Trandolapril (tran-DOE-la-pril), Verapamil Hydrochloride (ver-AP-a-mil hye-droe-KLOR-ide)

Treats high blood pressure that has not been controlled with other medicines. Lowering blood pressure reduces the risk of strokes and heart attacks. This medicine is a combination of an angiotensin-converting enzyme (ACE) inhibitor and a calcium channel blocker.

Brand Name(s):

Tarka

When This Medicine Should Not Be Used:

How to Use This Medicine:

Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine should not be the first medicine you use to treat your condition. It is meant to be used only after you have tried other medicines that have not worked or have caused unwanted side effects.
• It is best to take this medicine with food or milk.
• Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting. Check with your doctor right away if you continue to experience diarrhea or vomiting.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are taking carbamazepine (Tegretol®), clarithromycin (Biaxin®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), digoxin (Lanoxin®), erythromycin (Ery-Tab®), lithium (Lithobid®), phenobarbital, rifampin (Rifadin®, Rifamate®, Rifater®), ritonavir (Norvir®), telithromycin (Ketek®), or theophylline (Theo-Dur®). Tell your doctor if you are also using diuretic or "water pill" (such as amiloride, furosemide, hydrochlorothiazide [HCTZ], spironolactone, triamterene, Hyzaar®, Lotrel®, Midamor®, or Zestoretic®), certain blood pressure medicines (such as atenolol, metoprolol, prazosin, propranolol, terazosin, timolol, Blocadren®, Hytrin®, Lopressor®, Minipress®, Tenormin®, or Toprol®), or medicine for heart rhythm problems (such as disopyramide, flecainide, quinidine, Cardioquin®, Norpace®, Quinaglute®, Quinidex®, or Tambocor®).
• Tell your doctor if you are also using St. John's wort, almotriptan (Axert®), buspirone (Buspar®), colchicine (Colcrys®), doxorubicin (Adriamycin®), imipramine (Tofranil®), isoflurane, midazolam (Versed®), sirolimus (Rapamune®), sulfinpyrazone (Anturane®), tacrolimus (Prograf®), or tubocurarine. Make sure your doctor knows if you are also using gold injections (such as sodium aurothiomalate), insulin or a diabetes medicine that you take by mouth (such as glipizide, glyburide, metformin, Actos?, Amaryl®, Avandia®, Diabeta®, Glucophage®, Glucotrol®, Glynase®, or Micronase®), medicine to lower cholesterol (such as atorvastatin, simvastatin, Lipitor®, or Zocor®), or a pain or arthritis medicine, sometimes called "NSAIDs" (such as aspirin, celecoxib, ibuprofen, naproxen, rofecoxib, valdecoxib, Advil®, Aleve®, Bextra®, Celebrex®, Motrin®, or Vioxx®).
• Do not use medicines, supplements, or salt substitutes that contain potassium without checking first with your doctor.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant (especially in your second or third trimester) can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you have kidney problems, liver disease, heart disease, congestive heart failure, diabetes, heart rhythm problems (such as PR interval prolongation), low blood volume, or a mineral imbalance (high or low potassium or sodium in the blood). Tell your doctor if you have a collagen-vascular disease (such as lupus or scleroderma) or muscle problems (such as Duchenne's muscular dystrophy).
• This medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life.
• This medicine might sometimes lower your blood pressure too much. If your blood pressure gets too low, you will feel dizzy or lightheaded, especially when you stand up. This is more likely to happen when you first start using the medicine or if your body loses too much water or salt. Some things that could cause this are: if you use a diuretic or "water pill" for a long time, eat a low-salt diet, are on kidney dialysis, have diarrhea or vomiting, do not drink enough water, or sweat heavily. If you faint, stop using this medicine until you have talked to your doctor.
• Stop using this medicine and check with your doctor right away if you have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
• This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your face, hands, arms, legs, feet, lips, tongue, or throat.
• Check with your doctor if you notice any signs of fever, chills, or sore throat. These could be symptoms of an infection resulting from low white blood cell counts.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood and urine tests may be needed to check for unwanted effects.
• If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate.
• Chest pain (may be related to your disease and not a side effect).
• Confusion, body weakness, uneven heartbeat, or numbness or tingling in your hands, feet, or lips.
• Dark-colored urine or pale stools.
• Dry mouth, increased thirst, or muscle cramps.
• Fast, slow, pounding, or uneven heartbeat.
• Fever, chills, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Nausea, vomiting, loss of appetite, or pain in the upper stomach.
• Shortness of breath, cold sweat, or bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Back or joint pain.
• Blurred vision or ringing in your ears.
• Constipation, diarrhea, or stomach pain.
• Dry cough.
• Headache.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088