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Trandolapril-Verapamil ER Risks

Some Trandolapril-Verapamil ER Warnings and Precautions

Some trandolapril-verapamil ER warnings and precautions to be aware of include:
  • There are a number of medicines that trandolapril-verapamil ER can interact with (see Drug Interactions With Trandolapril-Verapamil ER).
  • Trandolapril-verapamil ER is more likely than other drugs to cause allergic reactions. For example, there have been reports of severe allergic reactions occurring in people who were taking trandolapril-verapamil ER during dialysis. There have also been reports of severe reactions in people getting bee or wasp venom to protect against stings.
Make sure to discuss these risks with your healthcare provider. Also, seek emergency medical attention immediately if you notice things such as hives, an unexplained rash, difficulty breathing, or swelling of the face or throat.
  • Medicines like trandolapril-verapamil ER that contain an ACE inhibitor may cause swelling (angioedema) of the head and neck, including the tongue, lips, eyes, or throat. This occurs more frequently in African Americans than in Caucasians. Seek emergency medical care immediately if you notice swelling in the head or neck area, wheezing, or difficulty breathing or swallowing.
  • In addition to head and neck angioedema, medicines like trandolapril-verapamil ER have been known to cause swelling in the intestines. This is known as intestinal angioedema. Symptoms may include, but are not limited to, abdominal pain (or stomach pain) with or without vomiting. Seek medical attention immediately if you develop any of these symptoms.
  • Trandolapril-verapamil ER may cause extremely low blood pressure in some people. Extremely low blood pressure is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are taking a diuretic; who are on dialysis; or who have diarrhea or vomiting, excessive sweating, or congestive heart failure. This is why it is important to drink fluids regularly while taking trandolapril-verapamil ER. If you are taking trandolapril-verapamil ER and have any possible symptoms of extremely low blood pressure -- such as dizziness, lightheadedness, or fainting -- contact your healthcare provider. If you have fainted, stop taking trandolapril-verapamil ER until you have talked with your healthcare provider.
Also, make sure not to drive, operate any heavy machinery, or perform any other tasks that require alertness before you know how trandolapril-verapamil ER affects you.
  • Trandolapril-verapamil ER is a pregnancy Category C medicine for the first trimester and a pregnancy Category D medicine for the second and third trimesters, meaning that trandolapril-verapamil ER has health risks to your unborn child. Let your healthcare provider know if you are pregnant or thinking of becoming pregnant. If you become pregnant while taking trandolapril-verapamil ER, contact your healthcare provider immediately (see Tarka and Pregnancy for more information).
  • Medicines like trandolapril-verapamil ER that contain an ACE inhibitor are known to cause a cough. If a cough becomes bothersome, talk with your healthcare provider about alternate options for your condition (see Tarka Cough).
  • While taking trandolapril-verapamil ER, do not use potassium supplements or salt substitutes with potassium unless you have discussed this with your doctor. This is because in some people taking trandolapril-verapamil ER, potassium in the blood can increase to dangerous levels. High potassium in the blood may cause signs or symptoms that include muscle weakness; numbness in the feet or hands; nausea; an irregular heartbeat; or a slow, weak, or absent pulse.
  • This medication may cause a decrease in kidney function, especially in people who are elderly, have kidney disease, have severe congestive heart failure (CHF), or are taking nonsteroidal anti-inflammatory drugs (NSAIDs) or diuretics (water pills). Your healthcare provider may choose to monitor your kidney function with a blood test while you are taking it. Contact your healthcare provider if you notice a decrease in urination or swelling in your hands, legs, ankles, or feet, which can be signs of kidney problems.


  • People on trandolapril-verapamil ER can be at an increased risk of infections. Talk with your healthcare provider if you develop any infections, such as a sore throat or fever.
  • If you have kidney disease or kidney failure, your body may metabolize the trandolapril-verapamil ER differently than intended. Therefore, your healthcare provider will monitor your situation more closely.
  • In clinical studies, medicines that contain an ACE inhibitor, including trandolapril-verapamil ER, have rarely been known to cause liver problems, including liver failure. Contact your healthcare provider immediately if you notice things such as nausea, fever, tiredness, lethargy, itchy or yellowing skin, abdominal pain (or stomach pain), or flu-like symptoms.
  • If you have liver disease or liver failure, your body may not metabolize the trandolapril-verapamil ER as quickly as it should. Therefore, you may require extra monitoring by your healthcare provider.
  • People with congestive heart failure (CHF) who take trandolapril-verapamil ER have an increased risk of their heart failure becoming worse. Taking trandolapril-verapamil ER can also increase the risk of developing the symptoms of congestive heart failure in those who already have severe left ventricular dysfunction. While trandolapril-verapamil ER is usually not recommended for people with CHF or severe left ventricular dysfunction, in some cases a healthcare provider may believe that the benefits of this drug outweigh the potential risks. If your provider prescribes trandolapril-verapamil ER, he or she may choose to monitor your situation more closely.
If you notice any of the following symptoms, contact your healthcare provider: unexplained weight gain; swelling of the ankles, feet, or legs; cough; and shortness of breath (see Symptoms of Congestive Heart Failure for more signs and symptoms).
  • If you are nursing, certain parts of trandolapril-verapamil ER can pass through your milk breast. Therefore, if you are taking trandolapril-verapamil ER and nursing, talk with your healthcare provider about whether you should stop taking trandolapril-verapamil ER or stop breastfeeding.
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