Trandolapril and verapamil is a combination medicine used in adults to treat high blood pressure (hypertension).

Lowering blood pressure may lower your risk of a stroke or heart attack.

Trandolapril and verapamil may also be used for purposes not listed in this medication guide.

You should not use trandolapril and verapamil if you are allergic to it, or if you have:

• "sick sinus syndrome" or "AV block" (unless you have a pacemaker);
• very low blood pressure;
• if your heart cannot pump blood properly;
• an allergy to any other ACE inhibitor, such as benazepril, captopril, fosinopril, enalapril, lisinopril, moexipril, perindopril, quinapril, or ramipril;
• certain heart rhythm disorders (such as 'Afib' or atrial flutter, Wolff-Parkinson-White syndrome or Lown-Ganong-Levine syndrome); or
• if you also use flibanserin (Addyi).

You may not be able to use trandolapril and verapamil if you have:

• severe congestive heart failure.

Do not take trandolapril and verapamil within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not take trandolapril and verapamil with any medication that contains aliskiren (a blood pressure medicine).

Tell your doctor if you have ever had:

• low blood pressure;
• abnormal thickening of the heart muscle;
• congestive heart failure;
• a nerve-muscle disorder such as myasthenia gravis or muscular dystrophy;
• low blood cell counts;
• diabetes;
• cirrhosis or other liver disease; or
• kidney disease (or if you are on dialysis).

You may also need to avoid taking trandolapril and verapamil with aliskiren if you have kidney disease.

Stop using this medicine and tell your doctor right away if you become pregnant. Trandolapril and verapamil can cause injury or death to the unborn baby if you use the medicine during your second or third trimester.

Do not breastfeed.

Use Trandolapril and Verapamil (Tarka) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: severe stomach pain, hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• chest pain, fast, slow, or uneven heart rate;
• a light-headed feeling, like you might pass out;
• heart problems--swelling, rapid weight gain, feeling short of breath;
• liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• fluid build-up in or around the lungs--pain when you breathe, feeling short of breath while lying down, wheezing, gasping for breath, cough with foamy mucus, cold, clammy skin, anxiety, rapid heartbeats;
• high blood potassium--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• kidney problems--swelling, urinating less, feeling tired or short of breath; or
• low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands and feet, feeling light-headed or short of breath.

Common side effects may include:

• cough;
• nausea, constipation;
• infections, flu symptoms;
• headache, dizziness;
• swelling;
• low blood pressure; or
• chest pain, back pain, joint pain, pain in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Grapefruit may interact with this medicine and cause side effects. Avoid consuming grapefruit products.

Drinking alcohol with this medicine can cause side effects.

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.