TRANDOLAPRIL-VERAPAMIL ER

Trandolapril 2mg, Verapamil Hydrochloride 240mg, Oral tablet, extended release

Alcohol

· Severity: Major

· Notes for Consumers: You should limit your ingestion of alcohol-containing beverages while taking verapamil. Verapamil can prolong the intoxicating effects of alcohol. You may experience impairment, such as sedation, confusion, or low blood pressure. If the blood pressure is too low, you may experience dizziness, falls, or fainting. Do not drive or operate machinery or perform other hazardous tasks if you drink alcohol while on verapamil, as the effects of alcohol may be greater.

· Notes for Professionals: Verapamil has been found to significantly inhibit ethanol elimination resulting in elevated blood ethanol concentrations that may prolong the intoxicating effects of alcohol. The patient may experience an increase in sedation, dizziness, hypotension, and CNS depression. Advise the patient to limit alcohol ingestion during verapamil therapy.

Trandolapril 2mg, Verapamil Hydrochloride 240mg, Oral tablet, extended release

Grapefruit juice

· Severity: Major

· Notes for Consumers: Avoid taking Verapamil with grapefruit juice. Grapefruit juice and grapefruit-containing foods may increase the effects of Verapamil. If your heart rate or blood pressure drops too low while taking this medicine, you may become dizzy or feel faint; do not stand or sit up too quickly. Contact your prescriber if you have dizziness which does not go away while taking this medicine. If you notice new or increased swelling of your legs or ankles, tell your health care provider.

· Notes for Professionals: Grapefruit juice contains an unknown compound that can inhibit the cytochrome P-450 CYP3A4 isozyme in the gut wall. Grapefruit juice can increase the serum concentrations and oral bioavailability of verapamil. Co-administration of oral verapamil with grapefruit juice significantly increases the AUC and peak plasma concentrations of verapamil. It is generally recommended to avoid grapefruit juice during verapamil therapy.

Trandolapril 2mg, Verapamil Hydrochloride 240mg, Oral tablet, extended release

Caffeine-containing Foods/Beverages

· Severity: Mild

· Notes for Consumers: Although an interaction is possible, these drugs are often used together. Side effects from Caffeine may get worse if you take Verapamil. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. You may need to limit your Caffeine intake. Common foods and beverages containing caffeine include coffee, teas, colas and chocolate. Many non-prescription drugs and diet aids may also contain caffeine.

· Notes for Professionals: Verapamil reduces the clearance of caffeine and increases serum caffeine concentrations, presumably via inhibition of hepatic metabolism. During concomitant therapy with verapamil, it may be prudent to advise patients to limit or minimize the intake of caffeinated products to minimize caffeine-related side effects.

Trandolapril 2mg, Verapamil Hydrochloride 240mg, Oral tablet, extended release

Marijuana

· Severity: Moderate

· Notes for Consumers: The effects of marijuana may be increased and side effects may get worse if it is combined with this medicine. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: The incidence of marijuana associated adverse effects may change following coadministration with verapamil. Verapamil is an inhibitor of CYP3A4, an isoenzyme partially responsible for the metabolism of marijuana's most psychoactive compound, delta-9-tetrahydrocannabinol (Delta-9-THC). When given concurrently with verapamil, the amount of Delta-9-THC converted to the active metabolite 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) may be reduced. These changes in Delta-9-THC and 11-OH-THC plasma concentrations may result in an altered marijuana adverse event profile.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>