Trandolapril and Verapamil

IMPORTANT WARNING:

Do not take trandolapril and verapamil if you are pregnant or breast-feeding. If you become pregnant while taking trandolapril and verapamil, call your doctor immediately.

WHY is this medicine prescribed?

The combination of trandolapril and verapamil is used to treat high blood pressure. It is a combination of two medications. It decreases certain chemicals that tighten the blood vessels, so blood flows more smoothly. It also relaxes your blood vessels so your heart does not have to pump as hard.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

The combination of trandolapril and verapamil comes as a tablet to take by mouth. It is usually taken once a day. The tablet should be swallowed whole. Do not chew, divide, or crush the tablets. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take trandolapril and verapamil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

The combination of trandolapril and verapamil controls high blood pressure but does not cure it. Continue to take trandolapril and verapamil even if you feel well. Do not stop taking trandolapril and verapamil without talking to your doctor.

What SPECIAL PRECAUTIONS should I follow?

Before taking trandolapril and verapamil,

• tell your doctor and pharmacist if you are allergic to trandolapril, verapamil, benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, quinapril, ramipril, or any other drugs.

• tell your doctor if you have diabetes (high blood sugar) and you are taking aliskiren (Tekturna, in Amturnide, Tekamlo, Tekturna HCT). Your doctor will probably tell you not to take trandolapril and verapamil if you have diabetes and you are also taking aliskiren.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking trandolapril and verapamil. Your doctor may need to change the doses of your medications or monitor you carefully for side effects..

• the following nonprescription or herbal products may interact with trandolapril and verapamil: nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); potassium supplements; cimetidine (Tagamet); St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking trandolapril and verapamil. Do not start any of these medications while taking trandolapril and verapamil without discussing with your healthcare provider.

• tell your doctor if you have or have ever had heart, liver, or kidney disease; a recent heart attack; an irregular heartbeat; muscular dystrophy; gastrointestinal obstruction (strictures); or diabetes.

• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how trandolapril and verapamil will affect you.

• remember that alcohol can add to the drowsiness caused by this drug. Do not drink alcohol while taking this medication.

What SPECIAL DIETARY instructions should I follow?

Trandolapril and verapamil may cause an upset stomach. Take trandolapril and verapamil with food or milk.Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Trandolapril and verapamil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• cough
• dizziness or lightheadedness
• sore throat
• hoarseness
• excessive tiredness
• headache
• diarrhea
• constipation
• upset stomach
• heartburn
• flushing (feeling of warmth)
• slow heartbeat
• vivid, unusual dreams

If you experience any of the following symptoms, call your doctor immediately:

• swelling of the face, eyes, lips, tongue, arms, or legs
• difficulty breathing or swallowing
• fainting
• rash
• yellowing of the skin or eyes
• fever
• increase in frequency or severity of chest pain (angina)

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to trandolapril and verapamil.

Your doctor may ask you to check your pulse (heart rate) daily and will tell you how fast it should be. If your pulse is slower than it should be, call your doctor for directions on taking trandolapril and verapamil that day. Ask your doctor or pharmacist to teach you how to check your pulse.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.