Tarka

How does it work?

This medicine contains two active ingredients, trandolapril and verapamil hydrochloride. Trandolapril belongs to a group of medicines called ACE inhibitors which block the action of a chemical in the body called angiotensin converting enzyme (ACE). Normally ACE produces another chemical, angiotensin. Angiotensin has two actions. Firstly, it causes blood vessels to tighten and narrow and secondly, it causes the kidneys to produce less urine. As trandolapril stops the production of angiotensin, these actions are reversed. Therefore more urine is produced by the kidneys, which results in less fluid in the blood vessels. The blood vessels also widen. The overall effect of this is a drop in blood pressure and a decrease in the workload of the heart. Verapamil hydrochloride belongs to a group of medicines called calcium channel blockers, which act on the heart and blood vessels. Verapamil slows the movement of calcium through cells, which has two results. Firstly, it decreases the rate at which the heart beats and secondly, it has a mild widening effect on blood vessels. The overall effect of this is to reduce blood pressure. The combination of these two medicines is particularly useful in treating high blood pressure.

What is it used for?

High blood pressure (hypertension) in people already stabilised on the separate components of this medicine

Warning!

Unless your doctor or pharmacist tells you otherwise, you should avoid drinking grapefruit juice while taking this medicine, as it may affect the level of this medicine in your blood.

This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

If you experience any signs of infection while taking this medicine, such as flu-like symptoms, high temperature (fever), sore throat or inflammation of the lining of the mouth (stomatitis), you should tell your doctor immediately.

If you should require local or general anaesthesia, it is important that you inform your anaesthetist you are taking this medicine.

The blood level and effect of alcohol may be increased by this medicine.

Use with caution in

Abnormal heart beats caused by Wolff-Parkinson-White syndrome

Chronic disease characterised by thickening and scarring of the skin, joints and internal organs (scleroderma)

Decreased kidney function

Elderly people

Long-term inflammation of skin and some internal organs (systemic lupus erythematosus)

Narrowing of the artery which supplies blood to the kidneys (renal artery stenosis)

People receiving therapy to remove certain types of fat from the blood using a machine (LDL apheresis)

People undergoing therapy to decrease allergy to animal venoms

People with low fluid volume or salt levels in the body, eg due to diuretic therapy, low-sodium diet, diarrhoea or vomiting

Slow heart rate (bradycardia)

Women of child-bearing age

Not to be used in

A problem common in the elderly, related to poor control of the working of the heart (sick sinus syndrome)

Allergy to ACE inhibitors, eg captopril

Breastfeeding

Children

Defect of the heart's electrical message pathways resulting in decreased function of the heart (heart block)

Failure of the heart to maintain adequate circulation of blood (cardiogenic shock)

Heart disease characterised by thickening of the internal heart muscle and a blockage inside the heart (hypertrophic obstructive cardiomyopathy)

Heart failure

High blood pressure associated with other diseases

High blood pressure caused by compression or blockage of the arteries that carry blood to the kidneys (renovascular hypertension)

History of swelling of the lips, face or tongue (angioedema)

History of swelling of the lips, face or tongue (angioedema) caused by an ACE inhibitor

Liver cirrhosis, with collection of fluid in the abdominal cavity

Narrowing of the main artery of the body (aortic stenosis)

Overproduction of the steroid hormone aldosterone by the adrenal glands, caused by an abnormality within the glands (primary aldosteronism)

Pregnancy

Recent heart attack which was complicated by other heart problems

Removal of toxic products from the body with the help of a machine

Severely decreased kidney function

Severely decreased liver function

Slow heart rate of less than 50 beats per minute (bradycardia)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used in pregnancy, particularly in the second and third trimesters, as it may affect the growth and development of the foetus or have adverse effects on foetal tissues. Seek medical advice from your doctor.

It is recommended that women should not breastfeed whilst taking this medicine.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Rash

Dizziness or loss of balance

Inability of the heart to pump blood efficiently (heart failure)

Impotence

Blood disorders

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Ankle swelling

Dry cough

Abnormal heart beats (arrhythmias)

Decreased kidney function

Severe swelling of lips, face or tongue (angioedema)

Severe reduction in blood pressure and fainting

Headache

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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