Trandolapril(tran dole’ ah pril)
Mavik
PREGNANCY CATEGORY D
Drug Classes
ACE inhibitor
Antihypertensive
Therapeutic Actions
Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis may also be involved in the antihypertensive action.
Indications
Treatment of hypertension, alone or in combination with other antihypertensives
Treatment of post-MI patients with evidence of left-ventricular dysfunction and symptoms of HF
Unlabeled use: Diabetic nephropathy
Contraindications and Cautions
Contraindicated with allergy to ACE inhibitors, history of ACE-associated angioedema.
Use cautiously with impaired renal function, HF, CAD, sodium or volume depletion, surgery, pregnancy, lactation, renal artery stenosis.
Available Forms
Tablets—1, 2, 4 mg
Dosages
Adults
Hypertension: African-American patients: 2 mg PO daily. All other patients: 1 mg PO daily. For maintenance, 2–4 mg/day. Maximum, 8 mg.
Patients on diuretics: To prevent hypotension, stop diuretic 2–3 days before beginning trandolapril. Resume diuretic only if BP is not controlled. If diuretic cannot be discontinued, start at 0.5 mg PO daily and adjust upward as needed.
HF or left ventricular dysfunction post-MI: May start therapy 3 to 5 days after the MI. 1 mg/day PO; adjust to a target of 4 mg/day.
Pediatric patients
Safety and efficacy not established.
Patients with renal or hepatic impairment
0.5 mg PO daily, adjust at 1-wk intervals to control BP; usual range is 2–4 mg PO daily.
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