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.

Do not use if you are pregnant. Stop using trandolapril and verapamil and tell your doctor right away if you become pregnant.

You should not use this medicine if you have a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker), Wolff-Parkinson-White syndrome, or Lown-Ganong-Levine syndrome.

Tell your doctor about all your other medicines. Some drugs should not be used with trandolapril and verapamil.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take with food.

Your blood pressure will need to be checked often, and you may need occasional blood tests.

Your blood pressure may get too low during prolonged illness. Call your doctor if you are sick with vomiting or diarrhea.

Tell your doctor if you have a planned surgery.

Keep using trandolapril and verapamil even if you feel well. High blood pressure often has no symptoms.

Store at room temperature away from moisture and heat.

Usual Adult Dose for Hypertension:

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.

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.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow heart rate, weak pulse, muscle weakness, tingly feeling, seizures, feeling light-headed, or fainting.

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 trandolapril and verapamil 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.

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.

Trandolapril and verapamil may cause serious side effects. 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 of trandolapril and verapamil 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.

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Trandolapril and verapamil can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, high blood pressure, pain or arthritis (including Advil, Motrin, and Aleve).

If you also take disopyramide, avoid taking it within 48 hours before or 24 hours after you take trandolapril and verapamil.

Many drugs can affect trandolapril and verapamil. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.