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trandolapril oral

Ace Inhibitors; ARBs/Loop Diuretics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known. Loop diuretics may increase the effects of the ACE inhibitor and the angiotensin II receptor antagonists.

What might happen:

Your blood pressure may decrease, causing weakness, dizziness, or fatigue. This is more likely to occur during the first few days after the ACE inhibitor or angiotensin II receptor antagonist is added to your diuretic.

What you should do about this interaction:

If you experience weakness, fatigue, or dizziness contact your doctor. The dose of your medicines may need to be adjusted.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Ferguson RK, Vlasses PH, Koplin JR, Shirinian A, Burke JF Jr, Alexander JC. Captopril in severe treatment-resistant hypertension. Am Heart J 1980 May;99(5):579-85.
2.Case DB, Atlas SA, Laragh JH, Sealey JE, Sullivan PA, McKinstry DN. Clinical experience with blockade of the renin-angiotensin-aldosterone system by an oral converting-enzyme inhibitor (SQ 14,225, captopril) in hypertensive patients. Prog Cardiovasc Dis 1978 Nov-Dec;21(3):195-206.
3.Koffer H, Vlasses PH, Ferguson RK, Weis M, Adler AG. Captopril in diuretic-treated hypertensive patients. JAMA 1980 Dec 5;244(22):2532-5.
4.Heel RC, Brogden RN, Speight TM, Avery GS. Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs 1980 Dec;20(6):409-52.
5.Funck-Brentano C, Chatellier G, Alexandre JM. Reversible renal failure after combined treatment with enalapril and frusemide in a patient with congestive heart failure. Br Heart J 1986 Jun;55(6):596-8.
6.Anonymous. Reversible renal failure after combined treatment with enalapril and frusemide in a patient with congestive heart failure. Br Heart J 1986 Nov;56(5):489-90.
7.Van Hecken AM, Verbesselt R, Buntinx A, Cirillo VJ, De Schepper PJ. Absence of a pharmacokinetic interaction between enalapril and frusemide. Br J Clin Pharmacol 1987 Jan;23(1):84-7.

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