Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Angioedema: Angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell) may occur with trandolopril, although uncommonly. If swelling of the face, tongue, or glottis occurs, stop the medication at once and seek immediate medical attention. If you experience angioedema with trandolapril, you should not take any of the other ACE inhibitors, such as enalapril, lisinopril, or quinapril.
People who have had angioedema caused by other substances may be at increased risk of angioedema while taking an ACE inhibitor such as trandolapril.
Blood disorders: In rare cases, a low white blood cell count has been reported by people taking this medication. Your doctor may occasionally monitor your level of white blood cells by performing blood tests. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection (e.g., fever, sore throat), contact your doctor as soon as possible.
Cough: People taking trandolapril may develop a dry, persistent cough that usually disappears only after stopping or lowering the trandolapril dose. Be sure to tell your doctor of any cough which does not seem to be related to a usual cause.
Fluid and electrolyte balance: Increases in blood levels of potassium may occur as a result of taking perindopril. This rarely causes problems, but your doctor will probably want to monitor your potassium levels regularly with blood tests. If you experience unexplained nausea, fatigue, muscle weakness, or tingling sensations, contact your doctor.
Kidney function: Changes in kidney function have been seen in certain people who take this medication. The use of diuretics (water pills) or aliskiren may further increase risk of kidney problems for those at risk for this problem. If you have kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Low blood pressure: Occasionally, blood pressure drops too low after taking trandolapril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take aliskiren, water pills, have a salt restricted diet, are on dialysis, or are experiencing diarrhea or vomiting. These individuals should be monitored closely by their doctor for the first weeks of treatment and whenever the dose of the medication is increased. To reduce the risk of dizziness, get up slowly from a lying down or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact your doctor.
Excessive sweating and lack of fluid intake may lead to an excessive fall in blood pressure because of reduced fluid in your blood vessels. Vomiting or diarrhea may also lead to a fall in blood pressure. Consult your doctor if you feel your blood pressure is too low.
Pregnancy: ACE inhibitors such as trandolapril may cause severe harm or death to a developing baby if taken by the mother during pregnancy. This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if trandolapril passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
Seniors: Seniors have an increased risk of experiencing side effects when taking trandolapril due to reduced kidney function. Lower doses may be necessary to minimize side effects.