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Overview: Trandolapril/verapamil is taken for high blood pressure. Common side effects include cough and constipation. Serious side effects are rare, but can include low blood pressure or liver problems. Notify your healthcare provider right away if you feel lightheaded or have nausea and vomiting.

Uses

What is trandolapril/verapamil used for?

Trandolapril/verapamil is commonly used to help lower high blood pressure (hypertension). 

Trandolapril/verapamil may also be used for other conditions as determined by your healthcare provider.

How does trandolapril/verapamil work (mechanism of action)?

Trandolapril/verapamil helps lower blood pressure by causing your blood vessels to relax.

How is trandolapril/verapamil supplied (dosage forms)?

Brands and other names

  • Tarka

Dosage forms and strengths

  • 1 mg/240 mg extended-release oral tablets
  • 2 mg/180 mg extended-release oral tablets
  • 2 mg/240 mg extended-release oral tablets
  • 4 mg/240 mg extended-release oral tablets

How should I store trandolapril/verapamil?

Trandolapril/verapamil should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of trandolapril/verapamil?

The most common side effects of trandolapril/verapamil are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Heart rhythm changes (see below)
  • Airway inflammation
  • Chest pain
  • Constipation or diarrhea
  • Cough
  • Dizziness
  • Tiredness
  • Shortness of breath

There may be other side effects of trandolapril/verapamil that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of trandolapril/verapamil?

While less common, the most serious side effects of trandolapril/verapamil are described below, along with what to do if they happen.

Low Blood Pressure (Hypotension). Trandolapril/verapamil may cause low blood pressure. Low blood pressure is more likely to occur if you have excessive sweating or persistent or severe vomiting or diarrhea. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking trandolapril/verapamil. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Rhythm Changes. Trandolapril/verapamil may cause heart rhythm problems that can lead to an irregular heartbeat and fainting. In rare cases, this may cause the heart to suddenly stop beating (cardiac arrest). Some people have a higher risk of this, including people with existing heart disease or who take other medicines that affect the heart. Get emergency help if you have any of the following signs of heart rhythm changes.

  • Chest pain
  • Shortness of breath
  • Feeling dizzy, lightheaded, or fainting
  • Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat

Low White Blood Cell Levels (Agranulocytosis). Trandolapril/verapamil may cause severely low levels of types of white blood cells (called granulocytes), which is known as agranulocytosis. This risk may be higher if you have kidney problems or a collagen vascular disease, such as systemic lupus erythematosus or scleroderma. Granulocytes help prevent infection. Having a very low level of granulocytes increases your risk of a serious infection. Tell your healthcare provider right away if you have any of the following symptoms of agranulocytosis.

  • Fever or chills
  • Sore throat
  • Any other flu-like symptoms
  • Sores in your mouth or nose
  • Swollen lymph nodes

Severe Allergic Reactions. Trandolapril/verapamil may cause allergic reactions, which can be serious. Stop taking trandolapril/verapamil and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use trandolapril/verapamil?

Allergies to Ingredients. People who are allergic to any of the following should not take trandolapril/verapamil.

  • Tarka
  • Trandolapril
  • Verapamil
  • Any other medicine known as an ACE inhibitor
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific trandolapril/verapamil products they stock.

History of Angioedema. Trandolapril/verapamil may cause a rare reaction called angioedema, where there is swelling under the skin. This medicine should not be used if you have had angioedema from a medicine called an ACE inhibitor, such as enalapril or lisinopril.

Severe Heart Failure. Trandolapril/verapamil should not be used if your heart failure is severe, causing you to feel very tired, have trouble breathing, or swelling in your legs. 

Low Blood Pressure (Hypotension). Trandolapril/verapamil should not be used if your blood pressure is too low. Your top number of your blood pressure measurement (systolic blood pressure) needs to be at least 90.

Cardiogenic Shock. Trandolapril/verapamil should not be used if you have a life-threatening condition called cardiogenic shock where your heart cannot pump enough blood to the rest of your body.

Heart Rhythm Problems. Trandolapril/verapamil should not be used if you have any of the following heart rhythm problems unless you have a working pacemaker.

Accessory Bypass Tract. Trandolapril/verapamil should not be used if you have atrial fibrillation or atrial flutter and an extra electrical pathway in the heart (accessory bypass tract), such as Wolff-Parkinson-White.

Drug Interactions. Trandolapril/verapamil should not be taken while you are using certain other medicines. Before taking trandolapril/verapamil, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about trandolapril/verapamil before using it?

Do not take trandolapril/verapamil unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Take each dose of trandolapril/verapamil with food.

Do not share trandolapril/verapamil with other people, even if they have the same condition as you. It may harm them.

Keep trandolapril/verapamil out of the reach of children.

Trandolapril/verapamil can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how trandolapril/verapamil can affect you. 

People who are 65 or older can be at greater risk for some side effects from trandolapril/verapamil. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using trandolapril/verapamil?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if trandolapril/verapamil is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

Pregnancy. Trandolapril/verapamil can cause death or serious harm to an unborn baby if taken during pregnancy. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, stop taking trandolapril/verapamil right away and contact your healthcare provider.

Breastfeeding. Trandolapril/verapamil passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop trandolapril/verapamil.

Interactions

Does trandolapril/verapamil interact with foods or drinks?

There are no known interactions between trandolapril/verapamil and foods or drinks.

It is unknown if drinking alcohol will affect trandolapril/verapamil. The risk of dizziness and low blood pressure may be increased if you drink alcohol while taking trandolapril/verapamil. It is best to limit the amount of alcohol you drink.

Does trandolapril/verapamil interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure you discuss if you are using any of the following before taking trandolapril/verapamil.

  • Flibanserin (Addyi), which is a medicine used to increase sexual desire in certain people
  • Erythromycin (Ery-Tab and others) or clarithromycin, which is a medicine used for bacterial infections
  • Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
  • Ivabradine (Corlanor), which is a medicine for heart failure
  • A statin, such as atorvastatin (Lipitor and others), lovastatin, or simvastatin, which is a medicine to lower cholesterol
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • An angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • Aliskiren (Tekturna), which is a medicine for high blood pressure
  • Entresto (sacubitril/valsartan), which is a medicine for heart failure 
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • Clonidine (Catapres-TTS and others), which is a medicine used for high blood pressure or attention deficit hyperactivity disorder (ADHD)
  • A medicine for seizures, such as carbamazepine or phenobarbital
  • Aspirin or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and over-the-counter (OTC) products for pain, swelling, and fever
  • Theophylline (Theo-24, Elixophyllin), which is a medicine for asthma or certain other breathing problems
  • Lithium, which is a medicine for certain mental health conditions
  • Colchicine, which is commonly used for gout
  • St. John’s wort, which is a supplement that may be used to treat depression
  • A medicine to treat cancer
  • A medicine that suppresses your immune system
  • A medicine used to control your heart rate or rhythm (antiarrhythmic)
  • A medicine for high blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A supplement or salt-substitute containing potassium

Many other medicines may alter the blood levels of trandolapril/verapamil, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with trandolapril/verapamil. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much trandolapril/verapamil?

If you or someone else has used too much trandolapril/verapamil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of trandolapril/verapamil?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.