Trandolapril - an ACE inhibitor

About trandolapril

Trandolapril belongs to a class of medicines called angiotensin-converting enzyme (ACE) inhibitors. You may be prescribed it to reduce high blood pressure (hypertension), or to protect your heart and blood vessels from further damage following a heart attack. Your doctor will tell you why it has been prescribed for you.

ACE inhibitors like trandolapril prevent your body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme. This widens your blood vessels and helps to reduce the amount of water put back into your blood by your kidneys. These actions help to reduce high blood pressure. People with high blood pressure often do not feel unwell but, if left untreated, high blood pressure can harm the heart and damage blood vessels, leading to a heart attack or stroke.

Trandolapril also has a protective effect on the heart in people who have recently had a heart attack.

Before taking trandolapril

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking trandolapril it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have any problems with the way your kidneys work, or any problems with the way your liver works.

• If you are lacking in fluid in the body (dehydrated) - for example, if you have had diarrhoea or sickness very recently.

• If you have been told you have a build-up of fatty deposits on the walls of your arteries, a condition called atherosclerosis.

• If you have a particular type of poor circulation called peripheral arterial disease.

• If you have collagen vascular disease - this includes conditions such as systemic lupus erythematosus (SLE) and scleroderma.

• If you have been told you have heart muscle disease (cardiomyopathy), or narrowing of the main blood vessel from your heart (aortic stenosis).

• If you have ever had a reaction where your face, tongue or throat swells (angio-oedema).

• If you are having desensitisation treatment to protect against bee and wasp stings.

• If you are having dialysis treatment, or treatment to remove cholesterol from your blood by a machine (LDL apheresis).

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• If you have ever had an allergic or unusual reaction to any other ACE inhibitor (such as captopril, lisinopril, ramipril or perindopril), or to any other medicine.

How to take trandolapril

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about trandolapril and will provide you with a full list of side-effects which you could experience from taking it.

• Take the capsules exactly as your doctor tells you to. Trandolapril is taken once a day. Your doctor may advise you to take your very first dose at bedtime. This is because you may feel dizzy when you first start taking it. With the exception of the first dose, you can generally take trandolapril at a time of day you find easy to remember. For most people this will be in the morning.

• Try to take your doses at the same time of day each day as this will help you to remember to take your doses regularly. You can take the capsule either with or without food. It is best to swallow the capsule with a drink of water. Do not open or chew the capsules.

• There are several strengths of trandolapril capsules - 500 micrograms, 2 mg and 4 mg. It is usual to start with a low strength and then for the strength to be increased as necessary after a few weeks. This allows your doctor to make sure that you have the dose that helps your condition, but helps avoid unwanted side-effects. Each time you collect a new supply of trandolapril, check to make sure it contains the strength of capsule that you are expecting.

• If you forget to take a dose at your usual time, take it as soon as you remember. If you do not remember until the following day, leave out the forgotten dose from the previous day and take the dose that is due as normal. Do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor. This is so your progress can be monitored. Your doctor will want you to have some blood tests from time to time to check that your kidneys are working well.

• It is very important that you follow any dietary and lifestyle advice that you have been given by your doctor. This can include advice about eating a healthy diet, not smoking, and taking regular exercise.

• If you buy any medicines, check with a pharmacist that they are suitable to take with trandolapril. This is because some medicines (such as anti-inflammatory painkillers and indigestion remedies) can interfere with your treatment.

• It is likely that your doctor will advise that you do not use salt substitutes while you are taking trandolapril. These products have a high content of potassium which could be harmful for you.

• If you drink alcohol, ask your doctor for advice about drinking alcohol while you are on trandolapril. Alcoholic drinks can make you feel light-headed or dizzy, and they may not be advisable for you.

• If you have diabetes you may need to check your blood sugar (glucose) more frequently, as the capsules can lower the levels of sugar in your blood. Your doctor will advise you about this.

• If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking trandolapril. This is because some anaesthetics could cause your blood pressure to drop too low.

• Treatment with trandolapril is often long-term unless you experience an adverse effect. Continue to take the capsules unless you are advised otherwise by your doctor.

Can trandolapril cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with trandolapril. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: if you experience any of the following rare but serious symptoms, stop taking trandolapril and contact your doctor for advice straightaway:

• Any difficulty breathing, or swelling of your face, mouth, tongue or throat. These are signs of an allergic reaction.

• Any yellowing of your skin or the whites of your eyes. These can be signs of a liver problem called jaundice, which is a rare side-effect.

If you experience any other symptoms which you think may be due to the capsules, speak with your doctor or pharmacist for further advice.

How to store trandolapril

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines