Initial dose should be based on the patient's requirements for each drug.
Comments: Patients receiving trandolapril (up to 8 mg) and verapamil (up to 240 mg) in separate tablets may receive this drug once a day in equivalent dosages.
Renal Dose Adjustments
Dose adjustment recommended; however, no specific guidelines have been suggested.
Liver Dose Adjustments
Dose adjustment may be required; however, no specific guidelines have been suggested. Caution recommended.
If jaundice or marked elevation of hepatic enzymes occurs: Discontinue this drug and seek medical attention.
Precautions
US BOXED WARNING:
FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin angiotensin system (RAS) can cause injury and death to the developing fetus.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice: Take with food.
Monitoring:
Cardiovascular: PR interval
Hepatic: Liver function periodically
Renal: Kidney function periodically
Hematologic: Consider periodic WBC monitoring in patients with collagen-vascular disease and/or renal disease.
Patient advice:
Female patients of childbearing age should be told about the consequences of exposure to this drug during pregnancy. Patients should be asked to report pregnancies as soon as possible.
Advise patients to report any signs of infection (e.g., sore throat, fever). If infection is suspected, WBCs should be performed immediately.
Advise patients to use caution when driving or operating machinery until the response to initial treatment has been determined.
