Trandolapril (Monograph)
Brand name: Mavik
Drug class: Angiotensin-Converting Enzyme Inhibitors
- ACE Inhibitors
VA class: CV800
Chemical name: 1-Ethyl ester (2S,3aR,7aS)-1-[(S)-N-[(S)-1-carboxy-3-phenylpropyl] alanyl]hexahydro-2-indolinecarboxylic acid
Molecular formula: C24H34N2O5
CAS number: 87679-37-6
Warning
Introduction
Nonsulfhydryl ACE inhibitor.1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Uses for Trandolapril
Hypertension
Management of hypertension (alone or in combination with other classes of antihypertensive agents).1 3 5 11 13 14 15 16 17 1200
ACE inhibitors are recommended as one of several preferred agents for the initial management of hypertension according to current evidence-based hypertension guidelines; other preferred options include angiotensin II receptor antagonists, calcium-channel blockers, and thiazide diuretics.501 502 503 504 1200 While there may be individual differences with respect to recommendations for initial drug selection and use in specific patient populations, current evidence indicates that these antihypertensive drug classes all generally produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.501 502 504 1200 1213
Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).501 502 503 504 515 1200 1201
A 2017 ACC/AHA multidisciplinary hypertension guideline classifies BP in adults into 4 categories: normal, elevated, stage 1 hypertension, and stage 2 hypertension.1200 (See Table 1.)
Source: Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13-115..
Individuals with SBP and DBP in 2 different categories (e.g., elevated SBP and normal DBP) should be designated as being in the higher BP category (i.e., elevated BP).
Category |
SBP (mm Hg) |
DBP (mm Hg) |
|
---|---|---|---|
Normal |
<120 |
and |
<80 |
Elevated |
120–129 |
and |
<80 |
Hypertension, Stage 1 |
130–139 |
or |
80–89 |
Hypertension, Stage 2 |
≥140 |
or |
≥90 |
The goal of hypertension management and prevention is to achieve and maintain optimal control of BP.1200 However, the BP thresholds used to define hypertension, the optimum BP threshold at which to initiate antihypertensive drug therapy, and the ideal target BP values remain controversial.501 503 504 505 506 507 508 515 523 526 530 1200 1201 1207 1209 1222 1223 1229
The 2017 ACC/AHA hypertension guideline generally recommends a target BP goal (i.e., BP to achieve with drug therapy and/or nonpharmacologic intervention) of <130/80 mm Hg in all adults regardless of comorbidities or level of atherosclerotic cardiovascular disease (ASCVD) risk.1200 In addition, an SBP goal of <130 mm Hg is recommended for noninstitutionalized ambulatory patients ≥65 years of age with an average SBP of ≥130 mm Hg.1200 These BP goals are based upon clinical studies demonstrating continuing reduction of cardiovascular risk at progressively lower levels of SBP.1200 1202 1210
Other hypertension guidelines generally have based target BP goals on age and comorbidities.501 504 536 Guidelines such as those issued by the JNC 8 expert panel generally have targeted a BP goal of <140/90 mm Hg regardless of cardiovascular risk and have used higher BP thresholds and target BPs in elderly patients501 504 536 compared with those recommended by the 2017 ACC/AHA hypertension guideline.1200
Some clinicians continue to support previous target BPs recommended by JNC 8 due to concerns about the lack of generalizability of data from some clinical trials (e.g., SPRINT study) used to support the 2017 ACC/AHA hypertension guideline and potential harms (e.g., adverse drug effects, costs of therapy) versus benefits of BP lowering in patients at lower risk of cardiovascular disease.1222 1223 1224 1229
Consider potential benefits of hypertension management and drug cost, adverse effects, and risks associated with the use of multiple antihypertensive drugs when deciding a patient's BP treatment goal.1200 1220
For decisions regarding when to initiate drug therapy (BP threshold), the 2017 ACC/AHA hypertension guideline incorporates underlying cardiovascular risk factors.1200 1207 ASCVD risk assessment is recommended by ACC/AHA for all adults with hypertension.1200
ACC/AHA currently recommend initiation of antihypertensive drug therapy in addition to lifestyle/behavioral modifications at an SBP ≥140 mm Hg or DBP ≥90 mm Hg in adults who have no history of cardiovascular disease (i.e., primary prevention) and a low ASCVD risk (10-year risk <10%).1200
For secondary prevention in adults with known cardiovascular disease or for primary prevention in those at higher risk for ASCVD (10-year risk ≥10%), ACC/AHA recommend initiation of antihypertensive drug therapy at an average SBP ≥130 mm Hg or an average DBP ≥80 mm Hg.1200
Adults with hypertension and diabetes mellitus, chronic kidney disease (CKD), or age ≥65 years are assumed to be at high risk for cardiovascular disease; ACC/AHA state that such patients should have antihypertensive drug therapy initiated at a BP ≥130/80 mm Hg.1200 Individualize drug therapy in patients with hypertension and underlying cardiovascular or other risk factors.502 1200
In stage 1 hypertension, experts state that it is reasonable to initiate drug therapy using the stepped-care approach in which one drug is initiated and titrated and other drugs are added sequentially to achieve the target BP.1200 Initiation of antihypertensive therapy with 2 first-line agents from different pharmacologic classes recommended in adults with stage 2 hypertension and average BP >20/10 mm Hg above BP goal.1200
Black hypertensive patients generally tend to respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to ACE inhibitors.24 56 57 79 80 501 504 1200 However, the combination of an ACE inhibitor or an angiotensin II receptor antagonist with a calcium-channel blocker or thiazide diuretic produces similar BP lowering in black patients as in other racial groups.1200
ACE inhibitors may be preferred in hypertensive patients with heart failure, ischemic heart disease, diabetes mellitus, CKD, or cerebrovascular disease or post-MI.501 502 504 523 524 525 526 527 534 535 536 543 1200 1214 1215
Heart Failure or Left Ventricular Dysfunction After Acute MI
Reduction of the risk of mortality (mainly cardiovascular mortality) and risk of heart failure-associated hospitalization following MI in hemodynamically stable patients who have evidence of left ventricular systolic dysfunction or who have demonstrated clinical signs of heart failure within a few days following acute MI.1 32 524
Expert guidelines recommend initiation of an oral ACE inhibitor within the first 24 hours of acute MI in patients with an anterior infarct, heart failure, or ejection fraction ≤40% who do not have any contraindications (e.g., hypotension, shock, renal dysfunction).527 Use with caution (and with gradual upward titration) during initial postinfarction period because of the possibility of hypotension or renal dysfunction.527 1100
Continue therapy indefinitely in patients with left ventricular dysfunction or other compelling indications (e.g., hypertension, diabetes mellitus, CKD).525 1100
Heart Failure
Management of heart failure† [off-label], usually in conjunction with other agents such as cardiac glycosides, diuretics, and β-adrenergic blocking agents (β-blockers).60 61 62 63 64 524 800
Some evidence indicates that therapy with an ACE inhibitor (enalapril) may be less effective than angiotensin receptor-neprilysin inhibitor (ARNI) therapy (e.g., sacubitril/valsartan) in reducing cardiovascular death and heart failure-related hospitalization.702 800
ACCF, AHA, and the Heart Failure Society of America (HFSA) recommend that patients with chronic symptomatic heart failure and reduced left ventricular ejection fraction (LVEF) (NYHA class II or III) who are able to tolerate an ACE inhibitor or angiotensin II receptor antagonist be switched to therapy containing an ARNI to further reduce morbidity and mortality.800
Diabetic Nephropathy
A recommended agent in the management of patients with diabetes mellitus and persistent albuminuria† [off-label] who have modestly elevated (30–300 mg/24 hours) or higher (>300 mg/24 hours) levels of urinary albumin excretion; slows rate of progression of renal disease in such patients.74 75 76 77 78 535 536 1232
Trandolapril Dosage and Administration
General
BP Monitoring and Treatment Goals
-
Monitor BP regularly (i.e., monthly) during therapy and adjust dosage of the antihypertensive drug until BP controlled.1200
-
If unacceptable adverse effects occur, discontinue drug and initiate another antihypertensive agent from a different pharmacologic class.1216
-
If adequate BP response not achieved with a single antihypertensive agent, either increase dosage of single drug or add a second drug with demonstrated benefit and preferably a complementary mechanism of action (e.g., calcium-channel blocker, thiazide diuretic).1200 1216 Many patients will require ≥2 drugs from different pharmacologic classes to achieve BP goal; if goal BP still not achieved, add a third drug.1200 1216 1220
Administration
Oral Administration
Administer orally once or twice daily.1
Administer trandolapril/verapamil fixed combination with food;29 manufacturer makes no specific recommendation regarding administration of trandolapril with meals.1
Dosage
In patients currently receiving diuretic therapy, discontinue diuretic or cautiously increase salt intake prior to initiating trandolapril.600 If diuretic cannot be discontinued, initiate trandolapril at a reduced dosage.600 (See Hypotension under Cautions and see the individual dosage sections in Dosage and Administration.)
Adults
Hypertension
Trandolapril Therapy
OralInitially, 2 mg once daily in black patients and 1 mg once daily in patients of other races as monotherapy.600 Adjust dosage based on BP response, usually at intervals of ≥1 week.600
In patients currently receiving diuretic therapy, discontinue diuretic, if possible, 2–3 days before initiating trandolapril.600 May resume diuretic therapy if BP not controlled adequately with trandolapril alone.600 If diuretic cannot be discontinued, initiate trandolapril therapy at 0.5 mg once daily under close medical supervision for several hours until BP has stabilized.600
Usual maintenance dosage: Manufacturer states 2–4 mg once daily.600 Some experts state 1–4 mg once daily.1200
If 4 mg once daily does not adequately control BP, consider administering drug in 2 divided doses.28 600
Limited clinical experience with dosages >8 mg daily.600
Trandolapril/Verapamil Fixed-combination Therapy
OralManufacturer states fixed-combination preparation should not be used for initial antihypertensive therapy.601
May be used after adequate response is not achieved with trandolapril or verapamil monotherapy.601
May be initiated in patients who experience dose-limiting adverse effects with either trandolapril or verapamil monotherapy.601
For patients receiving verapamil (up to 240 mg) and trandolapril (up to 8 mg) in separate tablets once daily, replacement with the fixed combination can be attempted using tablets containing the same component doses.29
Heart Failure or Left Ventricular Dysfunction After Acute MI
Oral
Manufacturer recommends initial dose of 1 mg.1 32 524 602
Some experts recommend initiation of therapy within the first 24 hours of MI with a test dose of 0.5 mg.527
Following initial dose, titrate as tolerated to a target dosage of 4 mg once daily; if 4 mg once daily is not tolerated, may continue therapy at the highest tolerated dosage.1 524 602
Prescribing Limits
Adults
Hypertension
Oral
Limited clinical experience with dosages >8 mg daily.600
Heart Failure† [off-label]
Oral
ACCF and AHA recommend maximum dosage of 4 mg once daily.524
Special Populations
Hepatic Impairment
Hypertension
Oral
Reduced initial dosage (0.5 mg once daily) recommended in patients with hepatic cirrhosis;1 16 titrate subsequent dosage according to BP response.1
Heart Failure or Left Ventricular Dysfunction after Acute MI
Oral
Reduced initial dosage (0.5 mg once daily) recommended in patients with hepatic cirrhosis;1 16 titrate subsequent dosage as tolerated according to response.1
Renal Impairment
Hypertension
Oral
Reduced initial dosage (0.5 mg once daily) recommended in patients with severe renal impairment (Clcr <30 mL/minute);1 3 4 16 17 titrate subsequent dosage according to BP response.1
Heart Failure or Left Ventricular Dysfunction after Acute MI
Oral
Reduced initial dosage (0.5 mg once daily) recommended in patients with severe renal impairment (Clcr <30 mL/minute); titrate subsequent dosage as tolerated according to response.1
Cautions for Trandolapril
Contraindications
-
Known hypersensitivity (e.g., history of angioedema) to trandolapril or another ACE inhibitor.1
-
History of hereditary/idiopathic angioedema.603
-
Concomitant therapy with aliskiren in patients with diabetes mellitus.603
-
Concomitant use (within 36 hours) of a neprilysin inhibitor (e.g., sacubitril).603
Warnings/Precautions
Warnings
Hypotension
Possible symptomatic hypotension, particularly in volume- and/or salt-depleted patients (e.g., those treated with diuretics or undergoing dialysis, patients with diarrhea or vomiting).1 Risk of marked hypotension, sometimes associated with oliguria, azotemia, and rarely, death in patients with heart failure with or without associated renal insufficiency.1
Hypotension may occur in patients undergoing surgery or during anesthesia with agents that produce hypotension; recommended treatment is fluid volume expansion.1
To minimize potential for hypotension, consider recent antihypertensive therapy, extent of BP elevation, sodium intake, fluid status, and other clinical conditions.1 May minimize potential for hypotension by correcting volume and/or salt depletion prior to initiating trandolapril therapy.1 (See Dosage under Dosage and Administration.)
Initiate therapy in patients with heart failure (with or without associated renal insufficiency) under close medical supervision; monitor closely for first 2 weeks following initiation of trandolapril or any increase in trandolapril or diuretic dosage.1
Take care to avoid hypotension in patients with ischemic heart disease, aortic stenosis, or cerebrovascular disease.1
If symptomatic hypotension occurs, place patient in supine position and, if necessary, administer IV infusion of 0.9% sodium chloride injection.1 Transient hypotension is not a contraindication to additional doses; however, consider reinitiating therapy at reduced doses of trandolapril and/or diuretic.1
Fetal/Neonatal Morbidity and Mortality
Possible fetal and neonatal morbidity and mortality when used during pregnancy.1 21 22 23 24 30 81 82 (See Boxed Warning.) Such potential risks occur throughout pregnancy, especially during the second and third trimesters.82
Also may increase the risk of major congenital malformations when administered during the first trimester of pregnancy.81 82
Discontinue as soon as possible when pregnancy is detected, unless continued use is considered lifesaving.82 Nearly all women can be transferred successfully to alternative therapy for the remainder of their pregnancy.1 21
Potential neonatal effects include skull hypoplasia, anuria, hypotension, renal failure, and death.603 Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations.603
Hepatic Effects
Clinical syndrome that usually is manifested initially by cholestatic jaundice and may progress to fulminant hepatic necrosis (occasionally fatal) reported rarely with ACE inhibitors.1 29
If jaundice or marked elevation of liver enzymes occurs, discontinue drug and monitor patient.1 29
Hematologic Effects
Neutropenia and agranulocytosis reported with captopril; risk of neutropenia appears to depend principally on presence of renal impairment and presence of collagen vascular disease (e.g., systemic lupus erythematosus, scleroderma); risk with trandolapril is unknown.1
Consider monitoring leukocytes in patients with collagen vascular disease, especially if renal impairment exists.1 29
Sensitivity Reactions
Anaphylactoid reactions and/or head and neck angioedema possible; angioedema associated with laryngeal edema may be fatal.1 29 Concomitant use of an ACE inhibitor and a mammalian target of rapamycin (mTOR) inhibitor or neprilysin inhibitor (e.g., sacubitril) may increase the risk of angioedema.603 If angioedema occurs, promptly discontinue trandolapril and observe patient until swelling disappears.1 Immediate medical intervention (e.g., epinephrine) for involvement of tongue, glottis, or larynx.1 29
Intestinal angioedema possible; consider in differential diagnosis of patients who develop abdominal pain.1
Anaphylactoid reactions reported in patients receiving ACE inhibitors while undergoing LDL apheresis with dextran sulfate absorption or following initiation of hemodialysis that utilized high-flux membrane.1 29
Life-threatening anaphylactoid reactions reported in at least 2 patients receiving ACE inhibitors while undergoing desensitization treatment with hymenoptera venom.1 29
Contraindicated in patients with a history of angioedema associated with ACE inhibitors.1
General Precautions
Renal Effects
Transient increases in BUN and Scr possible, especially in patients with preexisting renal impairment or those receiving concomitant diuretic therapy.1 Possible increases in BUN and Scr in patients with unilateral or bilateral renal artery stenosis; generally reversible following discontinuance of ACE inhibitor and/or diuretic.1 29
Possible oliguria, progressive azotemia, and rarely, acute renal failure and/or death in patients with severe heart failure.1
Closely monitor renal function following initiation of therapy in hypertensive patients with unilateral or bilateral renal artery stenosis.1 29 Some patients may require dosage reduction or discontinuance of ACE inhibitor and/or diuretic.1
Hyperkalemia
Possible hyperkalemia, especially in patients with renal impairment or diabetes mellitus and those receiving drugs that can increase serum potassium concentration (e.g., potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes).1 (See Specific Drugs under Interactions.)
Monitor serum potassium concentration carefully in these patients.1
Cough
Persistent and nonproductive cough; resolves after drug discontinuance.1
Specific Populations
Pregnancy
Category D.603
Can cause fetal and neonatal morbidity and mortality when administered to a pregnant woman.603 (See Boxed Warning.)
Lactation
Distributed into milk in rats.1 Use not recommended.1
Pediatric Use
If oliguria or hypotension occurs in neonates with a history of in utero exposure to trandolapril, support BP and renal function; exchange transfusions or dialysis may be required.603
Safety and efficacy not established.1
Geriatric Use
No substantial differences in safety and efficacy relative to younger adults; however, possibility exists of greater sensitivity to the drug in some geriatric individuals.1
Hepatic Impairment
Consider dosage reduction.1 (See Hepatic Impairment under Dosage and Administration.)
Renal Impairment
Deterioration of renal function may occur.1 (See Renal Effects under Cautions.)
Initial dosage adjustment recommended in patients with Clcr <30 mL/minute.1 (See Renal Impairment under Dosage and Administration.)
Black Patients
BP reduction may be smaller in black patients compared with patients of other races.24 25 56 57 (See Hypertension under Uses.)
Higher incidence of angioedema reported with ACE inhibitors in black patients compared with other races.1 57 1200
Common Adverse Effects
Patients with hypertension: Cough, dizziness, diarrhea.1
Patients with left ventricular dysfunction after acute MI: Cough, dizziness, hypotension, elevated serum uric acid concentrations, elevated BUN, percutaneous transluminal coronary angioplasty (PTCA) or CABG, dyspepsia, syncope, hyperkalemia.1
Drug Interactions
Specific Drugs
Drug |
Interaction |
Comments |
---|---|---|
Aliskiren |
Increased risk of renal impairment (including acute renal failure), hyperkalemia, and hypotension603 Dual blockade of renin-angiotensin system provides no additional benefit over monotherapy in most patients603 |
Monitor BP, renal function, and electrolytes if used concomitantly550 603 Concomitant use contraindicated in patients with diabetes mellitus; avoid concomitant use in patients with GFR <60 mL/minute per 1.73 m2550 603 |
Angiotensin II receptor antagonists |
Increased risk of renal impairment (including acute renal failure), hyperkalemia, and hypotension603 Dual blockade of renin-angiotensin system provides no additional benefit over monotherapy in most patients603 |
Generally, avoid concomitant use; monitor BP, renal function, and electrolytes if used concomitantly603 |
Antidiabetic agents, oral |
May increase blood glucose-lowering effect and increase risk of hypoglycemia603 |
|
Cimetidine |
Possible increase in plasma trandolapril concentrations but no change in plasma trandolaprilat concentrations and no change in ACE inhibition1 |
|
Digoxin |
Pharmacokinetic interaction unlikely1 |
|
Diuretics |
Increased hypotensive effect1 |
If possible, discontinue diuretic before initiating trandolapril1 (see Dosage under Dosage and Administration) |
Diuretics, potassium-sparing (amiloride, spironolactone, triamterene) |
Enhanced hyperkalemic effect1 |
Use with caution; monitor serum potassium concentrations frequently1 |
Gold |
Nitroid reactions reported rarely in patients receiving concomitant therapy with sodium aurothiomalate and an ACE inhibitor603 |
|
Insulin |
May increase blood glucose-lowering effect and increase risk of hypoglycemia603 |
|
Lithium |
Increased serum lithium concentrations; possible toxicity1 |
Use with caution; monitor serum lithium concentrations frequently1 |
mTor inhibitors (e.g., everolimus, sirolimus, temsirolimus) |
Increased risk of angioedema603 |
Monitor for signs of angioedema603 |
Neprilysin inhibitors (e.g., sacubitril) |
Increased risk of angioedema603 |
Concomitant use contraindicated; do not administer trandolapril within 36 hours of switching to or from a neprilysin inhibitor603 |
Nifedipine |
Pharmacokinetic interaction unlikely29 |
|
NSAIAs (including COX-2 inhibitors) |
May result in deterioration of renal function, including possible renal failure, in geriatric patients, volume-depleted patients, or patients with compromised renal function;603 effects usually reversible603 |
Monitor renal function periodically603 |
Potassium supplements or potassium-containing salt substitutes |
Enhanced hyperkalemic effect1 |
Use with caution; monitor serum potassium concentrations frequently1 |
Warfarin |
Pharmacologic interaction unlikely1 |
Trandolapril Pharmacokinetics
Absorption
Bioavailability
Prodrug;2 9 has little pharmacologic activity until hydrolyzed to trandolaprilat.1 3 4 5 7 12 16 17 Absolute bioavailability following oral administration of trandolapril is about 10% as trandolapril and 70% as trandolaprilat.1
Peak concentrations of trandolapril and trandolaprilat are achieved within 1 and 4–10 hours, respectively, following administration in fasted state.1
Onset
A single 2-mg dose results in approximately 70–85% inhibition of plasma ACE activity at 4 hours after administration.1
During chronic therapy, maximum antihypertensive effect with any dosage is achieved within 1 week.1
Duration
Following a single 2-mg dose, inhibition of plasma ACE activity declines by about 10% at 24 hours and by about one-half after 8 days.1
Food
Food decreases rate of absorption but does not affect extent of absorption or peak plasma concentration.1
Special Populations
In patients with mild to moderate alcoholic cirrhosis, plasma trandolapril and trandolaprilat concentrations are increased approximately 9- and 2-fold, respectively.1
In patients with Clcr <30 mL/minute, plasma trandolapril and trandolaprilat concentrations are increased approximately 2-fold.1
Distribution
Extent
Distributed into milk in rats.1
Plasma Protein Binding
Trandolapril: 80% (independent of concentration).1
Trandolaprilat: Concentration-dependent binding (65% at 1000 ng/mL and 94% at 0.1 ng/mL).1
Elimination
Metabolism
Metabolized in the liver3 4 8 17 to an active metabolite, trandolaprilat.1 3 4 5 6 12 16 17 At least 7 other metabolites, principally glucuronide conjugates or de-esterification products, have been identified.1
Elimination Route
Eliminated in urine (33%), principally as trandolaprilat, and in feces (66%).1
Half-life
Elimination half-life of trandolapril: 6 hours.603
Effective half-life of trandolaprilat: 22.5 hours.603
Stability
Storage
Oral
Tablets
20–25°C.1
Actions
-
Prodrug;2 9 has little pharmacologic activity until hydrolyzed in the liver3 4 8 17 to trandolaprilat.1 3 4 5 6 12 16 17
-
Suppresses the renin-angiotensin-aldosterone system.1
Advice to Patients
-
Risk of angioedema, anaphylactoid reactions, or other sensitivity reactions.1 Importance of reporting sensitivity reactions (e.g., edema of face, eyes, lips, tongue, or extremities; hoarseness; swallowing or breathing with difficulty) immediately to clinician and of discontinuing the drug.1
-
Importance of reporting signs of infection (e.g., sore throat, fever).1
-
Risk of hypotension.1 Importance of informing clinicians promptly if lightheadedness or fainting occurs.1
-
Importance of adequate fluid intake; risk of volume depletion with excessive perspiration, dehydration, vomiting, or diarrhea.1
-
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
-
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs (including salt substitutes containing potassium), as well as any concomitant illnesses.1
-
Importance of patients informing clinicians that they are receiving an ACE inhibitor with a long duration of action prior to undergoing surgery and/or anesthesia.1
-
Importance of informing patients of other important precautionary information.1 (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets |
1 mg* |
Mavik (scored) |
AbbVie |
Trandolapril Tablets |
||||
2 mg* |
Mavik |
AbbVie |
||
Trandolapril Tablets |
||||
4 mg* |
Mavik |
AbbVie |
||
Trandolapril Tablets |
Routes |
Dosage Forms |
Strengths |
Brand Names |
Manufacturer |
---|---|---|---|---|
Oral |
Tablets, extended-release core (containing verapamil hydrochloride 240 mg), film-coated |
1 mg with Verapamil Hydrochloride 240 mg |
Tarka |
AbbVie |
Tablets, extended-release core (containing verapamil hydrochloride 180 mg), film-coated |
2 mg with Verapamil Hydrochloride 180 mg |
Tarka |
AbbVie |
|
Tablets, extended-release core (containing verapamil hydrochloride 240 mg), film-coated |
2 mg with Verapamil Hydrochloride 240 mg |
Tarka |
AbbVie |
|
Tablets, extended-release core (containing verapamil hydrochloride 240 mg), film-coated |
4 mg with Verapamil Hydrochloride 240 mg |
Tarka |
AbbVie |
AHFS DI Essentials™. © Copyright 2025, Selected Revisions March 4, 2019. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
† Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration.
References
1. Abbott . Mavik (trandolapril) tablets prescribing information. North Chicago, IL; 2003 Jul.
2. Zannad F. Trandolapril: how does it differ from other angiotensin converting enzyme inhibitors? Drugs. 1993; 46(Suppl 2):172-82.
3. De Ponti F. Profile of the new ACE inhibitor trandolapril (RU 44570). Cardiovasc Drug Rev. 1994; 12:317-33.
4. Conen H, Brunner HR. Pharmacologic profile of trandolapril, a new angiotensin-converting enzyme inhibitor. Am Heart J. 1993; 125:1525-31. https://pubmed.ncbi.nlm.nih.gov/8480624
5. Gaillard CA, de Leeuw PW. Clinical experiences with trandolapril. Am Heart J. 1993; 125:1542-6. https://pubmed.ncbi.nlm.nih.gov/8480627
6. Guller B, Hall J, Reeves RL. Cardiac effects of trandolapril in hypertension. Am Heart J. 1993; 125:1536-41. https://pubmed.ncbi.nlm.nih.gov/8480626
7. De Ponti F, Marelli C, D’Angelo L et al. Pharmacological activity and safety of trandolapril (RU 44570) in healthy volunteers. Eur J Clin Pharmacol. 1991; 40:149-53. https://pubmed.ncbi.nlm.nih.gov/1648489
8. Patat A, Surjus A, Le Go A et al. Safety and tolerance of single oral doses of trandolapril (RU 44.570), a new angiotensin converting enzyme inhibitor. Eur J Clin Pharmacol. 1989; 36:17-23. https://pubmed.ncbi.nlm.nih.gov/2537217
9. Mancia G, De Cesaris R, Fogari R et al et al. Evaluation of the antihypertensive effect of once-a-day trandolapril by 24-hour ambulatory blood pressure monitoring. Am J Cardiol. 1992; 70:60-66D. https://pubmed.ncbi.nlm.nih.gov/1615871
10. Cesarone MR, De Sanctis MT, Laurora G et al. Effects of trandolapril on 24-H ambulatory blood pressure in patients with mild-to-moderate essential hypertension. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S65-72. https://pubmed.ncbi.nlm.nih.gov/7527105
11. Backhouse CI, Orofiamma B, Pauly NC et al. Long-term therapy with trandolapril, a new nonsulfhydryl ACE inhibitor, in hypertension: a multicenter international trial. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S86-90.
12. De Bruijn JHB, Orofiamma BA, Pauly NC et al. Efficacy and tolerance of trandolapril (0.5–2 mg) administered for 4 weeks in patients with mild-to-moderate hypertension. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S60-4.
13. Pauly NC, Safar ME, for the Investigator Study Group. Comparison of the efficacy and safety of trandolapril and captopril for 16 weeks in mild-to-moderate essential hypertension. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S73-6.
14. Meyer BH, Pauly NC, for the Investigator Study Group. Double-blind comparison of the efficacy and safety of trandolapril 2 mg and hydrochlorothiazide 25 mg in patients with mild- to-moderate essential hypertension. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S77-80.
15. Steiner G, Pauly NC, for the Investigator Study Group. Comparison of the efficacy and safety of trandolapril and nifedipine SR in mild-to-moderate hypertension. J Cardiovasc Pharmacol. 1994; 23(Suppl 4):S81-5.
16. Wiseman LR, McTavish D. Trandolapril: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in essential hypertension. Drugs. 1994; 48:71-90. https://pubmed.ncbi.nlm.nih.gov/7525196
17. Duc LNC, Brunner HR. Trandolapril in hypertension: overview of a new angiotensin-converting enzyme inhibitor. Am J Cardiol. 1992; 70:27-34D.
18. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The 1988 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1988; 148:1023-38. https://pubmed.ncbi.nlm.nih.gov/3365073
20. Anon. Drugs for hypertension. Med Lett Drugs Ther. 1984; 26:107-12. https://pubmed.ncbi.nlm.nih.gov/6150424
21. US Food and Drug Administration. Dangers of ACE inhibitors during second and third trimesters of pregnancy. FDA Med Bull. 1992; 22:2.
22. Shotan A, Widerhorn J, Hurst A et al. Risks of angiotensin-converting enzyme inhibition during pregnancy: experimental and clinical evidence, potential mechanisms, and recommendations for use. Am J Med. 1994; 96:451-6. https://pubmed.ncbi.nlm.nih.gov/8192177
23. Piper JM, Ray WA, Rosa FW. Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors. Obstet Gynecol. 1992; 80:429-32. https://pubmed.ncbi.nlm.nih.gov/1495700
24. Saunders E. Tailoring treatment to minority patients. Am J Med. 1990; 88(Suppl 3B):21-23S. https://pubmed.ncbi.nlm.nih.gov/2294761
25. Chrysant SG, Danisa K, Kem DC et al. Racial differences in pressure, volume and renin interrelationships in essential hypertension. Hypertension. 1979; 1:136-41. https://pubmed.ncbi.nlm.nih.gov/399939
26. Holland OB, Kuhnert L, Campbell WB et al. Synergistic effect of captopril with hydrochlorothiazide for the treatment of low-renin hypertensive black patients. Hypertension. 1983; 5:235-9. https://pubmed.ncbi.nlm.nih.gov/6337951
27. Ferguson RK, Vlasses PH, Rotmesch HH. Clinical applications of angiotensin-enzyme inhibitors. Am J Med. 1984; 77:690-8. https://pubmed.ncbi.nlm.nih.gov/6091446
28. Knoll Pharmaceutical, Parsippany, NJ: Personal communication.
29. Abbott Laboratories. Tarka (trandolapril/verapamil) tablets prescribing information. North Chicago, IL; 2003 Jul.
30. Rey E, LeLorier J, Burgess E et al. Report of the Canadian Hypertension Society consensus conference: 3. pharmacologic treatment of hypertensive disorders in pregnancy Can Med Assoc J. 1997; 157:1245-54.
31. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Bethesda, MD: National Institutes of Health; 1997 Nov. (NIH publication No. 98-4080.)
32. Kober L, Torp-Pedersen C, C.dtden JE eta l. A clinical trial of angiotensin-converting-enzyme inhibitor trandolapril in patients with left-ventricular dysfunction after myocardial infarction. N Engl J Med. 1995;333:1670-6.
33. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate single and together on 6-week mortality and ventricular function after acute myocardial infarction. Lancet. 1994; 343:1115-22. https://pubmed.ncbi.nlm.nih.gov/7910229
34. Ambrosioni E, Borghi C, Magnani B for the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study Investigators. The effect of the angiotensin-converting-enzyme inhibitor zofenopril on mortality and morbidity after anterior myocardial infarction. N Engl J Med. 1995; 332:80-5. https://pubmed.ncbi.nlm.nih.gov/7990904
35. Ball SG, Hall AS, Murray GD. Angiotensin-converting enzyme inhibitors after myocardial infarction: indications and timing. J Am Coll Cardiol. 1995; 25(Suppl):42-6S.
36. Simoons ML. Myocardial infarction: ACE inhibitors for all? for ever? Lancet. 1994; 344:279-81. Editorial.
37. Anon. An ACE inhibitor after a myocardial infarction. Med Lett Drugs Ther. 1994; 36:69-70. https://pubmed.ncbi.nlm.nih.gov/8035753
38. Ertl G, Jugdutt B. ACE inhibition after myocardial infarction: can megatrials provide answers? Lancet. 1994; 344:1068-9.
39. Ertl G. Angiotensin converting enzyme inhibitors in angina and myocardial infarction: what role will they play in the 1990s? Drugs. 1993; 46:209-18.
40. Purcell H, Coats A, Fox K et al. Improving outcome after acute myocardial infarction: what is the role of ACE inhibitors? Br J Clin Pract. 1995; 49:195-9. (IDIS 349780)
41. Ball SG, Hass AS. What to expect from ACE inhibitors after myocardial infarction. Br Heart J. 1994; 72(Suppl):S70-4.
42. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4: a randomised factorial trial assesssing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58 050 patients with suspected acute myocardial infarction. Lancet. 1995; 345:669-85. https://pubmed.ncbi.nlm.nih.gov/7661937
43. Chinese Cardiac Study Collaborative Group. Oral captopril versus placebo among 13 634 patients with suspected acute myocardial infarction: interim report from the Chinese Cardiac Study (CCS-1). Lancet. 1995; 345:686-7. https://pubmed.ncbi.nlm.nih.gov/7885123
44. Cohn JN. The prevention of heart failure--a new agenda. N Engl J Med. 1992; 327:725-7. https://pubmed.ncbi.nlm.nih.gov/1495526
45. Pfeffer MA, Braunwald E, Moye LA et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 1992; 327:669-77. https://pubmed.ncbi.nlm.nih.gov/1386652
46. Swedberg K, Held P, Kjekshus J et al. Effects of the early administration of enalapril on mortality in patients with acute myocardial infarction: results of the Cooperative New Scandinavian enalapril survival study II (Consensus II). N Engl J Med. 1992; 327:678-84. https://pubmed.ncbi.nlm.nih.gov/1495520
47. Sharpe N, Smith H, Murphy J et al. Early prevention of left ventricular dysfunction after myocardial infarction with angiotensin-converting-enzyme inhibition. Lancet. 1991; 337:872-6. https://pubmed.ncbi.nlm.nih.gov/1672967
48. Oldroyd KG, Pye MP, Ray SG et al. Effects of early captopril administration on infarct expansion, left ventricular remodeling and exercise capacity after acute myocardial infarction. Am J Cardiol. 1991; 68:713-8. https://pubmed.ncbi.nlm.nih.gov/1892076
49. Sharpe N, Murphy J, Smith H et al. Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet. 1988; 1:255-9. https://pubmed.ncbi.nlm.nih.gov/2893080
50. Pfeffer MA, Lamas GA, Vaughan DE et al. Effect of captopril on progressive ventricular dilatation after anterior myocardial infarction. N Engl J Med. 1988; 319:80-6. https://pubmed.ncbi.nlm.nih.gov/2967917
51. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. https://pubmed.ncbi.nlm.nih.gov/10818056
52. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. https://pubmed.ncbi.nlm.nih.gov/10818055
53. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. https://pubmed.ncbi.nlm.nih.gov/10977801
54. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. http://www.diabetes.org/newsroom/
55. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993; 153:154-83. https://pubmed.ncbi.nlm.nih.gov/8422206
56. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. https://pubmed.ncbi.nlm.nih.gov/12479770
57. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. https://pubmed.ncbi.nlm.nih.gov/12479763
60. Merck & Co. Vasotec tablets (enalapril maleate) prescribing information. Whitehouse Station, NJ; 2002 Jan.
61. Bristol-Myers Squibb. Monopril (fosinopril sodium) tablets prescribing information. Princeton, NJ; 2002 Feb.
62. Merck. Prinivil (lisinopril) tablets prescribing information. Whitehouse Station, NJ; 2002 Jan.
63. AstraZeneca. Zestril (lisinopril) tablets prescribing information. Wilmington, DE: 2002 Jan.
64. Parke Davis. Accupril (quinapril hydrochloride) tablets prescribing information. Morris Plains, NJ; 2001 Mar.
65. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. https://pubmed.ncbi.nlm.nih.gov/10818056
66. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. https://pubmed.ncbi.nlm.nih.gov/10818055
67. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. https://pubmed.ncbi.nlm.nih.gov/10977801
70. Novartis. Diovan (valsartan) tablets prescribing information. East Hanover, NJ; 2002 Aug.
74. Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993; 329:1456-62. https://pubmed.ncbi.nlm.nih.gov/8413456
75. Remuzzi G. Slowing the progression of diabetic nephropathy. N Engl J Med. 1993; 329:1496-7. https://pubmed.ncbi.nlm.nih.gov/8413463
76. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. https://pubmed.ncbi.nlm.nih.gov/8622249
77. Viberti G, Mogensen CE, Groop LC et al. Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria. JAMA. 1994; 271:275-9. https://pubmed.ncbi.nlm.nih.gov/8295285
78. Fournier A. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1994; 330:937. https://pubmed.ncbi.nlm.nih.gov/8114873
79. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. https://pubmed.ncbi.nlm.nih.gov/15811979
80. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. https://pubmed.ncbi.nlm.nih.gov/15811986
81. Cooper WO, Hernandez-Diaz S, Arbogast PG et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006; 354:2443-51. https://pubmed.ncbi.nlm.nih.gov/16760444
82. Food and Drug Administration. FDA public health advisory: angiotensin-converting enzyme inhibitor (ACE inhibitor) drugs and pregnancy. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm053113.htm
83. Solvay Pharmaceuticals. Aceon (perindopril erbumine) tablets prescribing information. Marietta, GA; 2003 Mar.
84. Bristol-Myers Squibb Co. Capoten tablets (captopril tablets) prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:710-4.
85. Hoechst-Roussel Pharmaceuticals Inc. Altace (ramipril) prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:1124-6.
86. Parke Davis. Accupril (quinapril hydrochloride) tablets prescribing information. Morris Plains, NJ; 2001 Mar.
87. Merck. Prinivil (lisinopril) tablets prescribing information. Whitehouse Station, NJ; 2002 Jan.
88. Merck & Co. Vasotec tablets (enalapril maleate) prescribing information. Whitehouse Station, NJ; 2002 Jan.
89. Ciba Pharmaceutical Company. Lotensin (benazepril hydrochloride) tablets prescribing information. In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:887-90.
90. Bristol-Myers Squibb. Monopril (fosinopril sodium) tablets prescribing information. Princeton, NJ; 2002 Feb.
91. Schwarz Pharma. Univasc (moexipril hydrochloride) tablets prescribing information. Milwaukee, WI; 2003 May.
92. Abbott Pharmaceuticals, Abbott Park, IL: Personal communication.
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. https://pubmed.ncbi.nlm.nih.gov/24352797
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. https://pubmed.ncbi.nlm.nih.gov/23817082
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. https://pubmed.ncbi.nlm.nih.gov/24243703
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. https://pubmed.ncbi.nlm.nih.gov/24341872
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. https://pubmed.ncbi.nlm.nih.gov/24424788
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. https://pubmed.ncbi.nlm.nih.gov/24549531
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. https://pubmed.ncbi.nlm.nih.gov/24352710
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. https://pubmed.ncbi.nlm.nih.gov/24352759
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. https://pubmed.ncbi.nlm.nih.gov/19139601
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. https://pubmed.ncbi.nlm.nih.gov/24591473
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.
524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.
525. Smith SC, Benjamin EJ, Bonow RO et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124:2458-73. https://pubmed.ncbi.nlm.nih.gov/22052934
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. https://pubmed.ncbi.nlm.nih.gov/24788967
527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3695607/
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. https://pubmed.ncbi.nlm.nih.gov/24641124
534. Qaseem A, Hopkins RH, Sweet DE et al. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159:835-47. https://pubmed.ncbi.nlm.nih.gov/24145991
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929429/ https://pubmed.ncbi.nlm.nih.gov/23684145
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. https://pubmed.ncbi.nlm.nih.gov/22555213
543. National Kidney Foundation Kidney Disease Outcomes Quality Initiative. K/DOQI Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease (2002). From National Kidney Foundation website. http://www.kidney.org/professionals/kdoqi/guidelines_commentaries.cfm
550. US Food and Drug Administration. FDA Drug Safety Communication: new warning and contraindication for blood pressure medicines containing aliskiren (Tekturna). Rockville, MD; 2012 April 4. From FDA website. http://www.fda.gov/Drugs/DrugSafety/ucm300889.htm
600. AbbVie Inc. Mavik (trandolapril) tablets prescribing information. North Chicago, IL; 2012 Dec.
601. Abbott Laboratories. Tarka (trandolapril/verapamil) tablets prescribing information. North Chicago, IL; 2012 Aug.
602. AbbVie Inc. Mavik (trandolapril) tablets prescribing information. North Chicago, IL; 2016 Jan.
603. Epic Pharma, LLC. Trandolapril tablets prescribing information. Laurelton, NY; 2017 Nov
701. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016; 37:2129-200. https://pubmed.ncbi.nlm.nih.gov/27206819
702. McMurray JJ, Packer M, Desai AS et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014; 371:993-1004. https://pubmed.ncbi.nlm.nih.gov/25176015
703. Ansara AJ, Kolanczyk DM, Koehler JM. Neprilysin inhibition with sacubitril/valsartan in the treatment of heart failure: mortality bang for your buck. J Clin Pharm Ther. 2016; 41:119-27. https://pubmed.ncbi.nlm.nih.gov/26992459
800. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2016; 134:e282-93.
803. Lamas GA, Escolar E, Faxon DP. Examining treatment of ST-elevation myocardial infarction: the importance of early intervention. J Cardiovasc Pharmacol Ther. 2010; 15:6-16. https://pubmed.ncbi.nlm.nih.gov/20061507
805. Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction. Lancet. 2017; 389:197-210. https://pubmed.ncbi.nlm.nih.gov/27502078
1100. Amsterdam EA, Wenger NK, Brindis RG et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130:e344-426. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676081/
1150. Flynn JT, Kaelber DC, Baker-Smith CM et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017; 140 https://pubmed.ncbi.nlm.nih.gov/28827377
1200. Whelton PK, Carey RM, Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71:el13-e115. https://pubmed.ncbi.nlm.nih.gov/29133356
1201. Bakris G, Sorrentino M. Redefining hypertension - assessing the new blood-pressure guidelines. N Engl J Med. 2018; 378:497-499. https://pubmed.ncbi.nlm.nih.gov/29341841
1202. Carey RM, Whelton PK, 2017 ACC/AHA Hypertension Guideline Writing Committee. Prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 American College of Cardiology/American Heart Association hypertension guideline. Ann Intern Med. 2018; 168:351-358. https://pubmed.ncbi.nlm.nih.gov/29357392
1207. Burnier M, Oparil S, Narkiewicz K et al. New 2017 American Heart Association and American College of Cardiology guideline for hypertension in the adults: major paradigm shifts, but will they help to fight against the hypertension disease burden?. Blood Press. 2018; 27:62-65. https://pubmed.ncbi.nlm.nih.gov/29447001
1209. Qaseem A, Wilt TJ, Rich R et al. Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166:430-437. https://pubmed.ncbi.nlm.nih.gov/28135725
1210. SPRINT Research Group, Wright JT, Williamson JD et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015; 373:2103-16. https://pubmed.ncbi.nlm.nih.gov/26551272
1213. Reboussin DM, Allen NB, Griswold ME et al. Systematic review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71:2176-2198. https://pubmed.ncbi.nlm.nih.gov/29146534
1214. American Diabetes Association. 9. Cardiovascular disease and risk management: standards of medical care in diabetes 2018. Diabetes Care. 2018; 41:S86-S104. https://pubmed.ncbi.nlm.nih.gov/29222380
1215. de Boer IH, Bangalore S, Benetos A et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017; 40:1273-1284. https://pubmed.ncbi.nlm.nih.gov/28830958
1216. Taler SJ. Initial treatment of hypertension. N Engl J Med. 2018; 378:636-644. https://pubmed.ncbi.nlm.nih.gov/29443671
1218. Messerli FH, Bangalore S, Bavishi C et al. Angiotensin-converting enzyme inhibitors in hypertension: to use or not to use?. J Am Coll Cardiol. 2018; 71:1474-1482. https://pubmed.ncbi.nlm.nih.gov/29598869
1220. Cifu AS, Davis AM. Prevention, detection, evaluation, and management of high blood pressure in adults. JAMA. 2017; 318:2132-2134. https://pubmed.ncbi.nlm.nih.gov/29159416
1222. Bell KJL, Doust J, Glasziou P. Incremental benefits and harms of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline. JAMA Intern Med. 2018; 178:755-7. https://pubmed.ncbi.nlm.nih.gov/29710197
1223. LeFevre M. ACC/AHA hypertension guideline: what is new? what do we do?. Am Fam Physician. 2018; 97(6):372-3. https://pubmed.ncbi.nlm.nih.gov/29671534
1224. Brett AS. New hypertension guideline is released. From NEJM Journal Watch website. Accessed 2018 Jun 18. https://www.jwatch.org/na45778/2017/12/28/nejm-journal-watch-general-medicine-year-review-2017
1229. Ioannidis JPA. Diagnosis and treatment of hypertension in the 2017 ACC/AHA guidelines and in the real world. JAMA. 2018; 319(2):115-6. https://pubmed.ncbi.nlm.nih.gov/29242891
1232. American Diabetes Association. 10. Microvascular complications and foot care: standards of medical care in diabetes 2018. Diabetes Care. 2018; 41:S105-S118. https://pubmed.ncbi.nlm.nih.gov/29222381
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