Trandolapril Capsules

This medicine contains trandolapril which belongs to a group of medicines called inhibitors of angiotensin-converting enzyme (ACEI). It is indicated in the treatment of hypertension and myocardial infarction with dysfunction left ventricular (with or without heart failure).

Trandolaprilat, the active metabolite of trandolapril, competes with angiotensin I in binding to the angiotensin-converting enzyme (ACE) binding site, blocking the conversion of angiotensin I to angiotensin II. As is known, angiotensin II is a potent vasoconstrictor and a negative factor in renin activity. Thus, by reducing plasma angiotensin II concentrations, trandolapril decreases blood pressure and increases plasma renin activity. Furthermore, reflex mechanisms in baroreceptors are stimulated in response to a drop in blood pressure.

Furthermore, kininase II, identical to ACE, is an enzyme that breaks down bradykinin, a powerful vasodilator, to other inactive peptides. It is not known exactly whether bradykinin also plays a role in the vasodilatory effect of ACE inhibitors. However, this mechanism could contribute to the induction of angioneurotic edema that is sometimes observed with ACE inhibitors.

ACE inhibitors act locally by reducing vascular tone, but they also inhibit the presynaptic release of norepinephrine and postsynaptic activity of adrenergic receptors, reducing vascular sensitivity to vasopressor stimuli. Reduction of angiotensin II levels also results in reduced aldosterone secretion, with subsequently decreased retention of water and sodium. ACE inhibitors reduce left ventricular hypertrophy, do not worsen insulin resistance or hyperlipidemia, or cause sexual dysfunction. Trandolapril causes arterial dilation, reducing total peripheral resistance. In hypertensive patients, blood pressure is reduced without changes in heart rate, volume-beat, or cardiac output.

Being a very effective High Blood Pressure Medication, trandolapril uses include being indicated to treat heart failure (weakened heart). This medicine is used to improve heart function after a heart attack.

Always use this medicine exactly as your doctor has told you. If in doubt, consult your doctor or pharmacist again. Take the capsules at the same time every day. This medicine is administered orally. Your doctor will tell you the duration of your treatment.

In high blood pressure in adults who do not take diuretics, do not have heart disease, or a kidney or liver disease, the recommended starting dose is 0.5 mg to 1 mg trandolapril once a day (1 to 2 capsules of 0.5 mg) or 2 mg once a day (1 capsule of 2 mg). If you are black, its recommended starting dose is 2 mg daily. If necessary, the dose of this medication can double after 1 to 4 weeks of treatment, up to a maximum of 4 mg to 8 mg of trandolapril daily (from 2 to 4 capsules of 2 mg).

If you are hypertensive and also have heart disease, associated or not with kidney disease, the initial dose is 0.5 mg to 1 mg of trandolapril once a day (1 to 2 capsules of 0.5 mg), and under close control of your doctor. In myocardial infarction with left ventricular dysfunction, the initial dose is 0.5 mg to 1 mg of trandolapril (1 to 2 capsules of 0.5 mg) once a day from the third day after the heart attack, and you should progressively increase to a maximum of 4 mg (2 capsules of 2 mg) as a single daily dose.

Like all medicines, these blood pressure tablets can cause side effects, although not all people suffer them.

The following have been reported:

Common (may affect up to 1 in 10 people):

• In the treatment of hypertension: dizziness, headache, cough and asthenia (weakness and lack of vitality).
• In the treatment after acute myocardial infarction: dizziness, hypotension, cough.

Uncommon (may affect up to 1 in 100 people):

• In the treatment of hypertension: hypotension, palpitations, nausea, itching, discomfort.
• In both treatments: infection of the upper respiratory tract (nose, mouth, pharynx, and larynx), insomnia, decreased sex drive, drowsiness, vertigo, hot flashes, inflammation of the tract upper respiratory, upper respiratory tract congestion, diarrhea, gastrointestinal pain, constipation, gastrointestinal disorder, skin rash, back pain, muscle spasms, pain in arms and legs, impotence, chest pain, swelling of ankles, feet, and legs from fluid accumulation, abnormal sensitivity.

Rare (may affect up to 1 in 1,000 people):

• In both treatments: urinary tract infection (kidneys, bladder and urethra), bronchitis, pharyngitis, decreased white blood cells, decreased red blood cells, platelet disorder, disorder white blood cells, allergy, excessive amount of blood glucose, low sodium concentration in the plasma, high blood cholesterol, too much fat in the blood, high uric acid, gout, loss of appetite, increased appetite, enzyme abnormality, hallucinations, depression, sleep, anxiety, agitation (restlessness, excitement and / or repetitive behavior), apathy, accident cerebrovascular (interruption of blood supply to any part of the brain), loss of sudden and usually brief and reversible awareness, sudden contraction or spasms of the muscles, abnormal tingling, numbness or burning sensation, usually in the extremities, migraine (chronic and recurring headache with other symptoms such as vomiting nausea or sensitivity to light), migraine without aura (migraine without visual disturbances), altered food and drink taste, inflammation of the eyelid, edema of the conjunctiva of the eye, decreased vision, eye disorder, ringing in the ears, myocardial infarction (death of muscle cells in the heart or part of it due to lack of blood supply), myocardial ischemia (poor supply of blood supply that if prolonged too long can cause the death of heart cells and, for both heart attack), angina pectoris (chest pain usually oppressive in consequence from myocardial ischemia), heart failure (when the heart can no longer pump enough blood to the rest of the body), rapid heartbeat that starts in the ventricles, increased rhythm of the heartbeat, decreased rhythm of the heartbeat

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