Tarka

How can this medicine affect other medicines?

When taken with other medicines which decrease blood pressure there is an increased risk of a large drop in blood pressure. With antipsychotic or antidepressant medicines this may be accompanied by dizziness or fainting. Non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin may reduce the effect of trandolapril on lowering blood pressure. When NSAIDs are combined with this medicine there may also be an increased risk of damage to kidney function, although there are no cases of this yet reported. Trandolapril may increase and verapamil may increase or decrease the blood level of lithium. Combined use of this medicine with lithium should therefore be monitored. When trandolapril is taken with potassium-sparing diuretics, potassium supplements or potassium containing salt substitutes there is an increased risk of high blood potassium levels (hyperkalaemia). These combinations are not recommended unless the blood potassium level is monitored. The risk of adverse effects such as slow heart rate, heart block and severe drop in blood pressure is increased if verapamil is taken with beta-blockers, some anaesthetics or antiarrhythmics such as disopyramide and flecainide. Rifampicin, phenobarbital and phenytoin reduce the blood level and effect of verapamil. Verapamil may increase the blood levels of carbamazepine, theophylline, digoxin, quinidine, cyclosporin and alcohol. When trandolapril is taken with allopurinol, corticosteroids, procainamide or medicines which suppress the immune system, including anti-cancer medicines, there may be an increased risk of blood disorders. Antacid medicines may decrease the absorption of this medicine from the gut. When taken together with antidiabetic medicines trandolapril may cause an excessive drop in blood glucose. Diabetics should monitor their glucose levels.

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