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CARDIOVASCULAR SYSTEM › AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM › ACE INHIBITORS, PLAIN › ACE inhibitors, plain
trandolapril
C09AA10
Forms & Strengths
- Oral tablets: 1 mg, 2 mg, 4 mg
Adult Dosing
- Hypertension: Initial 1 mg once daily (2 mg if diuretic is used); maintenance 2 to 4 mg once daily
- Heart failure post-myocardial infarction: Initial 1 mg once daily, titrated as tolerated to 4 mg once daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Management of essential hypertension
- Reduction of cardiovascular mortality and heart failure hospitalization post-myocardial infarction
Mechanism of Action
- Competitive inhibition of angiotensin-converting enzyme (ACE), preventing conversion of angiotensin I to angiotensin II
- Decreases systemic vascular resistance and aldosterone secretion while increasing plasma renin activity
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hereditary or idiopathic angioedema
- Concomitant use with aliskiren in patients with diabetes mellitus
- Co-administration with neprilysin inhibitors (e.g., sacubitril/valsartan)
Adverse Reactions
- Dizziness
- Cough
- Hyperkalemia
- Hypotension
- Fatigue
- Headache
- Elevated serum creatinine
Drug Interactions
- Potassium-sparing diuretics and potassium supplements increase risk of hyperkalemia
- NSAIDs may diminish antihypertensive efficacy and worsen renal function
- Lithium toxicity risk due to decreased renal clearance
- Dual blockade of the renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment
Curated Content: Needs Vetting Before Put to Clinical Use