Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Bulgaria: Gopten, Tensotran; Czech Republic: Fezzor, Gopten, Tanap, Trandolapril; Denmark: Odrik, Trandolapril; Estonia: Gopten, Trandolapril; France: Gopten, Odrik, Trandolapril; Germany: Gopten, Udrik; Greece: Daman, Odrik, Trandolapril; Hungary: Actapril, Gopten, Trandolapril; Ireland: Gopten, Odrik; Italy: Gopten, Trandolapril; Latvia: Gopten, Trandolapril; Lithuania: Gopten, Trandolapril; Luxembourg: Gopten, Odrik; Malta: Trandolapril; Netherlands: Gopten, Trandolapril; Poland: Fezzor, Gopten, TandoGen, Tensotrand, TrandoGen, Trandolapril, Trandox; Portugal: Gopten, Odrik, Trandolapril; Romania: Fezzor, Gopten, Trandolapril; Slovakia: Actapril, Fezzor, Gopten, Trandolapril; Slovenia: Gopten, Trandolapril; Spain: Gopten, Odrik; UK: Gopten, Trandolapril.

North America

Canada: Mavik; USA: Mavik, Trandolapril.

Latin America

Brazil: Gopten.


Japan: Odric, Predoric, Preran, Trantowa.

Drug combinations

Trandolapril and Verapamil


Trandolapril: C~24~H~34~N~2~O~5~. Mw: 430.54. (2S,3aR,7aS)-1-[(S)-N-[(S)-1-Carboxy-3-phenylpropyl]alanyl]hexahydro-2-indolinecarboxylic acid, 1-ethyl ester. CAS-87679-37-6.

Pharmacologic Category

Angiotensin-Converting Enzyme Inhibitors. (ATC-Code: C09AA10).

Mechanism of action

Prevents formation of angiotensin II from angiotensin I. Trandolapril must undergo enzymatic hydrolysis, mainly in liver, to its biologically active metabolite, trandolaprilat. A CNS mechanism may also be involved in hypotensive effect as angiotensin II increases adrenergic outflow from CNS. Vasoactive kallikreins may be decreased in conversion to active hormones by ACEIs, thus reducing blood pressure.

Therapeutic use

Treatment of hypertension alone or in combination with other antihypertensive agents. Treatment of heart failure or left ventricular dysfunction after myocardial infarction.

Pregnancy and lactiation implications

Use of ACEIs during 2^nd^ and 3^rd^ trimesters also associated with anuria, hypotension, renal failure (reversible or irreversible), skull hypoplasia, and death in fetus/neonate. Excretion in breast milk unknown (not recommended in nursing women).

Unlabeled use

As a class, ACEIs are recommended in treatment of heart failure. To delay progression of nephropathy and reduce risks of cardiovascular events in hypertensive patients with type 1 or 2 diabetes mellitus.


Hypersensitivity to trandolapril or any component of the formulation. History of angioedema related to previous treatment with ACEI.

Warnings and precautions

Use with caution in unstented unilateral/bilateral renal artery stenosis (this use is generally avoided due to elevated risk of deterioration in renal function, unless possible benefits outweigh risks). A rare toxicity associated with ACEIs includes cholestatic jaundice, which may progress to fulminant hepatic necrosis. Angioedema may occur rarely with ACEIs, and may involve head and neck or intestine (African-Americans and patients with idiopathic or hereditary angioedema may be at increased risk). Use in previous angioedema associated with ACEI therapy contraindicated. A dry, hacking, nonproductive cough usually occurs within first few months of treatment and should generally resolve within 1-4 weeks after discontinuation of ACEI. Use with caution in pre-existing renal insufficiency. Dosage adjustments needed in hepatic cirrhosis. Another ACEI, captopril, associated with rare cases of agranulocytosis, neutropenia or leukopenia with myeloid hypoplasia. Patients with renal impairment are at high risk of developing neutropenia. Patients with both renal impairment and collagen vascular disease are at even higher risk of developing neutropenia. Hyperkalemia may occur with ACEIs (use cautiously, if at all, with these agents). Anaphylactic/anaphylactoid reactions can occur with ACEIs. Rare cases of anaphylactoid reactions reported in patients undergoing sensitization treatment with hymenoptera (bee, wasp) venom while receiving ACEIs. Use with caution in hypertrophic cardiomyopathy and outflow tract obstruction (reduction in afterload may worsen symptoms). Symptomatic hypotension with or without syncope can occur with ACEIs; effects most often observed in volume-depleted patients. Trandolapril may be associated with deterioration of renal function and/or increases in serum creatinine, particularly in patients with low renal blood flow whose glomerular filtration rate is dependent on efferent arteriolar vasoconstriction by angiotensin II. Use with caution in severe aortic stenosis (may reduce coronary perfusion resulting in ischemia), in ischemic heart disease or cerebrovascular disease (due to potential consequences posed by falling blood pressure), in collagen vascular disease, especially with concomitant renal impairment (may be at increased risk for hematologic toxicity), and before, during, or immediately after major surgery. Cardiopulmonary bypass, intraoperative blood loss, or vasodilating anesthesia increases endogenous renin release. Use of ACEIs perioperatively will blunt angiotensin II formation and may result in hypotension.



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