ↔ Accessory Av Tracts

Severe Potential Hazard, High plausibility

Applies to: Preexcitation Syndrome

The use of verapamil is contraindicated for the management of atrial flutter or fibrillation in patients with an accessory AV tract (e.g., those with Wolff-Parkinson-White or Lown-Ganong-Levine syndrome). Intravenous verapamil has been reported to cause ventricular fibrillation and cardiac arrest in such patients, the mechanism of which is related to the drug's ability to shorten the refractory period and accelerate antegrade conduction within the accessory pathway. Although these events have not been associated with chronic use of oral verapamil, a similar risk may exist.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  2. Hame A, Peter T, Platt M, Mandel WJ "Effects of verapamil on supraventricular tachycardia in patients with overt and concealed wolff-parkinson-white syndrome." Am Heart J 101 (1981): 600-12
  3. McGovern B, Garan H, Ruskin JN "Precipitation of cardiac arrest by verapamil in patients with Wolff-Parkinson-White syndrome." Ann Intern Med 104 (1986): 791-4
  4. Jacob AS, Nielsen DH, Gianelly RE "Fatal ventricular fibrillation following verapamil in Wolff-Parkinson-White syndrome with atrial fibrillation." Ann Emerg Med 14 (1985): 159-60
  5. Schwartz JB, Jeang M, Raizner AE, et al "Accelerated junctional rhythms during oral verapamil therapy." Am Heart J 107 (1984): 440-3
  6. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  7. "Product Information. Covera-HS (verapamil)." Searle, Skokie, IL.
  8. Schwartz JB "Verapamil in atrial fibrillation: the expected, the unexpected, and the unknown." Am Heart J 106 (1983): 173-6
View all 8 references
Major

Verapamil (Includes Tarka) ↔ Chf/Ami

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Myocardial Infarction

The use of verapamil is contraindicated in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, verapamil should not be given to patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened. Verapamil has a negative inotropic effect, which in most patients is compensated by a simultaneous reduction in afterload (i.e. decreased systemic vascular resistance) without a net impairment of ventricular performance. However, congestive heart failure or pulmonary edema have developed in approximately 2% of patients treated with verapamil. Mild symptoms of cardiac failure should be under control, if possible, prior to initiating verapamil therapy.

References

  1. Shimoni A, Maorkendler Y, Neuman Y "Verapamil-induced acute right heart failure." Am Heart J 132 (1996): 193-4
  2. Baky SH, Singh BN "Verapamil hydrochloride: pharmacological properties and role in cardiovascular therapeutics." Pharmacotherapy 2 (1982): 328-50
  3. Pollak A, Falk RH "Left ventricular systolic dysfunction precipitated by verapamil in cardiac amyloidosis." Chest 104 (1993): 618-20
  4. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
View all 4 references
Major

Verapamil (Includes Tarka) ↔ Hypertrophic Cardiomyopathy

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertrophic Cardiomyopathy

The use of verapamil in patients with hypertrophic cardiomyopathy, or idiopathic hypertrophic subaortic stenosis, has been associated with serious side effects such as pulmonary edema, severe hypotension, sinus bradycardia, AV block, sinus arrest, and death. However, a causal relationship has not been established. Therapy with verapamil should be administered cautiously in patients with hypertrophic cardiomyopathy. Dosage reduction or drug discontinuation may be required if severe adverse effects occur.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
Moderate

Ace Inhibitors (Includes Tarka) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Rarely, elevations of liver enzymes and/or serum bilirubin have occurred with the use of ACE inhibitors. Patients receiving ACE inhibitors who develop jaundice or marked elevations of hepatic enzymes should discontinue the ACE inhibitor and receive appropriate medical follow-up.

Moderate

Ace Inhibitors (Includes Tarka) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

With the exception of fosinopril, ACE inhibitors (and/or their active metabolites in some cases) are primarily eliminated by the kidney and may accumulate in patients with renal impairment. ACE inhibitors can also worsen renal function in some patients by blocking the effect of angiotensin II-mediated efferent arteriolar vasoconstriction, thereby decreasing glomerular filtration. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting renal dysfunction, particularly those with renovascular disease. Patients with moderate to severe renal impairment usually require lower or less frequent doses and smaller increments in dose. In addition, a dosage reduction or discontinuation of any concomitantly administered diuretics may be helpful. Fosinopril probably does not require dosage adjustments unless hepatic function is also significantly impaired.

In patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, ACE inhibitors may reduce renal perfusion to a critically low level. Renal function should be monitored closely for the first few weeks of therapy.

References

  1. Dietz R, Nagel F, Osterziel KJ "Angiotensin-converting enzyme inhibitors and renal function in heart failure." Am J Cardiol 70 (1992): c119-25
  2. Frank GJ, Knapp LE, Olson SC, Phelps MC, Quade MM, Rieger MM, Sedman AJ "Overview of quinapril, a new ACE inhibitor." J Cardiovasc Pharmacol 15 (1990): s14-23
  3. "Moexipril: another ace inhibitor for hypertension." Med Lett Drugs Ther 37 (1995): 75-6
  4. Champ JD "Case report: azotemia secondary to enalapril and diuretic use and the diagnosis of renovascular hypertension." Am J Med Sci 305 (1993): 25-7
  5. Forette B, Koen R, Vivaut E "Efficacy and safety of quinapril in the elderly hypertensive patient." Am Heart J 123 (1992): 1426-32
  6. "Product Information. Accupril (quinapril)." Parke-Davis, Morris Plains, NJ.
  7. Inman WH, Rawson NS, Wilton LV, et al "Postmarketing surveillance of enalapril. I: results of prescription-event monitoring." Br Med J 297 (1988): 826-9
  8. "Product Information. Monopril (fosinopril)." Bristol-Myers Squibb, Princeton, NJ.
  9. Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with enalapril." Am J Cardiol 70 (1992): 479-87
  10. "Product Information. Univasc (moexipril)." Schwarz Pharma, Mequon, WI.
  11. Olivier PB, German ML, Carette BD, Millart HG, Trenque TC "Elevation of serum creatinine following fosinopril therapy." Ann Pharmacother 33 (1999): 382-3
  12. Thind GS "Renal insufficiency during angiotensin-converting enzyme inhibitor therapy in hypertensive patients with no renal artery stenosis." J Clin Hypertens 1 (1985): 337-43
  13. O'Donnell D "Renal failure due to enalapril and captopril in bilateral renal artery stenosis: greater awareness needed." Med J Aust 148 (1988): 525-7
  14. "Product Information. Prinivil (lisinopril)." Merck & Co, Inc, West Point, PA.
  15. "Product Information. Aceon (perindopril)." Solvay Pharmaceuticals Inc, Marietta, GA.
  16. Knapp LE, Frank GJ, McLain R, Rieger MM, Posvar E, Singer R "The safety and tolerability of quinapril." J Cardiovasc Pharmacol 15 (1990): s47-55
  17. Frank GJ, Knapp LE, McLain RW "Overall tolerance and safety of quinapril in clinical trials." Angiology 40 (1989): 405-15
  18. Howes LG, Nguyen T, Jackson B "Safety and efficacy of quinapril in hypertensive geriatric patients." J Am Geriatr Soc 44 (1996): 1135
  19. Heintz B, Verho M, Brockmeier D, Kirsten R, Nelson K, Maigatter S, Lefevre G, Kierdorf H, Sieberth HG "Influence of ramipril on renal function in patients with chronic congestive heart failure." J Cardiovasc Pharmacol 18 (1991): s174-9
  20. Thomson AH, Kelly JG, Whiting B "Lisinopril population pharmacokinetics in elderly and renal disease patients with hypertension." Br J Clin Pharmacol 27 (1989): 57-65
  21. Persson B, Stimpel M "Evaluation of the antihypertensive efficacy and tolerability of moexipril, a new ACE inhibitor, compared to hydrochlorothiazide in elderly patients." Eur J Clin Pharmacol 50 (1996): 259-64
  22. Cetnarowski-Cropp AB "Quinapril: a new second-generation ACE inhibitor." DICP 25 (1991): 499-504
  23. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  24. Heeg JE, de Jong PE, de Zeeuw D "Lisinopril and renal failure ." Lancet 1 (1989): 846
  25. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  26. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
  27. Sica DA, Cutler RE, Parmer RJ, Ford NF "Comparison of the steady-state pharmacokinetics of fosinopril, lisinopril and enalapril in patients with chronic renal insufficiency." Clin Pharmacokinet 20 (1991): 420-7
  28. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  29. Schwartz D, Averbuch M, Pines A, et al "Renal toxicity of enalapril in very elderly patients with progressive, severe congestive heart failure." Chest 100 (1991): 1558-61
  30. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  31. Antonios TFT, Macgregor GA "Angiotensin converting enzyme inhibitors in hypertension: potential problems." J Hypertens 13 Suppl (1995): s11-6
  32. Murray BM, Venuto RC, Kohli R, Cunningham EE "Enalapril-associated acute renal failure in renal transplants: possible role of cyclosporine." Am J Kidney Dis 16 (1990): 66-9
View all 32 references
Moderate

Verapamil (Includes Tarka) ↔ Neuromuscular Transmission

Moderate Potential Hazard, Moderate plausibility

Applies to: Myopathy, Myoneural Disorder

Verapamil has been reported to decrease neuromuscular transmission in patients with Duchenne's muscular dystrophy and to prolong recovery from the neuromuscular blocking agent, vecuronium. Therapy with verapamil should be administered cautiously in patients with attenuated neuromuscular transmission or myopathy, since these conditions may be exacerbated. A reduced dosage may be appropriate.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Reverte M "Adverse effect of verapamil in myasthenia gravis: an additional comment." Muscle Nerve 16 (1993): 879-81
  3. "Product Information. Isoptin (verapamil)." Knoll Pharmaceutical Company, Whippany, NJ.
Moderate

Verapamil (Includes Tarka) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Approximately 70% of an administered dose of verapamil is excreted as metabolites in the urine. The primary metabolite, norverapamil, has about 20% the cardiovascular activity and can reach steady-state plasma concentrations approaching those of the parent drug. Patients with impaired renal function may be at greater risk for adverse effects due to drug and metabolite accumulation. Therapy with verapamil should be administered cautiously in such patients, with appropriate monitoring for excessive pharmacologic effects (e.g., abnormal prolongation of PR interval) and the dosage adjusted accordingly as necessary.

References

  1. Kates RE "Calcium antagonists: pharmacokinetic properties." Drugs 25 (1983): 113-24
  2. McAllister RG Jr, Hamann SR, Blouin RA "Pharmacokinetics of calcium-entry blockers." Am J Cardiol 55 (1985): b30-40
  3. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  4. Pritza DR, Bierman MH, Hammeke MD "Acute toxic effects of sustained-release verapamil in chronic renal failure." Arch Intern Med 151 (1991): 2081-4
  5. Mooy J, Schols M, Baak MV, et al "Pharmacokinetics of verapamil in patients with renal failure." Eur J Clin Pharmacol 28 (1985): 405-10
  6. Johnson KE, Balderston SM, Pieper JA, Mann DE, Reiter MJ "Electrophysiologic effects of verapamil metabolites in the isolated heart." J Cardiovasc Pharmacol 17 (1991): 830-7
  7. Echizen H, Eichelbaum M "Clinical pharmacokinetics of verapamil, nifedipine and diltiazem." Clin Pharmacokinet 11 (1986): 425-49
  8. Storstein L, Larsen A, Midtbo K, Saevareid L "Pharmacokinetics of calcium blockers in patients with renal insufficiency and in geriatric patients." Acta Med Scand Suppl 681 (1984): 25-30
  9. Vazquez C, Huelmos A, Alegria E, Errasti P, Purroy A "Verapamil deleterious effects in chronic renal failure." Nephron 72 (1996): 461-4
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Moderate

Verapamil Hs (Includes Tarka) ↔ Gi Narrowing

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction

The controlled-onset, extended-release formulation of verapamil (Covera-HS) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the controlled-onset, extended-release formulation of verapamil should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

References

  1. "Product Information. Covera-HS (verapamil)." Searle, Skokie, IL.

Tarka (trandolapril / verapamil) drug Interactions

There are 1085 drug interactions with Tarka (trandolapril / verapamil)

Tarka (trandolapril / verapamil) alcohol/food Interactions

There are 4 alcohol/food interactions with Tarka (trandolapril / verapamil)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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