Trandolapril (Trandolapril)
Overview of Trandolapril
Trandolapril is oral, non-sulfhydryl-containing angiotensin converting enzyme inhibitor (ACEI). Trandolapril is a prodrug for itat which is about 8 times as potent as it in inhibiting ACE. It blocks the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and a negative feedback mediator for renin activity. Thus, it induced decreases in angiotensin II plasma levels, decreases blood pressure. Trandolapril is structurally similar to enalapril and both require hydrolysis for activity. Because of the pharmacokinetics of the active metabolite, itat, it can be administered once daily. Trandolapril is used to treat hypertension (high blood pressure) and heart failure. It can significantly reduce sudden death post-MI, and can decrease progression to severe heart failure, however, it did not reduce the risk of recurrent myocardial infarction.the drug blocks the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor and a negative feedback mediator for renin activity. Thus, it induced decreases in angiotensin II plasma levels, decreases blood pressure and increases plasma renin activity
Indication of Trandolapril
Trandolapril is primarily indicated in conditions like Advanced or metastatic breast cancer, Duodenal ulcer associated with h. Pylori, Heart failure, Heart failure (unlicensed indication), Hypertension, Mild to moderate hypertension, Myocardial infarction.
Contraindication of Trandolapril
Trandolapril is contraindicated in conditions like Hyperaldoesteronism,Renal artery stenosis,Angioedema.
Side Effects of Trandolapril
The severe or irreversible adverse effects of Trandolapril, which give rise to further complications include AV-block, Elevated SGPT & SGOT, Gout, Syncope, Cardiac stroke.,The symptomatic adverse reactions produced by Trandolapril are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Vomiting, Myalgia, Insomnia, Abdominal pain, Rashes, Pruritus, Bradycardia, Gastritis, VertigoX, Impotence, Hypotension, Neutropenia, Chest pain, Increased intracranial pressure.
Precautions of Trandolapril
Trandolapril should be used with caution in patients with history of angioedema, high blood levels of potassium, kidney dialysis, salt restrictive diet or liver disease. Before using salt substitutes, consult the doctor. Get up slowly, to avoid dizziness and lightheadedness when rising from a seated or lying position. It should be used with caution in patients with pre-existing bone marrow depression. The dose should be adjusted in patients with renal impairment. It should be used cautiously in patients with congestive heart failure. Initial doses should be lower than in the treatment of hypertension becauseof a greater risk of developing hypotension. It should not be administered to patients with pre-existing renal artery stenosis. Renal function should be monitored closely during the first 2 weeks after initiating therapy. It should be discontinued if renal function worsens acutely. It is classified as pregnancy category C and should be used with caution during pregnancy only if clearly needed. It should be used with caution in the elderly patients and in children.